title: A Prospective Assessment of Clinical and Patient-Reported Outcomes of Initial Non-Operative Management of Ventral Hernias.
abstract: BACKGROUND
  Little is known about the clinical or patient-reported outcomes with non-operative management of ventral hernias. The aim of this prospective study is to determine the clinical and patient-reported outcomes of patients undergoing initial non-operative treatment of their ventral hernia.
  
  
  METHODS
  This was a prospective observational study of patients undergoing non-operative management of ventral hernias. Primary outcome was rate of surgical repair of the ventral hernias. Secondary outcomes included rate of emergency repair, elective repair, and emergency room visits. In addition, validated measurement tools for patient satisfaction and cosmetic satisfaction with their abdomen, abdominal pain, and patient function (modified Activities Assessment Scale, AAS) were utilized.
  
  
  RESULTS
  Of 128 patients who underwent non-operative management of a ventral hernia, 99(77.3%) patients were followed for a median (interquartile range) of 12.2(10.4-13.5) months. Twenty (20.2%) patients had at least 1 emergency room visit associated with their hernia. One-quarter (n = 2323.2%) underwent ventral hernia repair following enrollment. Twenty (20.2%) underwent elective repair, and 3 (3.0%) underwent emergent repair. Based on the modified AAS survey, patients who were managed non-operatively experienced no change in patient centered outcomes, while patients converted to operative management had improved scores.
  
  
  CONCLUSIONS
  While the short-term risk of emergency surgery with non-operative management of ventral hernias is moderate, the chance of an emergency room visit and surgery is high. Patients who undergo non-operative management of their ventral hernias have no change in patient-reported outcomes at one year, while those converted to operative management experience improvement.
authors.affiliation: University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA. Julie.L.Holihan@uth.tmc.edu.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Holihan
authors.affiliation: University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA.
authors.forename: Juan R
authors.initials: JR
authors.lastname: Flores-Gonzalez
authors.affiliation: University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA.
authors.forename: Jiandi
authors.initials: J
authors.lastname: Mo
authors.affiliation: University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA.
authors.forename: Tien C
authors.initials: TC
authors.lastname: Ko
authors.affiliation: University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA.
authors.forename: Lillian S
authors.initials: LS
authors.lastname: Kao
authors.affiliation: University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 5.254, Houston, TX, 77030, USA.
authors.forename: Mike K
authors.initials: MK
authors.lastname: Liang
mesh_terms: D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery / Q000628:therapy*; D059685:Herniorrhaphy / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires