Extending the value of the National Surgical Quality Improvement Program claims dataset to study long-term outcomes: Rate of repeat ventral hernia repair

Stey, Anne M.; Russell, Marcia M.; Sugar, Catherine A.; Hall, Bruce L.; Zingmond, David S.; Lawson, Elise H.; Ko, Clifford Y.

doi:10.1016/j.surg.2014.12.027

Cited by 27 publications

(12 citation statements)

References 29 publications

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“…An analysis of any incisional or ventral hernia repairs in the American College of Surgeons National Surgical Quality Improvement Program identified risk factors for recurrence within 1 year (age, postoperative superficial surgical site infection, steroid use, smoking, increasing American Society of Anesthesiology score, and BMI). 14 Similar to our study, increasing age was associated with decreasing risk for recurrence and being a smoker increased recurrence risk. In comparison, a Danish study identified defect size, prior hernia repair, and nontacking fixation (for laparoscopic surgery) as risk factors for hernia repair reoperation.…”

Section: Discussionsupporting

confidence: 88%

The Impact of Surgical Approach on Late Recurrence in Incisional Hernia Repair

Yoo

Corso

Chung

et al. 2018

JSLS

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Background and Objectives:We conducted a retrospective, observational study to compare real-world recurrence rates for different surgical approaches after incisional hernia mesh repair.Methods:Two large US insurance claims databases, Truven Commercial Claims (CCAE) and Medicare Supplemental (MDCR), were evaluated for the period from 2009 to 2015. The first incisional hernia repair with mesh for patients 21 years or older was identified (INDEX). One-year continuous enrollment before INDEX was required. Mesh and approach (OPEN, laparoscopic [LAP], and conversion [CONV]) were identified with the use of CPT-4/ICD-9 codes. Recurrence was defined as a second incisional hernia repair 31 days or longer after INDEX. Kaplan-Meier (KM) estimates and Cox models were used to analyze the effect of approach on recurrence.Results:A total of 68,560 patients were identified for CCAE (78.7%) and MDCR (21.3%) with a mean (SD) age of 55.3 (12.8) years. The majority of procedures were OPEN (80.1%) followed by LAP (16.3%) and CONV (3.6%). OPEN had fewer female patients 53.7% compared with LAP (62.1%) and CONV (62.2%). CONV represented more inpatient (51.9%) procedures compared with LAP (41.0%) and OPEN (27.3%). Starting at 2 years post-INDEX, LAP (5.1%, 95% confidence interval [CI] 4.5%–5.6%) had lower KM estimates compared with OPEN (5.9%, 95% CI 5.7%–6.2%]); after 3 years, LAP (6.8%, 95% CI 6.2%–7.5%]) had lower estimates than both OPEN (7.9%, 95% CI 7.6%–8.3%) and CONV (9.3%, 95% CI 7.6%–11.0%). After controlling for confounders, the risk was lower for LAP compared with OPEN (hazard ratio 0.839, 95% CI 0.752–0.936) and CONV (hazard ratio 0.808, 95% CI 0.746–0.875), while OPEN and CONV were not significantly different from each other.Conclusion:Successful laparoscopic surgery incisional hernia mesh repair was associated with decreased risk of recurrence compared with OPEN and CONV.

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Section: Discussionsupporting

confidence: 88%

The Impact of Surgical Approach on Late Recurrence in Incisional Hernia Repair

Yoo

Corso

Chung

et al. 2018

JSLS

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“…3,6,14,15 All panel participants agreed that they would not perform elective surgery on an active smoker. 3,6,14,15 All panel participants agreed that they would not perform elective surgery on an active smoker.…”

Section: Explanation Of Panel Discussionmentioning

confidence: 99%

Ventral Hernia Management

et al. 2017

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Although there was consensus, supported by grade A-C evidence, on patient selection, the safety of short-term nonoperative management, and mesh reinforcement, among experts; there was limited evidence and broad variability in practice patterns in all other areas of practice. The lack of strong evidence and expert consensus on these topics has identified gaps in knowledge where there is need of further evidence.

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“…Commonly practiced techniques for hernia repair use mesh, which is placed either in a sublay or onlay position. 7 This study was conducted on a population of total 94 patients, predominantly male. The correction of ventral hernia is a complex challenge in surgical practice with the use of numerous types of mesh to close the defect and strengthen the musculofascial tissues to prevent return.…”

Section: Discussionmentioning

confidence: 99%

Mesh Repair Compare the Complications Inlay Versus Sublay Mesh Repair in Epigastric Hernia

Tagar¹,

Jamali

Jawed

et al. 2016

TPMJ

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Compare the complications of inlay versus sublay mesh repair in epigastric hernia. Study Design: Observational study. Setting: Surgical department of multiple hospitals and compares the results, JPMC, Civil Hospital Karachi and Naushahro Feroze. Period: March 2015 to February 2016. Methodology: 94 patients presenting with upper abdomen midline swellings aged between 25 to 60 years attended as outdoor patient at a tertiary care hospital. Patients associated with chronic obstructive pulmonary disease like asthma, abdominal malignancies and cirrhosis with end stage liver disease, multiple hernia, patients with prior hernia repair with mesh and defects < 4cm were excluded. Results: Out of the 94 patients, the majority was found to be male. 61 (64.89%) males and 33 (35.10%) females. Mean age was found to be 41.57+4.54 years. Inlay mesh repair group observed high complications as compared to sublay mesh repair group. Wound Infection observed 4(8.5 %) cases inlay mesh repair group and 2(4.25%) cases in sublay mesh repair group. Seroma Infection observed 3(6.38 %) cases inlay mesh repair group and 1(2.12 %) cases in sublay mesh repair group. Recurrence occurred inlay mesh repair group was observed in 2(4.25%) cases. Short Hospital stay was observed in sublay mesh repair group. Conclusion: We conclude that sublay mesh repair is a better alternative to only mesh repair for all forms of ventral hernia cases.

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Extending the value of the National Surgical Quality Improvement Program claims dataset to study long-term outcomes: Rate of repeat ventral hernia repair

Cited by 27 publications

References 29 publications

The Impact of Surgical Approach on Late Recurrence in Incisional Hernia Repair

The Impact of Surgical Approach on Late Recurrence in Incisional Hernia Repair

Ventral Hernia Management

Mesh Repair Compare the Complications Inlay Versus Sublay Mesh Repair in Epigastric Hernia

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