Obesity is a risk factor for recurrence after incisional hernia repair

Sauerland, Stefan; Korenkov, Michael; Kleinen, T.; Arndt, M.; Paul, Andreas

doi:10.1007/s10029-003-0161-x

Cited by 216 publications

(90 citation statements)

References 20 publications

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“…Similarly, obesity was confirmed as a prognostic variable [23]. Contrary to common belief [1], however, this study also found that young age is independently associated with incisional hernia recurrence.…”

Section: Discussioncontrasting

confidence: 83%

Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up

Sauerland

Schmedt

Lein

et al. 2005

Langenbecks Arch Surg

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Section: Discussioncontrasting

confidence: 83%

Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up

Sauerland

Schmedt

Lein

et al. 2005

Langenbecks Arch Surg

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“…First, ventral hernia should be repaired by mesh implantation under the same anaesthesia, as this reduces the risk of bowel ischemia (EL 2b [89,286]). Second, cholecystectomy has been proposed for all patients (with or without gallstones) at the time of surgery (EL 4 [3,8,50,99,290]), because obesity surgery furthers postoperative gallstone formation and necessitates cholecystectomy in about 10% of patients following RYGB (EL 4 [3,8,73,305,306]).…”

Section: General Aspectmentioning

confidence: 99%

Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

Sauerland

Angrisani

Belachew³

et al. 2004

Surg Endosc

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280

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After the patient's multidisciplinary evaluation, obesity surgery should be considered in adults with a documented BMI greater than or equal to 35 and related comorbidity, or a BMI of at least 40. In addition to standard laboratory testing, chest radiography, electrocardiography, spirometry, and abdominal ultrasonography, the preoperative evaluation of obesity surgery patients also includes upper gastrointestinal endoscopy or radiologic evaluation with a barium meal. Psychiatric consultation and polysomnography can safely be restricted to patients with clinical symptoms on preoperative screening. Adjustable gastric banding (GB), vertical banded gastroplasty (VBG), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure therefore should be tailored to the individual situation. There is evidence that a laparoscopic approach is advantageous for LAGB, VBG, and GB (and probably also for BPD). Antibiotic and antithromboembolic prophylaxis should be used routinely. Patients should be seen 3 to 8 times during the first postoperative year, 1 to 4 times during the second year and once or twice a year thereafter. Outcome assessment after surgery should include weight loss and maintainance, nutritional status, comorbidities and quality-of-life.

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“…Several authors have recognized that obesity hinders the healing process in a number of types of tissue [12][13][14] .Operations to repair incisional hernias range from simple syntheses to prosthesis. Sauerland et al 15 . report that obesity is an important factor in the repair of incisional hernias.…”

Section: Introductionmentioning

confidence: 99%

Obesity and abdominal wound healing in rats

et al. 2010

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Introduction: Treatment for obesity essentially has to do with weight loss, which can be achieved through surgical procedures. Despite the considerable rise in the number of such procedures, the relationship between obesity and the healing process has not been totally clarified. Purpose: To investigate abdominal wound healing in obese Wistar rats on the seventh and fourteenth days following a laparotomy. Methods: Thirty-six Wistar rats were randomly distributed into two groups, the control and experiment group. The control group were fed on either a standard diet for the species and the experiment group were put on a high calorie diet. After 116 days, all the animals were submitted to a laparotomy followed by laparorrhaphy. After euthanasia on the seventh or fourteenth day, fragments of the abdominal wound containing the scar were submitted to histopathological and tensiometric analysis. Results: The average weight of the animals from the experiment group was higher than that of the control group (p<0.001). The difference in the resistance of the cutaneous scars was not significant. The aponeurotic scars were more resistant in the control group after seven days (p=0.011) and fourteen days (p=0.040). There was no difference in terms of intensity of the inflammatory reaction and the collagen density was similar in both groups. Conclusion: In rats, obesity lowered the resistance of the aponeurotic scars but not the skin scars. It did not interfere with the delayed inflammatory response and the collagen density. Key words: Wound Healing. Obesity. Collagen. Rats. RESUMO Introdução:O tratamento da obesidade é baseado essencialmente na perda de peso, e isto pode ser conseguido por meio de procedimentos cirúrgicos. Apesar do grande aumento no número destes procedimentos, a relação entre obesidade e o processo de cicatrização ainda não está totalmente elucidada. Objetivo: Investigar a cicatrização da parede abdominal de ratos Wistar obesos, sete e 14 dias após laparotomia. Métodos: Ratos Wistar, em número de 36 foram alocados em dois grupos, controle e experimento. Os do grupo controle receberam dieta padrão para a espécie e os do experimento dieta hipercalórica. Depois de 116 dias, todos os animais foram submetidos à laparotomia seguida de laparorrafia. Após a eutanásia com sete ou 14 dias, fragmentos da parede abdominal contendo a cicatriz receberam análise histopatológica e tensiométrica. Resultados: O peso médio dos animais do grupo experimento foi maior do que o do grupo controle (p<0,001). A diferença da resistência das cicatrizes cutâneas não foi significante. As cicatrizes aponeuróticas foram mais resistentes no grupo controle aos sete dias (p=0,011) e aos 14 dias (p=0,040). Não houve diferença quanto à intensidade da reação inflamatória e a densidade de colágeno foi semelhante nos dois grupos. Conclusão: Em ratos, a obesidade diminuiu a resistência das cicatrizes aponeuróticas, mas não a das cicatrizes da pele. Não interferiu na reação inflamatória tardia e nem na densidade do colágeno. Descritores: Cica...

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Obesity is a risk factor for recurrence after incisional hernia repair

Abstract: This and other studies found hernia recurrence to be more likely in obese patients. Probably, such patients, therefore, should receive mesh rather than suture repair.

Cited by 216 publications

References 20 publications

Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up

Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up

Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

Obesity and abdominal wound healing in rats

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