دورية أكاديمية
أعرض في EDS

Chronic groin pain following open inguinal hernia repair: has consenting practice improved?

التفاصيل البيبلوغرافية
العنوان: Chronic groin pain following open inguinal hernia repair: has consenting practice improved?
المؤلفون: Sivarajah V; East and North Hertfordshire NHS Trust, UK., Farquharson B; East and North Hertfordshire NHS Trust, UK., Mahdi S; East and North Hertfordshire NHS Trust, UK., Cathcart P; East and North Hertfordshire NHS Trust, UK., Jeyarajah S; East and North Hertfordshire NHS Trust, UK.
المصدر: Annals of the Royal College of Surgeons of England [Ann R Coll Surg Engl] 2021 Jan; Vol. 103 (1), pp. 5-9. Date of Electronic Publication: 2020 Sep 28.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Royal College of Surgeons of England Country of Publication: England NLM ID: 7506860 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1478-7083 (Electronic) Linking ISSN: 00358843 NLM ISO Abbreviation: Ann R Coll Surg Engl Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : Royal College of Surgeons of England
مواضيع طبية MeSH: Chronic Pain/*epidemiology , Disclosure/*trends , Herniorrhaphy/*adverse effects , Informed Consent/*standards , Pain, Postoperative/*epidemiology , Practice Patterns, Physicians'/*trends, Aged ; Chronic Pain/etiology ; Disclosure/standards ; Female ; Groin ; Hernia, Inguinal/surgery ; Herniorrhaphy/methods ; Humans ; Male ; Middle Aged ; Pain, Postoperative/etiology ; Physician-Patient Relations ; Practice Patterns, Physicians'/standards ; Retrospective Studies ; Time Factors
مستخلص: Introduction: Chronic groin pain following inguinal hernia surgery is a common and potentially debilitating complication, and yet patients are infrequently informed of this risk. This leaves surgeons open to negligence claims, especially given recent changes to case law, which for the first time highlighted the need for a more patient-centred approach to risk disclosure. We investigated how these changes have influenced our consenting practice with respect to the disclosure of this risk.
Methods: We compared how often surgeons discussed the risk of chronic groin pain with adults undergoing elective open unilateral inguinal hernia mesh repairs in 2019 and 2009. The first 50 patients in each of these two years were retrospectively compared. Discussions during the initial consultation and on the day of surgery were assessed by reviewing clinic letters, medical notes and consent forms.
Findings: The risk of chronic pain was discussed with significantly more patients in 2019 than in 2009 (96% v 54%, p <0.0001). Most of these discussions occurred on the day of surgery (92% v 54%, p <0.0001). Only a few patients had these discussions during their initial consultation (18% v 4%, p <0.025).
Conclusions: Discussing the risk of chronic groin pain has improved significantly over the past 10 years. However, these discussions occur mostly on the day of surgery, which gives patients very little time to weigh up the risk. This potentially invalidates the consent they give for surgery. Patients should be given an opportunity to discuss their operative risks in advance of their operation.
References: J R Soc Med. 2007 Feb;100(2):97-100. (PMID: 17277283)
Ann Med Surg (Lond). 2019 Feb 20;40:1-2. (PMID: 30906542)
Postgrad Med J. 2017 Jan;93(1095):46-50. (PMID: 27466410)
Br J Surg. 2001 Feb;88(2):309-12. (PMID: 11167887)
Patient Educ Couns. 2019 Feb;102(2):340-345. (PMID: 30173877)
BMJ. 2015 Mar 16;350:h1481. (PMID: 25779588)
Hernia. 2017 Apr;21(2):215-221. (PMID: 28181088)
Br J Hosp Med (Lond). 2013 Apr;74(4):224-7. (PMID: 23571394)
Hernia. 2010 Apr;14(2):181-6. (PMID: 20012456)
Hernia. 2018 Feb;22(1):1-165. (PMID: 29330835)
Ann R Coll Surg Engl. 2008 Nov;90(8):643-6. (PMID: 18796191)
BMJ Qual Improv Rep. 2017 Feb 8;6(1):. (PMID: 28243444)
Ann R Coll Surg Engl. 2020 Jan;102(1):25-27. (PMID: 31418302)
Surgeon. 2017 Aug;15(4):190-195. (PMID: 26791394)
Hernia. 2009 Feb;13(1):73-6. (PMID: 18836687)
Br J Gen Pract. 1994 Apr;44(381):153-6. (PMID: 8185988)
Surgery. 2006 Apr;139(4):523-6. (PMID: 16627062)
J Visc Surg. 2019 Sep;156 Suppl 1:S57-S60. (PMID: 31104901)
Br J Surg. 2002 Nov;89(11):1476-9. (PMID: 12390395)
فهرسة مساهمة: Keywords: Chronic pain; Consent; Groin; Inguinal hernia; Neuralgia
تواريخ الأحداث: Date Created: 20200928 Date Completed: 20210204 Latest Revision: 20220102
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC7705140
DOI: 10.1308/rcsann.2020.0184
PMID: 32981334
قاعدة البيانات: MEDLINE
الوصف
تدمد:1478-7083
DOI:10.1308/rcsann.2020.0184