Ventral Hernia Repair and Obesity: Results from a Nationwide Register Study in France According to the Timeframes of Hernia Repair and Bariatric Surgery

Autor: Lionelle Nkam, David Moszkowicz, Madalina Jacota, Lamiae Grimaldi, Davide Giovinazzo, Andrea Lazzati
Rok vydání: 2021
Předmět:
Zdroj: Obesity Surgery. 31:5251-5259
ISSN: 1708-0428
0960-8923
DOI: 10.1007/s11695-021-05720-3
Popis: Several strategies are suggested for ventral hernia repair (VHR) in bariatric candidates, in terms of timing and technique. The aim was to describe practices in VHR in bariatric patients on a nationwide scale in France.We used the prospective national hospital discharge summaries database system to conduct a retrospective cohort study. We included patients operated once for sleeve or bypass, between 2007 and 2018, and who had VHR concomitant with bariatric surgery (BS) or within 2 years before or after.Among 11,680 eligible patients, 2039 underwent VHR in the 2 years before BS, 3388 had concomitant BS and VHR, and 6260 patients had VHR within 2 years after BS. Patients who underwent a concomitant surgery presented a higher suture repair rate (86.1% versus 37.1% and 44.0%, P 0.001). Overall recurrence of VH at 10 years was 23.3% and was higher for patients who underwent VHR first (36.2%) than patients who underwent BS first (24.5%) and the concomitant group (18.6%), P 0.001. Major complication rate was 11.1%, 7.8%, and 16.9% (P 0.001) for VHR-first, concomitant, and BS-first groups, respectively. Mesh infection was found in 0.6% (13/2039) of patients in the VHR-first group, in 0.6% (20/3388) in the concomitant group, and in 1.1% (68/6260) in the BS-first group (P 0.001).About one-quarter of bariatric patients undergoing VHR will be reoperated for an anterior hernia. VHR before BS entailed a higher risk of reoperation for recurrence and should be avoided. A concomitant repair entailed the lowest rate of recurrence.
Databáze: OpenAIRE
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