• Hernia · Jun 2008

    Comparative Study

    Laparoscopic ventral hernia repair (LVHR) in morbidly obese patients.

    • Z Tsereteli, B A Pryor, B T Heniford, A Park, G Voeller, and B J Ramshaw.
    • One Hospital Drive, University of Missouri-Columbia, DC075.00, Columbia, MO 65212, USA. ztsereteli@hotmail.com
    • Hernia. 2008 Jun 1;12(3):233-8.

    ObjectiveThe aim of this study was to evaluate our experience with LVHR in morbidly obese patients (BMI >40) and to compare their outcomes to those of patients with lower BMI.MethodsData on adult (>18 years old) patients who underwent LVHR with mesh over the last 13 years performed by four experienced surgeons were collected retrospectively and from a previously collected database. Of the 1,071 patients, 901 had completed LVHR and were available for follow-up. One hundred and thirty-four patients (group A) met BMI criteria for morbid obesity (>or=40, mean 46), 767 patients had BMI < 40, mean 30 (group B). The follow-up time ranged from 1 to 91 months. The Wilcoxon rank sum test was used for nonparametric data analysis. Outcomes were stratified on the follow up time and analyzed using Cochran-Mantel-Haenszel methodology.ResultsThe groups did not differ in terms of ASA score, previous surgery and conversion rate (p=0.22, 0.32 and 0.23). Morbidly obese patients were younger (48.3 vs. 54; p<0.01) and were more often female (p=0.02), but this did not correlate with outcome. Group A also had longer operative time (154 vs. 119 min, p<0.01) and hospital stay (3.6 vs. 2.4 days, p=0.03). Mesh size was significantly larger in group A (449 vs. 349 cm(2), p=002). During mean follow-up time of 19 months hernia recurrence was 8.3% in group A and 2.9% in group B (p=0.003), with an odds ratio of 4.3 (95% CI 1.9-9.9). However, there was no significant difference in the rate of complications (19.7 vs. 15.3%; p=0.46).ConclusionsLVHR in the morbidly obese population is both safe and feasible, although there is a higher, but still acceptable recurrence rate. Despite the increased risk for recurrence, LVHR in morbidly obese patients minimizes the potential wound and mesh complications that frequently occur for open mesh repair in this group of patients.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…