Simultaneous Ventral Hernia Repair and Panniculectomy
| Autor: | Jamie P. Levine, Vishal D. Thanik, Cara K. Black, Michael Sosin, Pierre B. Saadeh, Kareem M. Termanini |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty MEDLINE 030230 surgery Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Recurrence Excess skin medicine Panniculectomy Humans Hernia Young adult Herniorrhaphy Aged Aged 80 and over business.industry Ventral hernia repair Abdominoplasty Middle Aged medicine.disease Hernia Ventral digestive system diseases Surgery stomatognathic diseases Treatment Outcome surgical procedures operative medicine.anatomical_structure 030220 oncology & carcinogenesis Meta-analysis Female Epidemiologic Methods business Subcutaneous tissue |
| Zdroj: | Plastic and Reconstructive Surgery. 145:1059-1067 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000006677 |
| Popis: | Simultaneous ventral hernia repair and panniculectomy (SVHRP) is a procedure that is more commonly being offered to patients with excess skin and subcutaneous tissue in need of a ventral hernia repair; however, there are concerns about surgical-site complications and uncertainty regarding the durability of repair. SVHRP outcomes vary within the literature. This study assessed the durability, complication profile, and safety of SVHRP through a large data-driven repository of SVHRP cases.360 METHODS:: The current SVHRP literature was queried using the MEDLINE, PubMed, and Cochrane databases. Predefined selection criteria resulted in 76 relevant titles yielding 16 articles for analysis. Meta-analysis was used to analyze primary outcomes, identified as surgical-site occurrence and hernia recurrence. Secondary outcomes included review of techniques used and systemic complications, which were analyzed with pooled weighted mean analysis from the collected data.There were 917 patients who underwent an SVHRP (mean age, 52.2 ± 7.0 years; mean body mass index, 36.1 ± 5.8 kg/m; mean pannus weight, 3.2 kg). The mean surgical-site occurrence rate was 27.9 percent (95 percent CI, 15.6 to 40.2 percent; I = 70.9 percent) and the mean hernia recurrence rate was 4.9 percent (95 percent CI, 2.4 to 7.3 percent; I = 70.1 percent). Mean follow-up was 17.8 ± 7.7 months. The most common complications were superficial surgical-site infection (15.8 percent) and seroma formation (11.2 percent). Systemic complications were less common (7.8 percent), with a thromboembolic event rate of 1.2 percent. The overall mortality rate was 0.4 percent.SVHRP is associated with a high rate of surgical-site occurrence, but surgical-site infection seems to be less prominent than previously anticipated. The low hernia recurrence rate and the safety of this procedure support its current implementation in abdominal wall reconstruction. |
| Databáze: | OpenAIRE |
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