Long-Term Patient-Reported Quality-of-Life Outcomes After Ventral Primary or Incisional Hernia Repair

Background: Long-term quality-of-life (QOL) outcomes after ventral primary and incisional hernia repair are underreported, especially beyond the early postoperative period. This cross-sectional study evaluated postoperative functional status, mental health and overall satisfaction using patient-reported outcome measures (PROMs) at least five years after ventral hernia surgery. Methods: Four separate PROM assessment tools were used to assess long-term outcomes in patients who underwent ventral hernia repair between 2009 and 2014. Two subgroup analyses were performed, categorizing patients by recalled preoperative pain and Ventral Hernia Working Group risk classification (low-risk Grade 1/2 vs. high-risk Grade 3/4), based on wound contamination and comorbidities at the time of surgery. Results: Eighty-seven patients were assessed with a median follow-up of eight years (range 6–11) from the time of surgery to survey completion. Patients with Grade 3/4 hernias (18%, 16/87) reported significantly worse QOL outcomes across multiple PROMs than those in the Grade 1/2 group (82%, 71/87), including social functioning (p = 0.010), pain (p = 0.013), general health (p = 0.007), and cosmetic discomfort (p = 0.018). Patients with moderate to severe preoperative pain (53%, 46/87) were more likely to experience long-term postoperative pain (p = 0.02) and worse social functioning (p = 0.004) compared with patients with minimal or no preoperative pain (47%, 41/87). Conclusions: Overall, many patients had favorable long-term patient-reported QOL outcomes following ventral primary and incisional hernia repair. Patients with high-risk, complex hernias and those with moderate-to-severe recalled preoperative pain experienced more pain and worse overall health at long-term follow-up than those with low-risk hernias and those with minimal or no recalled preoperative pain.