Concomitant open ventral hernia repair: what is the financial impact of performing open ventral hernia with other abdominal procedures concomitantly?

Madabhushi, Vashisht; Plymale, Margaret A.; Roth, J. Scott; Johnson, Sara E.; Wade, Alex; Davenport, Daniel L.

doi:10.1007/s00464-017-5884-3

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…Consistent with the present findings, increased financial costs for combined ventral hernia repair and stoma closure compared with two separate procedures have been reported, thus advocating for a dual-stage approach from an economical point-of-view [ 19 ]. In the present study, data on a stoma closure prior to an incisional hernia repair was not included.…”

Section: Discussionsupporting

confidence: 88%

Should simultaneous stoma closure and incisional hernia repair be avoided?

Oma

Baastrup

Jensen

2020

Hernia

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Purpose Patients scheduled for stoma closure may also have an incisional hernia. Studies have reported acceptable outcomes after contaminated ventral hernia repair, but whether stoma closure and incisional hernia repair should be performed as a combined procedure is unknown. This study examined combined stoma closure and incisional hernia repair compared with incisional hernia repair only. Methods This was a nationwide propensity-score matched study. Patients who underwent elective incisional hernia repair from 2007–2017 were identified in the Danish Hernia Database. All patients who underwent concurrent stoma closure were matched 1:3 with patients who underwent incisional hernia repair only. The primary outcome was reoperation for hernia recurrence, whereas secondary outcomes included anastomotic leakage, length of hospital stay, and 30-day reoperation and readmission rates. Results In total, 516 patients were included. The risk of reoperation for recurrence was increased after concurrent stoma closure compared with incisional hernia repair only (hazard ratio 1.69, 95% confidence interval 1.01–2.82, p = 0.044). Seven (5.4%) patients who underwent incisional hernia repair concurrent to stoma closure were reoperated for anastomotic leakage. Length of hospital stay and reoperation rates within 30 days were increased after concurrent stoma closure compared with incisional hernia repair only (median 8 versus 3 days, p < 0.001 and 29.5% versus 18.6%, p = 0.013), whereas there was no difference in 30-day readmission rates ( p = 0.251). Conclusions Stoma closure and incisional hernia repair should be performed as a dual-stage procedure to decrease the risk of hernia recurrence.

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Section: Discussionsupporting

confidence: 88%

Should simultaneous stoma closure and incisional hernia repair be avoided?

Oma

Baastrup

Jensen

2020

Hernia

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“…The same authors reported non-significant difference between groups regarding BMI, indicating that, BMI did not affect the choice of the operative intervention. In addition, Madabhushi et al [17] reported comparable results as the current study regarding patient age and gender; although they performed intervention in an older group [the mean age was around 53.0 years in both groups]. But both groups were statistically comparable.…”

Section: Discussionsupporting

confidence: 71%

Comparative Study to Assess the Outcome of the Abdominohernioplasty Versus the Sole Hernioplasty

El-Bahy¹,

Megahed

Sayouh

2021

International Journal of Medical Arts

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Background: Abdominoplasty was increasingly performed in daily surgical practice. It is usually associated with hernia. Different surgeons prefer to carry out hernioplasty with abdominoplasty. However, this was challenged by longer operative time and theoretical increase of associated complications. Objective of the Study:The present study aimed to assess the surgical outcome of the hernioplasty alone versus combined abdominohernioplasty.Patients and Methods: This study was conducted between September 2019 and September 2020. Forty patients with ventral hernias were included and divided randomly into two equal groups; First group for combined hernioplasty with abdominoplasty and the other group for hernioplasty alone. All patients were evaluated preoperatively by full history, physical examination and preoperative routine Lab investigations to assure fitness for surgery. Postoperatively, patients were observed overnight in hospital. Pain was controlled and ambulation was permitted as early as possible after surgery. To ensure patient comfort and abdominal support, a compressive binder was used. Patients were clinically reevaluated 7 days and at one, three and six months after surgery.Results: Groups A and B were comparable regarding patient age, gender, body mass index, and hernia type. The operative time and intraoperative bleeding were significantly higher in abdominoplasty group compared to hernioplasty group [154.01±13.73 minutes, 417.5±106.72 CC vs 64.75±9.11 and 92.5±32.55 respectively]. Early and late postoperative complications showed non-significant difference, except significant increase of recurrence among hernioplasty than abdominoplasty group [25.0% vs 0.0% respectively]. Abdominoplasty was associated with significant increase of total drain output, longer duration of drain and early mobility. Finally, there was significant increase of satisfaction with body size, body shape, relief of lower back pain, easy sex practice satisfaction and scar satisfaction in abdominoplasty group. Conclusion:Abdominoplasty with hernioplasty is a safe approach for ventral hernia repair, with superior aesthetic outcome and patient satisfaction than hernioplasty alone.

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“…Значимость данного аргумента под черкивает тот факт, что 32,8% больных после выпол нения первого этапного вмешательства на длительный срок откладывают выполнение второй операции [12]. По данным ряда исследований, этапное лечение сочетанных хирургических заболеваний сопровожда ется дополнительными эмоциональными нагрузками и финансовыми расходами, связанными с повторны ми операциями, анестезией [8,13]. Также отмечает ся меньшая удовлетворенность пациентов непосред ственными, отдаленными и косметическими результа тами этапных оперативных вмешательств [14].…”

Section: Optimization Of Surgical Treatment Of Patients With Inguinal...unclassified

Optimization of treatment of patients with inguinal hernia in combination with recurrence of varicose veins

Milyukov,

Chernookov,

Kandyba

et al. 2024

Ambulatornaya khirurgiya

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Introduction. In recent years, surgeons have increasingly used combined operations in patients with inguinal hernias and recurrent varicose veins. However, it is necessary to justify the choice of the type and volume of the main and concomitant stages of combined surgery, depending on the individual characteristics of both diseases.Aim. Optimization of surgical treatment of patients with inguinal hernias in combination with relapses of varicose veins.Materials and methods. The study included 39 patients aged 35 to 78 years with inguinal hernias and RVB. Of these, 21 patients who underwent combined operations were included in the main group. The control group included 18 patients who underwent staged hernioplasty, and then after 1–26 months, operations for RVB, or interventions were performed in reverse order. A comparative assessment of the duration of operations, the level of postoperative pain, immediate and long-term results, and the number of complications of uncorrected diseases in two-stage treatment was carried out.Results and discussion. Performing combined operations in this category of patients does not lead to an increase in the level of postoperative complications, it is accompanied by an average increase in the duration of surgery by 33.6 minutes and an increase in the intensity of postoperative pain by 0.8 points, a decrease in temporary disability by 1.2 times.Conclusions. Performing combined operations is the optimal intervention in patients with inguinal hernias with concomitant recurrence of varicose veins. The use of combined operations makes it possible to simultaneously eliminate both diseases and exclude the development of complications from an uncorrected disease, which, with two-stage treatment, was observed in 11.1% of cases and required emergency operations.

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Concomitant open ventral hernia repair: what is the financial impact of performing open ventral hernia with other abdominal procedures concomitantly?

Cited by 10 publications

References 22 publications

Should simultaneous stoma closure and incisional hernia repair be avoided?

Should simultaneous stoma closure and incisional hernia repair be avoided?

Comparative Study to Assess the Outcome of the Abdominohernioplasty Versus the Sole Hernioplasty

Optimization of treatment of patients with inguinal hernia in combination with recurrence of varicose veins

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