Concomitant ventral hernia repair and bariatric surgery: a retrospective analysis from a UK-based bariatric center

Autor: Omer Al-Taan, Andrea Giorga, Miss Sylvia Krivan, Vigyan Jain, Marco Barreca
Rok vydání: 2018
Předmět:
Zdroj: Surgical Endoscopy. 33:705-710
ISSN: 1432-2218
0930-2794
Popis: Ventral hernias (VH) are frequently encountered in patients with morbid obesity. Concomitant ventral hernia repair (VHR) and bariatric surgery (BS) is practiced but still controversial. Wound-related complications (seroma, hematoma, wound infection) and hernia recurrence rates are possible inhibitor factors. We aimed to estimate the rate of complications from concomitant BS (laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy) and VHR and identify patient subgroups at higher risk of complications from synchronous repair.A retrospective analysis of successive 106 patients who underwent concomitant BS + VHR at our institute (09/2007 to 09/2015) was performed using data from patients' record. Parameters considered were: type of repair (open/laparoscopic and primary closure/mesh), size and type of hernia ( 5 cm, 5-10 cm, 10 cm and primary/incisional), patient gender and comorbidities.One hundred and six patients underwent concomitant BS and VHR. Fifty-nine had laparoscopic VHR and 47 open. Hernias recurred in 5 (8.47%) laparoscopic and 7 (14.89%) open VHR. Wound-related complications were common in open (15%) vs. laparoscopic (11.7%) VHR. Patients with VH recurrence included 8 (75%) with defects 5 cm, 10 (83%) female, and all had BMI 45. Six patients had wound infection, 5 of which had type 2 diabetes mellitus. Six patients had hematoma, 5 of which underwent mesh repairs. Finally, four patients developed seroma (BMI 48, defects 5 cm, laparoscopic mesh repair).Synchronous VHR and BS in a bariatric unit is feasible with low recurrence rate. Laparoscopic VHR has lower complication rates than open, apart from seroma formation. Patients with diabetes have higher risk of infection.
Databáze: OpenAIRE
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