Michael Lewis1, Mihai Paduraru1, Rita Chotai1, Anita Pandya1, Jeanine Smirl2, Kristina Lillig2, James Foster2, Daniel Stolady3
1Norfolk and Norwich University Hospital, Norwich, United Kingdom. 2St Stephens gate Medical Practice, Norwich, United Kingdom. 3Queen Elizabeth Hospital, Kings Lynn, United Kingdom
Abstract
Introduction: Inguinal hernia repair remains one of the commonest elective general surgical procedures with high rates of chronic pain afterwards. The aim of this study was to evaluate changes in quality of life after local anaesthetic inguinal hernia surgery performed in a primary care setting.
Methods: A standard QoL form (EuraHS) was given to all patients pre-operatively and at six months post-operative. Data was analysed by grouping according to initial symptom score.
Results: 497 patients filled out preoperative QoL forms between June 2020 and May 2022. 6 month forms were received back for 179 inguinal hernia repair patients. Median preop score was 33 (IQR 20-48). Median post operative score was 4 (IQR 1-11). 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: Local Anaesthetic Inguinal hernia repair improves quality of life substantially 6 months after surgery. However in those patients with low preoperative scores (<11) the gain is minimal. We recommend avoiding surgery in this group and instead adopting a surveillance approach.