title: Patient-centered outcomes following laparoscopic inguinal hernia repair.
abstract: BACKGROUND
  Inguinal hernia repair is the most common surgery in the world. Health-related quality of life (HRQOL) outcomes are arguably the most important elements of successful repair. This study is aimed to describe short- and long-term quality of life outcomes in patients undergoing laparoscopic inguinal hernia repair.
  
  
  METHODS
  We prospectively followed patients who underwent totally extraperitoneal laparoscopic inguinal hernia repair (TEP) as part of an Institutional Review Board-approved study. HRQOL was measured preoperatively, or 3 weeks, 6 months, and 1 year postoperatively using Short Form 36 Health Survey Version 2 (SF-36v2) and Carolinas Comfort Scale. Postoperative HRQOL scores were compared to baseline using paired t tests.
  
  
  RESULTS
  Between June 2009 and February 2014, 1,175 patients underwent TEP by four surgeons. Of those, 301 patients with 388 hernias were registered in the database and followed by a research coordinator. Mean age was 56.4 ± 15.2 years and 93% were male. Mean body mass index was 26.1 ± 3.7 kg/m(2). Seventy-eight percent presented with pain, the majority of which were described as mild. Hernias were unilateral right-sided in 43%, left-sided in 28%, and bilateral in 29 %. Eighty-five percent were primary hernias. Average operative time was 43.5 ± 17.9 min and there were no intraoperative complications. Urinary retention occurred in 6%. Visual analog scale at discharge was 1.9 ± 1.7. Analgesics were used an average of 2.5 ± 3.4 days and return to activities of daily living and work occurred on postoperative 5.5 ± 4.4 and 5.6 ± 3.9 days. Recurrence occurred in 2.1%. Significant improvements between baseline and 1 year were found in role limitations due to physical health (81.5 ± 25.6 vs. 91.8 ± 19.4, p = 0.02), social functioning (87.4 ± 21.3 vs. 92.9 ± 15.3, p = 0.02), and pain (78.2 ± 19.7 vs. 86.6 ± 15.9, p = 0.007).
  
  
  CONCLUSIONS
  TEP results in significant improvement in HRQOL including physical health, social functioning, and pain at 1 year. On average, patients are able to return to activities of daily living and work within a week.
authors.affiliation: Section of Minimally Invasive Surgery, Department of Surgery, NorthShore Center for Simulation and Innovation (NCSI), NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL, 60201, USA, mujiki@northshore.org.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ujiki
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Gitelis
authors.forename: Joann
authors.initials: J
authors.lastname: Carbray
authors.forename: Brittany
authors.initials: B
authors.lastname: Lapin
authors.forename: John
authors.initials: J
authors.lastname: Linn
authors.forename: Steven
authors.initials: S
authors.lastname: Haggerty
authors.forename: Chi
authors.initials: C
authors.lastname: Wang
authors.forename: Ryota
authors.initials: R
authors.lastname: Tanaka
authors.forename: Ermilo
authors.initials: E
authors.lastname: Barrera
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Butt
authors.forename: Woody
authors.initials: W
authors.lastname: Denham
mesh_terms: D000203:Activities of Daily Living; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D063868:Patient Outcome Assessment; D011788:Quality of Life; D011795:Surveys and Questionnaires