Background Few studies have examined the impact of abdominoplasty on chronic back pain. Objectives The aim of this study was to test our hypothesis that patients undergoing abdominoplasty with anterior abdominal wall plication will show significant improvements in back pain and physical function compared with those without plication. Methods We utilized Current Procedural Terminology (CPT) codes to identify patients who underwent abdominoplasty with the senior author over a 10-year period. The Oswestry Disability Index (ODI) and the RAND 36-Item Short-Form Health Survey (SF-36) were administered. All patients indicating preoperative back pain were reviewed. Results Of 338 patients, 143 surveys (42.3%) were returned; 51 patients (35.7%; n = 28 aesthetic, n = 23 massive weight loss) reported preoperative back pain on the ODI. Paired t tests compared overall and strata-specific changes in ODI and SF-36 pre- and postsurgery. Multivariable linear regression models were fitted to model relations between scores and plication, adjusting for presurgery scores and patient variables. There were significant improvements in overall patient cohort in ODI (–15.14), SF-36 physical function (19.92), and pain (17.42) (P < 0.001), as well as when patients were stratified by plication status. However, outcomes between those with plication and those without were not significantly different. Conclusions Abdominoplasty with and without anterior abdominal wall plication significantly improves ODI and SF-36 scores relating to physical function and pain, in both aesthetic and massive weight loss patients. Outcomes did not differ based on plication status. All patients with preoperative back pain showed improvement regardless of operation performed, suggesting that abdominoplasty with or without abdominal wall plication improves chronic back pain in this patient population. Level of Evidence: 4
and c) NSQIP plus hepatectomy-specific outcomes (bile leak [BL], post-hepatectomy liver failure [PHLF], and postoperative invasive intervention [INTERV]). Subgroups were compared by Chi-squared, Fisher's exact, and McNemar analyses. RESULTS: Overall rates of BL, PHLF, and INTERV were 6.0%, 4.3%, and 7.3%, respectively. Mortality was highest in patients with cholangiocarcinoma and gallbladder cancer. Overall morbidity was higher in patients with malignant than with benign lesions. Overall morbidity was significantly increased when either perioperative transfusions or hepatectomy-specific outcomes were included in the definition (p<0.001, McNemar). CONCLUSIONS: Mortality is higher in malignant than benign liver lesions and is highest in biliary malignancies. Morbidity doubles when perioperative transfusions are included in the definition and significantly increases when hepatectomy-specific outcomes are utilized. Perioperative transfusions should be considered an operative risk-factor, not an outcome. Hepatectomy-specific complications should be routinely reported.
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