Ventral Hernia Repairs: 10-Year Single-Institution Review at Thomas Jefferson University Hospital

Sailes, Frederick C.; Walls, Jason D.; Guelig, Daria; Mirzabeigi, Mike; Long, William D.; Crawford, Albert; Moore, J. H.; Copit, Steven E.; Tuma, Gary A.; Fox, James W.

doi:10.1016/j.jamcollsurg.2010.08.021

Cited by 26 publications

(14 citation statements)

References 12 publications

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“…[4][5][6] Mean age of occurrence of incisional hernia in present study was 48.3 years which is earlier as compared to mean age of western studies and is consistent with Indian studies. [5][6][7] Incisional hernias were commonly observed in females in present study which is quite consistent with studies from Indian sub-continent. [8][9][10][11] Multiparity was one of the major risk factor observed in present study.…”

Section: Discussionsupporting

confidence: 91%

Incisional hernia: predictive factors, clinical presentation and management

2019

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Background: Incisional hernia is an iatrogenic complication of abdominal surgery and an important cause of morbidity. It occurs in 11-20% of the patients after abdominal surgery. The present study aimed to evaluate predictive factors associated with causation of incisional hernia, clinical presentation, modalities of management and their post-operative complications.Methods: In a hospital based observational study, the subjects were diagnosed cases of incisional hernias with or without comorbidities undergoing planned or emergency surgeries. Patients unfit for anaesthesia were excluded. Predictive factors studied were multiparity, obesity, diabetes mellitus, postoperative wound infection, retention of urine and cough. Time of onset of incisional hernia after initial abdominal surgery, type of abdominal incision was recorded. Local examination of hernia was done to record the position, size, cough impulse, and reducibility of hernia. Patients were either managed by open or laparoscopic approach which was compared with respect to post-repair complications and recurrence.Results: Total of 64 patients were enrolled with mean age of 48.3 and SD ± 8.82 years. Incisional hernia was more common in middle-aged patients (31-50 yrs) and in females. Majority of hernias have occurred within one year (73.43%) of previous surgery. Commonest predictive factors were midline high BMI (87.5%), multiparity (64.06%), infraumbilical incision (59.37%) and postoperative surgical site infection (56.25%). Laparoscopic repair was done in 5 patients (7.83%) and was not associated with any complications while in rest 59 patients (92.17%) treated by open repair, seroma and SSI were common complications. On mean follow up of 34.8months there was 1 recurrence observed in open onlay repair.Conclusions:Middle age females with multiparity with BMI>25 having midline infraumbilical incision with history of SSI commonly developed incisional hernia in first year of previous surgery. Laparoscopic repair had no complications or recurrence.

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Section: Discussionsupporting

confidence: 91%

Incisional hernia: predictive factors, clinical presentation and management

2019

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“…Much of our understanding of the disease process pertains to the subsequent management of hernia and risk factors for hernia recurrence after repair. 20 Increased understanding of hernia repair has been the primary, and arguably sole, focus in advancing the treatment of this disease process.…”

Section: Discussionmentioning

confidence: 99%

A Risk Model and Cost Analysis of Incisional Hernia After Elective, Abdominal Surgery Based Upon 12,373 Cases

et al. 2016

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Objectives:Incisional hernia (IH) remains a common, highly morbid, and costly complication. Modest progress has been realized in surgical technique and mesh technology; however, few advances have been achieved toward understanding risk and prevention. In light of the increasing emphasis on prevention in today's health care environment and the billions in costs for surgically treated IH, greater focus on predictive risk models is needed.Methods:All patients undergoing gastrointestinal or gynecologic procedures from January 1, 2005 to June 1, 2013, within the University of Pennsylvania Health System were identified. Comorbidities and operative characteristics were assessed. The primary outcome was surgically treated IH after index procedures. Patients with prior hernia, less than 1-year follow-up, or emergency surgical procedures were excluded. Cox hazard regression modeling with bootstrapped validation, risk factor stratification, and assessment of model performance were conducted.Results:A total of 12,373 patients with a 3.5% incidence of surgically treated IH (follow-up 32.2 ± 26.6 months) were identified. The cost of surgical treatment of IH and management of associated complications exceeded $17.5 million. Notable independent risk factors for IH were ostomy reversal (HR = 2.76), recent chemotherapy (HR = 2.04), bariatric surgery (HR = 1.78), smoking history (HR = 1.74), liver disease (HR = 1.60), and obesity (HR = 1.96). High-risk patients (20.6%) developed IH compared with 0.5% of low-risk patients (C-statistic = 0.78).Conclusions:This study demonstrates an internally validated preoperative risk model of surgically treated IH after 12,000 elective, intra-abdominal procedures to provide more individualized risk counseling and to better inform evidence-based algorithms for the role of prophylactic mesh.

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“…All these positive effects of PC mesh make us to choose it to repair the large abdominal defect of our case. Porcine-derived biomaterials have typically been used to repair ventral hernias in clinic and experimental studies [13]. …”

Section: Discussionmentioning

confidence: 99%

Instant Abdominal Wall Reconstruction with Biologic Mesh following Resection of Locally Advanced Colonic Cancer

Kaya

Olcucuoglu

Şeker

et al. 2012

Case Reports in Medicine

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We present a case of immediate abdominal wall reconstruction with biologic mesh following the resection of locally advanced colonic cancer. The tumor in the right colon did not respond to neoadjuvant chemotherapy. Surgical enbloc excision, including excision of the invasion in the abdominal wall, was achieved, and the defect was reconstructed with porcine dermal collagen mesh. The patient was discharged with no complication, and adaptation of the mesh was excellent at the six-month followup.

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Ventral Hernia Repairs: 10-Year Single-Institution Review at Thomas Jefferson University Hospital

Cited by 26 publications

References 12 publications

Incisional hernia: predictive factors, clinical presentation and management

Incisional hernia: predictive factors, clinical presentation and management

A Risk Model and Cost Analysis of Incisional Hernia After Elective, Abdominal Surgery Based Upon 12,373 Cases

Instant Abdominal Wall Reconstruction with Biologic Mesh following Resection of Locally Advanced Colonic Cancer

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