Sagar Chavan, Chirag Kakadiya, Vikas Singhal, Azhar Perwaiz, Amanjeet Singh, Adarsh Chaudhary
PFH offer statistically significant improvement in patient-reported quality of life and low rates of early complications. PFH instils reasonable confidence among surgeons, as the anticipated bulge from this bridge technique does not necessarily indicate decreased QoL or recurrence. It serves as an effective, selective strategy for complex hernia repairs, though further long-term observation is required to determine its durable functional success.
PURPOSE: Prospective data evaluating patient-reported outcomes after Peritoneal Flap Hernioplasty (PFH) are scarce. We aimed to prospectively evaluate quality of life (QoL) using the EuraHS-QoL instrument in complex ventral hernia patients undergoing PFH and determine if the postoperative abdominal bulge associated with this bridge technique impacts clinical success from the patient's perspective.
METHODS: A prospective observational cohort study was conducted at a single tertiary care centre from June 2023 to June 2025. Consecutive patients undergoing PFH with or without component separation for large ventral hernias were enrolled. Quality of life (QoL) was assessed using a Hindi translation of the validated EuraHS-QoL score preoperatively and at 3 months postoperatively.
RESULTS: Of the 61 enrolled patients, one was excluded due to an iatrogenic bowel injury, resulting in population of 60. Safety outcomes were evaluated for all 61 patients, whereas efficacy outcomes were assessed for the remaining 60. The mean EuraHS-QoL score demonstrated significant improvement, declining from 43.67 ± 4.70 preoperatively to 14.40 ± 3.73 at the 3-month follow-up. The mean defect width was 9.38 ± 4.75 cm, with an average operative duration of 249.92 ± 99.69 min. Minor morbidity occurred in 19.7% of cases, and one major complication (1.6%, n = 61) required mesh explantation due to iatrogenic bowel injury. No hernia recurrences were identified at the 3-month follow-up; although 21.7% of patients reported subjective abdominal bulging, none exhibited clinical or radiological recurrence.
CONCLUSION: PFH offer statistically significant improvement in patient-reported quality of life and low rates of early complications. PFH instils reasonable confidence among surgeons, as the anticipated bulge from this bridge technique does not necessarily indicate decreased QoL or recurrence. It serves as an effective, selective strategy for complex hernia repairs, though further long-term observation is required to determine its durable functional success.