Outcomes of Ventral Hernia Repair with Concomitant Panniculectomy

Colton H.L. McNichols, Silviu DIaconu, Yuanyuan Liang, Eseigboria Ikheloa, Shivum Kumar, Saahil Kumar, Arthur Nam, Yvonne Rasko

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose Combined ventral hernia repair and panniculectomy (VHR/PAN) is controversial, and the safety profile including anticipated complications has been questioned. We present a retrospective case series review of patients from the University of Maryland Medical Center to help surgeons counsel patients on the risks and benefits of this procedure. Methods A retrospective database was collected using current procedural terminology codes for VHR/PAN. The patient-specific variables that were studied include the following: sex, body mass index (BMI), smoking, diabetes, chronic obstructive pulmonary disease, cirrhosis, immunosuppression, length of operation, acute incarcerated hernias, hernia size and location, mesh size and location, pannus weight, concomitant component separation, use of negative-pressure wound therapy, intestinal violation, follow-up duration, ventral hernia working group, history of bariatric surgery, previous hernia repair, skin dehiscence, skin necrosis, chronic wound, surgical site infection, seroma, hematoma, fascial dehiscence, hernia recurrence, unplanned return to operating room, and medical complication. Both univariate and multivariate analyses were performed to determine which factors affected the complication outcomes. Results There were 106 patients with an average age and BMI of 53 years and 39, respectively. Fifty-eight patients (54.72%) had at least 1 surgical site occurrence. Twenty-three patients (21.70%) had at least 1 repair failure. Twenty-eight patients (26.42%) had an unplanned trip back to the operating room. Seventeen patients (16.04%) had at least 1 medical complication. Conclusions The risk factors associated with developing complications are higher BMI, longer operating time, larger mesh size, larger hernia size, component separation, use of biologic mesh, chronic obstructive pulmonary disease, and intestinal violation. The use of negative-pressure wound therapy decreased complication rates, and patients with a previous hernia repair seemed to benefit the most from having a combined VHR/PAN. However, when compared with previous reports of VHR alone, VHR/PAN does seem to increase wound complications and reoperation rates.

Original languageEnglish (US)
Pages (from-to)391-394
Number of pages4
JournalAnnals of Plastic Surgery
Volume80
Issue number4
DOIs
StatePublished - Apr 1 2018
Externally publishedYes

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Abdominoplasty
Ventral Hernia
Herniorrhaphy
Hernia
Negative-Pressure Wound Therapy
Body Mass Index
Operating Rooms
Chronic Obstructive Pulmonary Disease
Current Procedural Terminology
Seroma
Surgical Wound Infection
Skin
Bariatric Surgery
Wounds and Injuries
Reoperation
Hematoma
Immunosuppression
Fibrosis
Necrosis
Multivariate Analysis

Keywords

  • complication
  • high-risk patients
  • obese
  • outcomes
  • panniculectomy
  • ventral hernia repair

ASJC Scopus subject areas

  • Surgery

Cite this

McNichols, C. H. L., DIaconu, S., Liang, Y., Ikheloa, E., Kumar, S., Kumar, S., ... Rasko, Y. (2018). Outcomes of Ventral Hernia Repair with Concomitant Panniculectomy. Annals of Plastic Surgery, 80(4), 391-394. https://doi.org/10.1097/SAP.0000000000001277

Outcomes of Ventral Hernia Repair with Concomitant Panniculectomy. / McNichols, Colton H.L.; DIaconu, Silviu; Liang, Yuanyuan; Ikheloa, Eseigboria; Kumar, Shivum; Kumar, Saahil; Nam, Arthur; Rasko, Yvonne.

In: Annals of Plastic Surgery, Vol. 80, No. 4, 01.04.2018, p. 391-394.

Research output: Contribution to journalArticle

McNichols, CHL, DIaconu, S, Liang, Y, Ikheloa, E, Kumar, S, Kumar, S, Nam, A & Rasko, Y 2018, 'Outcomes of Ventral Hernia Repair with Concomitant Panniculectomy', Annals of Plastic Surgery, vol. 80, no. 4, pp. 391-394. https://doi.org/10.1097/SAP.0000000000001277
McNichols CHL, DIaconu S, Liang Y, Ikheloa E, Kumar S, Kumar S et al. Outcomes of Ventral Hernia Repair with Concomitant Panniculectomy. Annals of Plastic Surgery. 2018 Apr 1;80(4):391-394. https://doi.org/10.1097/SAP.0000000000001277
McNichols, Colton H.L. ; DIaconu, Silviu ; Liang, Yuanyuan ; Ikheloa, Eseigboria ; Kumar, Shivum ; Kumar, Saahil ; Nam, Arthur ; Rasko, Yvonne. / Outcomes of Ventral Hernia Repair with Concomitant Panniculectomy. In: Annals of Plastic Surgery. 2018 ; Vol. 80, No. 4. pp. 391-394.
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AU - Kumar, Shivum

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N2 - Purpose Combined ventral hernia repair and panniculectomy (VHR/PAN) is controversial, and the safety profile including anticipated complications has been questioned. We present a retrospective case series review of patients from the University of Maryland Medical Center to help surgeons counsel patients on the risks and benefits of this procedure. Methods A retrospective database was collected using current procedural terminology codes for VHR/PAN. The patient-specific variables that were studied include the following: sex, body mass index (BMI), smoking, diabetes, chronic obstructive pulmonary disease, cirrhosis, immunosuppression, length of operation, acute incarcerated hernias, hernia size and location, mesh size and location, pannus weight, concomitant component separation, use of negative-pressure wound therapy, intestinal violation, follow-up duration, ventral hernia working group, history of bariatric surgery, previous hernia repair, skin dehiscence, skin necrosis, chronic wound, surgical site infection, seroma, hematoma, fascial dehiscence, hernia recurrence, unplanned return to operating room, and medical complication. Both univariate and multivariate analyses were performed to determine which factors affected the complication outcomes. Results There were 106 patients with an average age and BMI of 53 years and 39, respectively. Fifty-eight patients (54.72%) had at least 1 surgical site occurrence. Twenty-three patients (21.70%) had at least 1 repair failure. Twenty-eight patients (26.42%) had an unplanned trip back to the operating room. Seventeen patients (16.04%) had at least 1 medical complication. Conclusions The risk factors associated with developing complications are higher BMI, longer operating time, larger mesh size, larger hernia size, component separation, use of biologic mesh, chronic obstructive pulmonary disease, and intestinal violation. The use of negative-pressure wound therapy decreased complication rates, and patients with a previous hernia repair seemed to benefit the most from having a combined VHR/PAN. However, when compared with previous reports of VHR alone, VHR/PAN does seem to increase wound complications and reoperation rates.

AB - Purpose Combined ventral hernia repair and panniculectomy (VHR/PAN) is controversial, and the safety profile including anticipated complications has been questioned. We present a retrospective case series review of patients from the University of Maryland Medical Center to help surgeons counsel patients on the risks and benefits of this procedure. Methods A retrospective database was collected using current procedural terminology codes for VHR/PAN. The patient-specific variables that were studied include the following: sex, body mass index (BMI), smoking, diabetes, chronic obstructive pulmonary disease, cirrhosis, immunosuppression, length of operation, acute incarcerated hernias, hernia size and location, mesh size and location, pannus weight, concomitant component separation, use of negative-pressure wound therapy, intestinal violation, follow-up duration, ventral hernia working group, history of bariatric surgery, previous hernia repair, skin dehiscence, skin necrosis, chronic wound, surgical site infection, seroma, hematoma, fascial dehiscence, hernia recurrence, unplanned return to operating room, and medical complication. Both univariate and multivariate analyses were performed to determine which factors affected the complication outcomes. Results There were 106 patients with an average age and BMI of 53 years and 39, respectively. Fifty-eight patients (54.72%) had at least 1 surgical site occurrence. Twenty-three patients (21.70%) had at least 1 repair failure. Twenty-eight patients (26.42%) had an unplanned trip back to the operating room. Seventeen patients (16.04%) had at least 1 medical complication. Conclusions The risk factors associated with developing complications are higher BMI, longer operating time, larger mesh size, larger hernia size, component separation, use of biologic mesh, chronic obstructive pulmonary disease, and intestinal violation. The use of negative-pressure wound therapy decreased complication rates, and patients with a previous hernia repair seemed to benefit the most from having a combined VHR/PAN. However, when compared with previous reports of VHR alone, VHR/PAN does seem to increase wound complications and reoperation rates.

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