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Hernia recurrence inventory: inguinal hernia recurrence can be accurately assessed using patient-reported outcomes

Abstract

Purpose

Relying solely on in-person encounters to assess long-term outcomes of hernia repair leads to substantial loss of information and patients lost-to-follow-up, hindering research and quality improvement initiatives. We aimed to determine if inguinal hernia recurrences could be assessed using the Ventral Hernia Recurrence Inventory (VHRI), a previously existing patient-reported outcome (PRO) tool that can be administered through the telephone and has already been validated for diagnosing ventral hernia recurrence.

Methods

A prospective, multicentric comparative study was conducted. Adult patients from two centers (United States and Brazil) at least 1 year after open or minimally invasive inguinal hernia repair were asked to answer the questions of the VHRI in relation to their prior repair. A physical exam was then performed by a blinded surgeon. Testing characteristics and diagnostic performance of the PRO were calculated. Patients with suspected recurrences were preferentially recruited.

Results

128 patients were enrolled after 175 repairs. All patients answered the VHRI and were further examined, where a recurrence was present in 32% of the repairs. Self-reported bulge and patient perception of a recurrence were highly sensitive (84–94%) and specific (93–94%) for the diagnosis of an inguinal hernia recurrence. Test performance was similar in the American and Brazilian populations despite several baseline differences in demographic and clinical characteristics.

Conclusion

The VHRI can be used to assess long-term inguinal hernia recurrence and should be reestablished as the Hernia Recurrence Inventory (HRI). Its implementation in registries, quality improvement efforts, and research could contribute to improving long-term follow-up rates in hernia patients.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Correspondence to L. Tastaldi.

Ethics declarations

Conflict of interest

Luciano Tastaldi has received a Resident/Fellow Research Grant award from the Americas Hernia Society Quality Collaborative (AHSQC) that is not related to the present submission. David Krpata received an educational grant from W.L. Gore not related to the present work. Ajita S. Prabhu receives personal fees from Medtronic and Intuitive Surgical Inc. and has an ongoing research grant from Intuitive Inc. Sergio Roll has received personal fees for consulting from B. Braun, Medtronic, Ethicon and Bard that are not related to the present submission. Michael Rosen received salary support for his leadership position in the AHSQC, is a board member and has stock/stock options from Ariste Medical and has ongoing research grants from Pacira Pharmaceuticals Inc. and Intuitive Inc. Benjakim Poulose receives salary support for his leadership position in the AHSQC and research funding from Bard Davol Inc.

Ethical approval

This study complies with institutional/national ethical standards and was approved by the Institutional Review Board and/or Ethics Committee of the participating institutions.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Tastaldi, L., Barros, P.H.F., Krpata, D.M. et al. Hernia recurrence inventory: inguinal hernia recurrence can be accurately assessed using patient-reported outcomes. Hernia 24, 127–135 (2020). https://doi.org/10.1007/s10029-019-02000-z

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Keywords

  • Patient-reported outcomes
  • Hernia recurrence inventory
  • Inguinal
  • Hernia
  • Recurrence