Defining surgical outcomes and quality of life in massive ventral hernia repair: an international multicenter prospective study

Abstract Background Our goal was to set criteria for massive ventral hernia and to compare surgical outcomes and quality of life after ventral hernia repair (VHR). Methods The International Hernia Mesh Registry was queried for patients undergoing VHR from 2007 to 2013. Defect was categorized as mass...

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Bibliographic Details
Published in:The American journal of surgery 2015-11, Vol.210 (5), p.801-813
Main Authors: Ross, Samuel W., M.D., M.P.H, Wormer, Blair A., M.D, Kim, Mimi, M.D., F.A.C.S, Oommen, Bindhu, M.D., M.P.H, Bradley, Joel F., M.D, Lincourt, Amy E., M.B.A., Ph.D, Augenstein, Vedra A., M.D., F.A.C.S, Heniford, B. Todd, M.D., F.A.C.S
Format: Article
Language:English
Subjects:
Abdominal wall reconstruction
Carolinas Comfort Scale
Confidence intervals
Defects
Europe - epidemiology
Female
Hematoma - epidemiology
Hernia defect size
Hernia, Ventral - epidemiology
Hernia, Ventral - surgery
Hernias
Humans
International Hernia Mesh Registry
Laparoscopy
Length of Stay - statistics & numerical data
Male
Middle Aged
Mobility Limitation
Multivariate analysis
North America - epidemiology
Operative Time
Pain
Pain Measurement
Patients
Pneumonia - epidemiology
Postoperative Complications - epidemiology
Prospective Studies
Quality of Life
Questionnaires
Registries
Severity of Illness Index
Studies
Surgery
Surgical Mesh
Surgical outcomes
Ventral hernia repair
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Summary:Abstract Background Our goal was to set criteria for massive ventral hernia and to compare surgical outcomes and quality of life after ventral hernia repair (VHR). Methods The International Hernia Mesh Registry was queried for patients undergoing VHR from 2007 to 2013. Defect was categorized as massive if the width or length was greater than 15 cm or area greater than 150 cm2 . Massive VHR was compared to regular VHR. Results A total of 878 patients underwent VHR: 436 open, 442 laparoscopic with 13 deaths (1.5%) and 45 hernia recurrences (5.1%). Of those, 158 patients (18%) met criteria for massive VHR. Massive VHR patients had longer length of stay (LOS) and operative time and more hematomas, wound infections, wound complications, and pneumonias ( P < .05). On multivariate analysis, LOS was longer, and early postoperative pain and activity limitation were greater in massive VHRs ( P < .01). Massive VHR in the laparoscopic approach resulted in greater long-term mesh sensation ( P < .01). Conclusions VHR in massive hernias have increased rates of complications and longer LOS.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.06.020