LAUSR

Quality of life (QOL) has become a key outcome measure in VHR. Although recurrent hernias can be more challenging to repair and often have more postoperative complications compared to primary hernias, QOL outcomes have not been specifically studied between these two groups. The International Hernia Mesh Registry was queried for patients who underwent either recurrent or primary VHR. Patients detailed QOL using the Carolinas Comfort Scale (CCS). Patient characteristics and preoperative and 1-year postoperative CCS scores were compared between groups with standard statistical methods. There were 1,349 patients identified from 2008–2019 who underwent VHR with preoperative and 1-year postoperative CCS data, 227(16.8%) of which had recurrent hernias and 1,122(83.2%) had primary hernias. The recurrent group had a higher BMI(32.5±6.7 vs 30.7±6.5 kg/m2,p<0.001), larger hernia defects(78.9±103.5 vs 39.0±79.9 cm2,p<0.001), and more postoperative hernia recurrence(13.7% vs 5.3%,p<0.001). Recurrent patients had increased(difference=3.1±7.9) mesh sensation and more mesh sensation at 1-year(4.6±7.7 vs 2.7±5.5,p<0.001) compared to the primary group. They had greater preoperative(11.1±9.6 vs 6.7±8.2,p<0.001) and 1-year postoperative(4.1±7.2 vs 2.3±5.6,p<0.001) pain but had greater improvement in their pain after surgery(-6.3±10.2 vs -4.3±8.3,p=0.002). They also had greater preoperative(9.4±9.1 vs 5.2±7.1,p<0.001) and 1-year postoperative(4.1±7.2 vs 1.9±4.8,p<0.001) movement limitation but experienced greater improvement in this category (-5.5±10.0 vs -3.2±7.2,p<0.001). Patients presenting with recurrent hernias had more hernia-related symptoms than patients presenting with primary hernias but experienced greater improvement with pain and movement limitation. They did have increased mesh sensation postoperatively. These data may help in counseling patients preoperatively.