Abstract：
OBJECTIVE: Inguinal hernia repair remains one of the most common elective general surgical procedures. Previous studies have suggested high rates of chronic pain afterwards. The aim of this study was to evaluate changes in quality of life after local anaesthetic (LA) inguinal hernia surgery performed in a primary care setting.
METHODS: Quality of life (QoL) was measured in all patients both pre-operatively and at 6-months post-operatively using the European Hernia Society Scoring tool. Data was analysed by tertile grouping according to initial symptom score.
RESULTS: 497 patients filled out pre-operative QoL forms between June 2020 and May 2022. Post-operative QoL scores were received from 179 patients (164 male (91.6%)). Median pre-operative score was 33 (IQR 20-48). Median post-operative score was 4 (IQR 1-11). Mean improvement in QoL score was 27.8. Nine patients had a worse score at 6-months compared to pre-op (5%). When the data was analysed by pre-op QoL group as expected the low symptom group (score 0-10) had minimal improvement in QoL (0.23) and 5 out of 13 patients (38%) had a worse score. The medium group (score 11-40) had a mean improvement in QoL of 17.25 with 3 out of 92 (3.2%) experiencing a worse score. The high symptom group (score 41-90) had a mean improvement in QoL of 45.4 with only 1 of 76 (1.3%) experiencing a worse score.
CONCLUSIONS: LA Inguinal hernia repair improves QoL substantially 6-months after surgery. However, in those patients with low pre-operative scores (< 11) the gain is minimal and rates of chronic symptoms following surgery are very high. We recommend avoiding surgery in this group and instead adopting a surveillance approach.
METHODS: Quality of life (QoL) was measured in all patients both pre-operatively and at 6-months post-operatively using the European Hernia Society Scoring tool. Data was analysed by tertile grouping according to initial symptom score.
RESULTS: 497 patients filled out pre-operative QoL forms between June 2020 and May 2022. Post-operative QoL scores were received from 179 patients (164 male (91.6%)). Median pre-operative score was 33 (IQR 20-48). Median post-operative score was 4 (IQR 1-11). Mean improvement in QoL score was 27.8. Nine patients had a worse score at 6-months compared to pre-op (5%). When the data was analysed by pre-op QoL group as expected the low symptom group (score 0-10) had minimal improvement in QoL (0.23) and 5 out of 13 patients (38%) had a worse score. The medium group (score 11-40) had a mean improvement in QoL of 17.25 with 3 out of 92 (3.2%) experiencing a worse score. The high symptom group (score 41-90) had a mean improvement in QoL of 45.4 with only 1 of 76 (1.3%) experiencing a worse score.
CONCLUSIONS: LA Inguinal hernia repair improves QoL substantially 6-months after surgery. However, in those patients with low pre-operative scores (< 11) the gain is minimal and rates of chronic symptoms following surgery are very high. We recommend avoiding surgery in this group and instead adopting a surveillance approach.
摘要：
目的：腹股沟疝修补术仍然是最常见的择期普外科手术之一。先前的研究表明，以后的慢性疼痛发生率很高。这项研究的目的是评估在初级保健环境中进行局部麻醉（LA）腹股沟疝手术后生活质量的变化。
方法：使用欧洲疝学会评分工具在所有患者术前和术后6个月测量生活质量（QoL）。根据初始症状评分，通过三元分组对数据进行分析。
结果：497名患者在2020年6月至2022年5月之间填写了术前QoL表格。术后QoL评分来自179名患者（164名男性（91.6%））。术前中位数评分为33分（IQR20-48）。术后中位数评分为4分（IQR1-11）。QoL评分的平均改善为27.8。与手术前相比，9例患者在6个月时得分更差（5％）。当按预期的术前QoL组分析数据时，低症状组（评分0-10）的QoL改善最小（0.23），13例患者中有5例（38％）的评分较差。中等组（得分11-40）的QoL平均改善为17.25，92人中有3人（3.2％）的得分较差。高症状组（得分为41-90）的QoL平均改善为45.4，76人中只有1人（1.3％）的得分较差。
结论：LA腹股沟疝修补术可显著改善术后6个月的QoL。然而,在那些术前评分较低(<11)的患者中,增加幅度很小,术后慢性症状的发生率非常高.我们建议在该组中避免手术，而是采用监测方法。
方法：使用欧洲疝学会评分工具在所有患者术前和术后6个月测量生活质量（QoL）。根据初始症状评分，通过三元分组对数据进行分析。
结果：497名患者在2020年6月至2022年5月之间填写了术前QoL表格。术后QoL评分来自179名患者（164名男性（91.6%））。术前中位数评分为33分（IQR20-48）。术后中位数评分为4分（IQR1-11）。QoL评分的平均改善为27.8。与手术前相比，9例患者在6个月时得分更差（5％）。当按预期的术前QoL组分析数据时，低症状组（评分0-10）的QoL改善最小（0.23），13例患者中有5例（38％）的评分较差。中等组（得分11-40）的QoL平均改善为17.25，92人中有3人（3.2％）的得分较差。高症状组（得分为41-90）的QoL平均改善为45.4，76人中只有1人（1.3％）的得分较差。
结论：LA腹股沟疝修补术可显著改善术后6个月的QoL。然而,在那些术前评分较低(<11)的患者中,增加幅度很小,术后慢性症状的发生率非常高.我们建议在该组中避免手术，而是采用监测方法。
