Outcomes in complex ventral hernia repair with anterior component separation in class III obesity patients

Smolevitz, Jill; Jacobson, Richard A.; Thaqi, Milot; Millikan, Samantha; Millikan, Keith W.

doi:10.1016/j.amjsurg.2017.10.056

Cited by 14 publications

(9 citation statements)

References 7 publications

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“…The authors believe that the laparoscopic approach to the IVH treatment minimizes the risks of the complications caused by obesity during abdominal wall surgery. The study [ 9 ] demonstrates analogous results in patients with grade III obesity compared to patients with a BMI of ≤39.9 kg/m 2 . It should be noted that the bulk of patients with complications and recurrences (74.5%) who took part in our research were patients with some degree of obesity.…”

Section: Discussionmentioning

confidence: 70%

“…From predicting the clinical and economic results of the IVH treatment throughout life, the developed method is not only comparative in terms of quality and reproducibility of results with other studies but also has some advantages. In a typical group of patients with a ventral hernia, laparoscopic recovery [ 9 ] at the time of diagnosis was very cost-effective compared to other interventions commonly used in healthcare in other countries. The average cost of the operation in the US was $ 27,700 … $ 50,000.…”

Section: Discussionmentioning

confidence: 99%

“…The average cost of the operation in the US was $ 27,700 … $ 50,000. Patients with a high risk of perioperative mortality, complications, and recurrences need conservative monitoring [ 9 12 ]. Due to economic issues, patients who experience no reduction in quality of life caused by ventral hernia also need monitoring [ 12 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Synthetic prostheses in herniology have reduced the frequency of hernia recurrences to 6–10% [ 7 8 9 ], but most authors prefer to use combined prosthetic methods, considering them the best option for surgical IVH treatment [ 7 8 9 ]. At the same time, the widespread use of prosthetic methods increased the number of wound complications and decreased the quality of life in 30–40% of operated patients [ 10 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy Evaluation of a Case-Specific Approach for Surgical Treatment of Inicisional Ventral Hernia

Sokolova

Sherbatykh

Tolkachev

et al. 2021

International Journal of Surgery Protocols

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Background: The research aims to improve the surgical treatment results of incisional ventral hernia by applying a case-specific approach and a new method of anterior abdominal wall surgery. Materials and Methods: The paper reports the results of the prospective dynamic cohort study on 219 patients under 60 years of age, with small and medium hernias and up to 10 cm defects in the anterior abdominal wall (W1–W2), who underwent incisional ventral hernia treatment with mesh endoprostheses. Results: The paper offers a selection algorithm for anterior abdominal wall repair surgery and an original proprietary technique. We have developed and described in detail a new ‘extra-sublay’ technique of surgical intervention. The paper displays the frequency and pattern of complications, as well as the quality of life of patients after different prosthetic surgeries. In the main group, 65.0% of patients showed improvement, 88.4% showed long-term surgical success, 13.6% faced complications, and 4.5% experienced recurrence. Conclusion: After receiving the “on lay” treatment, 59.4% of patients showed positive results, 74.7% showed long-term surgical success, 40% had complications, and 3.1% experienced recurrence. After the “sub lay” intervention, 40.0% of patients demonstrated excellent results, 81.9% reached long-term success, 12% had complications, and 1.4% encountered recurrence. Highlights: The article shows a selection algorithm for anterior abdominal wall plastic repair method. One of the factors that cause relapses and ventral hernias themselves is obesity. The authors’ method of the VH surgical treatment has shown good results. Excellent indicators showed 65.0% of patients of the main group.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy Evaluation of a Case-Specific Approach for Surgical Treatment of Inicisional Ventral Hernia

Sokolova

Sherbatykh

Tolkachev

et al. 2021

International Journal of Surgery Protocols

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“…Congestive heart failure, chronic pulmonary and hepatic disease, neurological disorders and paralysis were associated with a higher mortality risk 13,21,24 . Obesity was associated with an increased risk of respiratory failure 23 but not mortality 26 . Dialysis patients had a significantly greater rate of 30‐day perioperative mortality 27 …”

Section: Discussionmentioning

confidence: 99%

Elective abdominal wall hernia repair surgical mortality—A systematic review of the literature and peer review of mortality in Australia

Patiniott

Reid

Maloney

et al. 2021

ANZ Journal of Surgery

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Background This study systematically reviewed the literature regarding perioperative mortality in human adults undergoing elective surgical abdominal wall hernia repair, including an audit of the Royal Australasian College of Surgeons (RACS) Australian and New Zealand Audit of Surgical Mortality (ANZASM) database. Methods A systematic review was conducted in accordance with PRISMA guidelines for the reporting of systematic reviews and meta‐analysis of observational studies. Cochrane Library, PubMed, MEDLINE and Embase database searches and data extraction were conducted from June 1979 to October 2019. Statistical analysis was undertaken utilising denominator values for elective hernia procedures derived from the Australian Institute of Health and Welfare (AIHW) data. Risk‐adjusted perioperative mortality rates for the relevant procedures were also produced, using a binary logistic regression for the risk adjustment. Results Through systematic review of the literature, it was established that the overall reported perioperative mortality in human adults undergoing elective surgical abdominal wall hernia repair was low (0.1%–0.5%). Using ANZASM and AIHW data, the calculated risk‐adjusted mortality rate for Australian patients was found to be significantly lower (0.04%–0.06%, p < 0.001). Conclusion The risk‐adjusted mortality rate for elective abdominal wall hernia surgery in Australia is very low and compares favourably to international cohorts. Despite low absolute numbers, the factors which were most significantly associated with increased perioperative mortality in patients undergoing elective surgical abdominal wall hernia repair were increased age, cardiorespiratory co‐morbidity and incisional hernia repair.

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Ventral hernia patient outcomes postoperatively housed on surgical vs non-surgical units

et al. 2020

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Background Inpatient hospital units vary in staffing ratios, monitoring, procedural abilities, and experience with unique patients and diagnoses. The purpose of this study is to assess the impact of patient cohorting upon ventral hernia repair outcomes. Methods An IRB-approved retrospective review of open ventral hernia repairs between August 2013 and July 2017 was performed. The information of all patient locations during hospitalization, time at location, post-anesthesia care unit duration (PACU), and intensive care unit (ICU) duration was collected. Patient demographics, comorbidities, operative details, cost, and patient outcomes were analyzed. Multivariable analysis of log length of stay (LOS) was assessed with adjustment for clinical and operative factors. Results 235 patients underwent open ventral hernia repair. 179 patients were admitted to surgical units, 33 non-surgical units, and 23 stayed on both units. Clinical characteristics including patient age, gender, BMI, and medical comorbidities were similar between patients boarded on surgical versus non-surgical units. Hernia, wound, and operative data were also statistically similar. Patients admitted to non-surgical units for any duration experienced longer hospital stay (4 vs. 6 days, p < 0.001). Patients housed on a non-surgical unit were more likely to transfer rooms than patients on surgical units, 42.9% vs. 10.1% ( p < 0.001), respectively. Multivariable analysis of natural log-transformed LOS showed any stay on a non-surgical unit increased LOS by 1.0 days (95% Cl 0.9–1.2 days, p = 0.026). There were no differences in ICU or PACU stay, cost, or postoperative complications in patients housed on surgical versus non-surgical units. Conclusions Postoperative surgical patients had an increased length of stay when admitted to non-surgical units. More frequent room transfers occurred in patients admitted to non-surgical units. Evaluation of patient outcomes and LOS in open ventral hernia repair patients based on hospital unit is unique to this study.

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Outcomes in complex ventral hernia repair with anterior component separation in class III obesity patients

Cited by 14 publications

References 7 publications

Efficacy Evaluation of a Case-Specific Approach for Surgical Treatment of Inicisional Ventral Hernia

Efficacy Evaluation of a Case-Specific Approach for Surgical Treatment of Inicisional Ventral Hernia

Elective abdominal wall hernia repair surgical mortality—A systematic review of the literature and peer review of mortality in Australia

Ventral hernia patient outcomes postoperatively housed on surgical vs non-surgical units

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