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Background <p>Preoperative concerns about mesh are common, but their relationship to long-term decision regret after hernia repair (HR) remains unclear. We evaluated long-term decision regret (DR) among patients who previously completed a preoperative mesh perception survey followed by mesh-based hernia repair.</p> Methods <p>Patients who had previously completed a preoperative mesh perception survey and later underwent HR were surveyed to assess DR using the Brehaut Decision Regret Scale (BDRS). The BDRS ranges from 0 (no regret) to 100 (highest regret). Scores ≤ 25 were considered minimal regret, while scores &gt; 25 indicated more than minimal regret. Descriptive analyses were performed.</p> Results <p>Of 202 patients in the original survey cohort, 97 (48.0%) underwent HR, and 48 (49.5%) completed the follow-up BDRS survey. Mean age was 58.9 ± 12.8&#xa0;years, 64.6% were male, and 29.2% had history of recurrent hernia. The average time since surgery to survey was 60.2 ± 18.8&#xa0;months. Overall, mean BDRS was 9.9 ± 14.5, and 95.9% agreed that surgery was the right decision, with 85.4% reporting minimal regret and 52.1% reporting no regret.</p> <p>Ventral hernias comprised 47.9% of cases and had the lowest mean regret (3.9 ± 6.6), with no patients scoring &gt; 25. Inguinal (31.3%) and umbilical (8.3%) hernias had higher mean scores (16.7 ± 17.2 and 23.8 ± 18.9, respectively). Among the 7 (14%) patients with scores &gt; 25, all were primary hernias, and most reported postoperative discomfort or minor wound complications. Correlation analyses comparing preoperative survey with postoperative BDRS scores found very early expectation of recovery and graduate-level education were associated with higher regret scores.</p> Conclusion <p>Long-term DR following mesh-based HR is uncommon, with most patients reporting minimal or no regret an average of 5&#xa0;years postoperatively. Ventral hernia repair had the lowest DR, while inguinal and umbilical repair had higher scores. These findings suggest that mesh-based hernia repair is associated with favorable long-term, patient-reported decision satisfaction.</p> Graphical Abstract <p></p>

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Low long-term decision regret following mesh-based hernia repair: 5-year outcomes in a previously surveyed cohort

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Alynna J. Wiley,
  • Samantha W. Kerr,
  • Alexis M. Holland,
  • Sharbel A. Elhage,
  • Brittany S. Mead,
  • Gregory T. Scarola,
  • Kent W. Kercher,
  • Vedra A. Augenstein,
  • Sullivan A. Ayuso,
  • B. Todd Heniford

摘要

Background

Preoperative concerns about mesh are common, but their relationship to long-term decision regret after hernia repair (HR) remains unclear. We evaluated long-term decision regret (DR) among patients who previously completed a preoperative mesh perception survey followed by mesh-based hernia repair.

Methods

Patients who had previously completed a preoperative mesh perception survey and later underwent HR were surveyed to assess DR using the Brehaut Decision Regret Scale (BDRS). The BDRS ranges from 0 (no regret) to 100 (highest regret). Scores ≤ 25 were considered minimal regret, while scores > 25 indicated more than minimal regret. Descriptive analyses were performed.

Results

Of 202 patients in the original survey cohort, 97 (48.0%) underwent HR, and 48 (49.5%) completed the follow-up BDRS survey. Mean age was 58.9 ± 12.8 years, 64.6% were male, and 29.2% had history of recurrent hernia. The average time since surgery to survey was 60.2 ± 18.8 months. Overall, mean BDRS was 9.9 ± 14.5, and 95.9% agreed that surgery was the right decision, with 85.4% reporting minimal regret and 52.1% reporting no regret.

Ventral hernias comprised 47.9% of cases and had the lowest mean regret (3.9 ± 6.6), with no patients scoring > 25. Inguinal (31.3%) and umbilical (8.3%) hernias had higher mean scores (16.7 ± 17.2 and 23.8 ± 18.9, respectively). Among the 7 (14%) patients with scores > 25, all were primary hernias, and most reported postoperative discomfort or minor wound complications. Correlation analyses comparing preoperative survey with postoperative BDRS scores found very early expectation of recovery and graduate-level education were associated with higher regret scores.

Conclusion

Long-term DR following mesh-based HR is uncommon, with most patients reporting minimal or no regret an average of 5 years postoperatively. Ventral hernia repair had the lowest DR, while inguinal and umbilical repair had higher scores. These findings suggest that mesh-based hernia repair is associated with favorable long-term, patient-reported decision satisfaction.

Graphical Abstract