title: Patient-reported outcomes (PROs) after total extraperitoneal hernia repair (TEP).
abstract: Patient-reported outcomes (PROs) such as quality of life (QoL), patient satisfaction, and work impairment, are arguably the most important outcomes of any medical treatment. In 2011, Staerkle and Villiger developed the Core Outcome Measurements Index (COMI) to standardise PROs and PRO measurement for inguinal hernia patients, in an attempt to increase inter-study comparability. The aim of this study is to prospectively evaluate the short- and long-term postoperative QoL, function, patient well-being, pain, and social/work disability, after total extraperitoneal (TEP) inguinal hernia repair and to provide the first clinical experience with the COMI-hernia questionnaire.
  
  
  
  Between January 2013 and December 2014, all patients ≥18 years that were scheduled for elective uni- or bilateral TEP in a regional hospital were approached to participate in this study. Measurements were taken preoperatively, and 6 weeks and 1 year postoperatively.
  
  
  
  One hundred and twenty patients (113 men, 7 women), mean age 59 years (SD ±12), completed the follow-up of 1 year. Ninety-seven percent of the population reported that the operation improved their complaints. QoL, function, well-being, and pain all improved after 6 weeks and 1 year after surgery. Patients experienced more social and work-related limitations 6 weeks after surgery compared to baseline measurements, though this improved to normal 1 year postoperatively. The incidence of chronic pain was 14% (VAS ≥ 2), which had a negative impact on the patients' sense of well-being.
  
  
  
  Patients recovered well after TEP repair with a good quality of life and fast restore of function. Patient well-being was lower than expected due to a 14% incidence of chronic pain. The COMI-hernia scale provided reasonable insight into the patients' experience, though it was difficult to interpret for both patient and physician.
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. e.mommers@maastrichtuniversity.nl.|Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands. e.mommers@maastrichtuniversity.nl.
authors.forename: E H H
authors.initials: EHH
authors.lastname: Mommers
authors.affiliation: Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands.
authors.forename: D R M
authors.initials: DRM
authors.lastname: Hünen
authors.affiliation: Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands.
authors.forename: J C H M
authors.initials: JCHM
authors.lastname: van Hout
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Guit
authors.affiliation: Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Wegdam
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: S W
authors.initials: SW
authors.lastname: Nienhuijs
authors.affiliation: Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands.
authors.forename: T S
authors.initials: TS
authors.lastname: de Vries Reilingh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000209:etiology; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D010537:Peritoneum / Q000601:surgery; D011788:Quality of Life; D020127:Recovery of Function; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Function; Pain; Patient well-being; Patient-reported outcome (PRO); Quality of life (QoL); Social and work disability; Total extraperitoneal herniorrhaphy (TEP)