Impact of Body Mass Index (BMI) on perioperative outcomes following minimally invasive retromuscular abdominal wall reconstruction: a comparative analysis

Addo, Alex; Lu, Richard; Broda, Andrew; George, Philip; Huerta, Nick; Park, Adrian; Zahiri, H. Reza; Belyansky, Igor

doi:10.1007/s00464-020-08069-3

Cited by 15 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As half of the US population is estimated to be obese by 2030, it is expected that more obese patients will present with a ventral hernia 3. Most of these patients might not achieve the target weight to become optimal candidates for hernia repair, which prevents them from having a better quality of life and keeps them at risk for acute incarceration and strangulation 12. In one randomized clinical trial enrolling 118 obese patients with ventral hernias, only 12 patients (20%) were able to achieve the target weight loss of 7% of total body weight even with a prehabilitation program, and only half of them were able to maintain that weight loss after 2 years 8…”

Section: Discussionmentioning

confidence: 99%

Preoperative Optimization Before Ventral Hernia Repair: A Systematic Review and Meta-analysis

Marcolin¹,

Figueiredo

Araújo³

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

Self Cite

View full text Add to dashboard Cite

Background: Obesity is associated with an increased risk of ventral hernia development and recurrence rates after ventral hernia repair (VHR). The metabolic derangements caused by obesity can also lead to many postoperative complications. Therefore, it is a common practice to attempt weight loss before VHR. However, there is still no consensus on optimal preoperative management for obese patients with a ventral hernia. This study aims to perform a metaanalysis to evaluate the effect of preoperative weight optimization on VHR outcomes. Methods:We performed a literature search of PubMed, Scopus, and Cochrane Library databases to identify studies comparing obese patients who underwent surgical or non-surgical weight loss interventions before undergoing hernia repair surgery to obese patients who underwent hernia repair surgery without prehabilitation. Postoperative outcomes were assessed by means of pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I 2 statistics.

show abstract

Section: Discussionmentioning

confidence: 99%

Preoperative Optimization Before Ventral Hernia Repair: A Systematic Review and Meta-analysis

Marcolin¹,

Figueiredo

Araújo³

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

Self Cite

View full text Add to dashboard Cite

show abstract

“…2 It is common for patients with obesity to be unsuccessful in achieving a specific BMI goal, which excludes them from improving their quality of life (QoL) with surgery and keeps them at risk for acute incarceration and strangulation. 9 In one randomized control trial that enrolled 114 obese patients with ventral hernias to prehabilitation or standard weight-loss counseling, only 20% of patients met the proposed weight loss goal of 7% total body weight during the study period. 22 Although there is a lack of studies evaluating QoL outcomes, a prospective matched study evaluating ventral hernia patients with comorbidities (including obesity) found that elective repair was associated with significant improvement in QoL scores at 6 months, better patient satisfaction, decreased pain scores.…”

Section: Discussionmentioning

confidence: 99%

“…After excluding studies that included open cases and did not compare patients with different BMIs, 11 studies with a total of 3199 patients were included. 4,9,[12][13][14][15][16][17][18][19][20] Studies characteristics are reported in Table 1. All studies included were retrospective or retrospective reviews of prospectively collected data.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Body Mass Index Effect on Minimally Invasive Ventral Hernia Repair: A Systematic Review and Meta-analysis

Mazzola Poli de Figueiredo,

Mao,

Dela Tejera

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

Self Cite

View full text Add to dashboard Cite

Purpose: Obesity is one of the most important risk factors for complications after ventral hernia repair (VHR), and minimally invasive (MIS) techniques are preferred in obese patients as they minimize wound complications. It is common practice to attempt weight loss to achieve a specific body mass index (BMI) goal; however, patients are often unable to reach it and fail to become surgical candidates. Therefore, we aim to perform a meta-analysis of studies comparing outcomes of obese and nonobese patients undergoing laparoscopic or robotic VHR. Patients and Methods: A literature search of PubMed, Scopus, and Cochrane Library databases was performed to identify studies comparing obese and nonobese patients undergoing MIS VHR. Postoperative outcomes were assessed by means of pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I 2 statistics. Results: A total of 6483 studies were screened and 26 were thoroughly reviewed. Eleven studies and 3199 patients were included in the meta-analysis. BMI >40 kg/m2 cutoff analysis included 5 studies and 1533 patients; no differences in hernia recurrence [odds ratios (OR): 1.64; 95% CI: 0.57-4.68; P = 0.36; I 2 = 47%), seroma, hematoma, and surgical site infection (SSI) rates were noted. BMI >35 kg/m2 cutoff analysis included 5 studies and 1403 patients; no differences in hernia recurrence (OR: 1.24; 95% CI: 0.71-2.16; P = 0.58; I 2 = 0%), seroma, hematoma, and SSI rates were noted. BMI >30 kg/m2 cutoff analysis included 4 studies and 385 patients; no differences in hernia recurrence (OR: 2.07; 95% CI: 0.5-8.54; P = 0.32; I 2 = 0%), seroma, hematoma, and SSI rates were noted. Conclusion: Patients with high BMI undergoing MIS VHR have similar hernia recurrence, seroma, hematoma, and SSI rates compared with patients with lower BMI. Further prospective studies with long-term follow-up and patient-reported outcomes are required to establish optimal management in obese patients undergoing VHR.

show abstract

“…For each patient with SP, we assigned one who was never diagnosed with SP via propensity score matching. The matching variables were age; sex; index year; and comorbidities including hypertension (ICD-9-CM codes 401-405) [13,14], diabetes (ICD-9-CM codes 250) [15,16], hyperlipidemia (ICD-9-CM code 272) [17] and smoking related disease (ICD-9-CM codes 305.1, 430-438, 410-414, 493 and 496) [18].…”

Section: Study Populationmentioning

confidence: 99%

Risk of diaphragmatic hernia in patients with spontaneous pneumothorax

et al. 2022

View full text Add to dashboard Cite

Background Few studies have implied the incidence of diaphragmatic hernia (DH) after spontaneous pneumothorax (SP) with unknown mechanisms. The current study aimed to identify whether there is an association between the DH and SP. Methods We selected 46,897 patients with SP (SP cohort) and 46,897 without SP (non-SP matched cohort) from the National Health Insurance Database. Patients were frequency matched according to age, sex, and index year. The incidence of DH and its association with SP were assessed after stratifying different characteristics and comorbidities. Statistical analysis including chi-square test, t-test, cox proportional hazard model, and Kaplan–Meier method were used. Results The results suggested there were significant associations between SP and DH, especially in the subgroup of patients with older age (aged 40–64 years: 2.61-fold in adjusted hazard ratio (aHR), 95% confidence interval (CI): 1.27–5.36; aged > 65 years: 1.97-fold in aHR, 95% CI 1.43–2.71), male sex (2.11-fold in aHR, 95% CI 1.56–2.85), hypertension (2.05-fold in aHR, 95% CI 1.30–3.23), diabetes mellitus (2.58-fold in aHR, 95% CI 1.37–4.86), and smoking-related disease (1.86-fold in aHR, 95% CI 1.28–2.71). The SP cohort has significantly correlated with DH within 5-year follow-up (< 2 years: 3.22-fold in aHR, 95% CI 2.10–4.94; 2–5 years: 1.70-fold in aHR, 95% CI 1.05–2.75). Conclusions The SP cohort had a higher incidence of DH than the non-SP matched cohort. A prospective study of indications based on the findings of the current research should be performed.

show abstract

Impact of Body Mass Index (BMI) on perioperative outcomes following minimally invasive retromuscular abdominal wall reconstruction: a comparative analysis

Cited by 15 publications

References 19 publications

Preoperative Optimization Before Ventral Hernia Repair: A Systematic Review and Meta-analysis

Preoperative Optimization Before Ventral Hernia Repair: A Systematic Review and Meta-analysis

Body Mass Index Effect on Minimally Invasive Ventral Hernia Repair: A Systematic Review and Meta-analysis

Risk of diaphragmatic hernia in patients with spontaneous pneumothorax

Contact Info

Product

Resources

About