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 |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Sleeve gastrectomy medicine.medical_specialty medicine.medical_treatment Gastric Bypass 03 medical and health sciences Postoperative Complications 0302 clinical medicine Hematoma Gastrectomy Recurrence medicine Humans Hernia Herniorrhaphy Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged medicine.disease Hernia Ventral United Kingdom Obesity Morbid Surgery Treatment Outcome surgical procedures operative Diabetes Mellitus Type 2 030220 oncology & carcinogenesis Concomitant Seroma Female Laparoscopy 030211 gastroenterology & hepatology business Complication Abdominal surgery |
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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