Postoperative Outcomes in Obese Patients That Undergo Ventral Hernia Repair versus Ventral Hernia Repair with Concurrent Panniculectomy
| Autor: | Colton H.L. McNichols, Michael P. Grant, Ronald P. Silverman, Yuanyuan Liang, Sara AlFadil, Jennifer Bai, Yvonne M. Rasko, Silviu C. Diaconu, Arthur J. Nam |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Panniculitis 030230 surgery Panniculus Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Panniculectomy Humans Obesity Herniorrhaphy Aged Retrospective Studies Aged 80 and over business.industry Ventral hernia repair Abdominoplasty Retrospective cohort study Middle Aged medicine.disease Hernia Ventral Surgery Treatment Outcome Hernia recurrence Clinical question 030220 oncology & carcinogenesis Ventral hernia Female business |
| Zdroj: | Plastic and Reconstructive Surgery. 143:1211-1219 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000005471 |
| Popis: | BACKGROUND The safety of concurrent panniculectomy during ventral hernia repair remains a widely debated topic. This study aims to compare outcomes in obese patients who undergo ventral hernia repair with concurrent panniculectomy versus ventral hernia repair alone. METHODS An 8-year retrospective cohort study was performed on obese patients who underwent ventral hernia repair. Patients were divided into those who underwent concurrent panniculectomy and those who did not. Postoperative complications were compared between these groups. RESULTS A total of 223 patients were analyzed: 122 in the ventral hernia repair with concurrent panniculectomy group and 101 in the ventral hernia repair-only group. Median follow-up duration was 141 days. Patients in the ventral hernia repair with concurrent panniculectomy group had more surgical-site occurrences (57 percent versus 40 percent; p = 0.012). Both groups had similar rates of surgical-site occurrences that required an intervention (39 percent versus 31 percent; p = 0.179) and similar rates of hernia recurrence (23 percent versus 29 percent; p = 0.326). Multivariate analysis showed that concurrent panniculectomy increased the risk of surgical-site occurrences by two-fold; however, it did not increase the risk of surgical-site occurrences that required an intervention. CONCLUSIONS The addition of a panniculectomy to ventral hernia repair increases surgical-site occurrences but does not increase complications that require an intervention. As such, ventral hernia repair with concurrent panniculectomy can be considered in obese patients with a symptomatic panniculus who wish to have a single-stage operation and the lifestyle benefits of a panniculectomy. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III. |
| Databáze: | OpenAIRE |
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