Modifiable comorbidities impact on ventral hernia recurrence following robotic abdominal wall reconstruction using resorbable biosynthetic mesh: 36-month follow-up.
Abdominal, wall
Comorbidity
Hernia, abdominal
Obesity
Postoperative complications
Robotics
Journal
Surgery open science
ISSN: 2589-8450
Titre abrégé: Surg Open Sci
Pays: United States
ID NLM: 101768812
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
18
05
2023
revised:
28
06
2023
accepted:
16
07
2023
medline:
3
8
2023
pubmed:
3
8
2023
entrez:
3
8
2023
Statut:
epublish
Résumé
There is an ongoing debate on the role of comorbidities in hernia outcomes, particularly with minimally invasive approaches. This study evaluated the impact of modifiable comorbidities (MCMs) on 36-month hernia recurrence rates after robotic transversus abdominis release (TAR) with resorbable biosynthetic mesh underlay for primary ventral hernia repair. A review of medical records for patients who underwent the robotic TAR procedure between January 2015 and May 2022 performed by a single surgeon was conducted. Patients were separated into three groups: those with 0, 1, and 2+ MCMs, followed by a breakdown of comorbidity types and combinations of comorbidities. MCMs included obesity, diabetes, and tobacco use. The primary outcomes included hernia recurrence at 36 months and the time between surgery and recurrence. 175 patients met the inclusion criteria, with a mean hernia diameter of 12.9 ± 5.4 cm and a mean BMI of 34 ± 8 kg/m The presence of MCMs, either alone or in combination with another, did not significantly increase the odds of hernia recurrence at 36 months following ventral hernia repair using this approach. Future studies with larger sample sizes and multiple surgeons are needed to corroborate this data. Modifiable comorbidities have previously been shown to increase the risk of hernia recurrence after ventral hernia repair. Our study found relatively low rates of hernia recurrence and no significantly increased odds of recurrence among different comorbid groups at 36-month follow-up following robotic transversus abdominis release with resorbable biosynthetic mesh underlay.
Sections du résumé
Background
UNASSIGNED
There is an ongoing debate on the role of comorbidities in hernia outcomes, particularly with minimally invasive approaches. This study evaluated the impact of modifiable comorbidities (MCMs) on 36-month hernia recurrence rates after robotic transversus abdominis release (TAR) with resorbable biosynthetic mesh underlay for primary ventral hernia repair.
Methods
UNASSIGNED
A review of medical records for patients who underwent the robotic TAR procedure between January 2015 and May 2022 performed by a single surgeon was conducted. Patients were separated into three groups: those with 0, 1, and 2+ MCMs, followed by a breakdown of comorbidity types and combinations of comorbidities. MCMs included obesity, diabetes, and tobacco use. The primary outcomes included hernia recurrence at 36 months and the time between surgery and recurrence.
Results
UNASSIGNED
175 patients met the inclusion criteria, with a mean hernia diameter of 12.9 ± 5.4 cm and a mean BMI of 34 ± 8 kg/m
Conclusion
UNASSIGNED
The presence of MCMs, either alone or in combination with another, did not significantly increase the odds of hernia recurrence at 36 months following ventral hernia repair using this approach. Future studies with larger sample sizes and multiple surgeons are needed to corroborate this data.
Key message
UNASSIGNED
Modifiable comorbidities have previously been shown to increase the risk of hernia recurrence after ventral hernia repair. Our study found relatively low rates of hernia recurrence and no significantly increased odds of recurrence among different comorbid groups at 36-month follow-up following robotic transversus abdominis release with resorbable biosynthetic mesh underlay.
Identifiants
pubmed: 37533880
doi: 10.1016/j.sopen.2023.07.012
pii: S2589-8450(23)00044-1
pmc: PMC10392596
doi:
Types de publication
Journal Article
Langues
eng
Pagination
60-65Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ms. Skoczek reported no declarations of interest. Mr. Ruane reported no declarations of interest. Dr. Fernandez disclosed receiving honoraria from BD.
Références
World J Surg. 2016 Jan;40(1):89-99
pubmed: 26423675
JAMA Surg. 2013 Mar;148(3):259-63
pubmed: 23552714
Am J Surg. 2012 Nov;204(5):709-16
pubmed: 22607741
Hernia. 2021 Dec;25(6):1471-1480
pubmed: 34491460
Hernia. 2021 Aug;25(4):1071-1082
pubmed: 34031762
Hernia. 2019 Apr;23(2):375-385
pubmed: 30771032
J Am Coll Surg. 2022 Dec 1;235(6):894-904
pubmed: 36102523
Surgery. 2013 Jan;153(1):120-5
pubmed: 22862901
J Surg Res. 2016 Nov;206(1):214-222
pubmed: 27916364
Robot Surg. 2017 May 05;4:57-67
pubmed: 30697564
Hernia. 2021 Apr;25(2):305-312
pubmed: 31776878
Surgery. 2019 Jul;166(1):94-101
pubmed: 31097319
Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006438
pubmed: 18646155
Trials. 2013 Oct 28;14:357
pubmed: 24165473
Surg Endosc. 2017 Jan;31(1):341-351
pubmed: 27287900
Int J Surg. 2015 Aug;20:65-74
pubmed: 26074289
Ann Med Surg (Lond). 2020 Dec 15;61:1-7
pubmed: 33363718
Am J Robot Surg. 2015 Dec;2(1):22-26
pubmed: 27419223
Hernia. 2012 Apr;16(2):179-83
pubmed: 21904861