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Concurrent Laparoscopic Ventral Hernia Repair with Bariatric Surgery: a Propensity-Matched Analysis

  • 2019 SSAT Plenary Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Ventral hernias are a common finding during bariatric surgery; however, the risks and benefits of repair during surgery remain unclear. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, we examined the short-term outcomes of patients undergoing bariatric surgery with concurrent ventral hernia repair (VHR) versus bariatric surgery alone.

Methods

Patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) were included. A propensity-matched analysis was performed between laparoscopic bariatric surgery with and without concurrent VHR. The primary outcome was the 30-day major complication rate which includes but is not limited to 30-day reoperation, deep surgical site infection, and sepsis. Secondary outcomes included operative time, length of hospital stay, 30-day readmission, and 30-day mortality.

Results

A total of 430,225 patients were included, of which 4690 (1.1%) received concomitant VHR. With one-to-one propensity score matching, 4648 pairs were selected. Concurrent VHR was associated with a higher major complication rate (5.8 vs 3.8%, p < 0.001) but no significant difference in mortality (0.3 vs 0.2%, p = 0.531). Both LSG with VHR (3.2 vs 2.4%, p = 0.007) and RYGB with VHR (9.3 vs 5.7%, p < 0.001) were associated with an increase in major complications.

Conclusions

Patients undergoing VHR during bariatric surgery do not experience higher mortality. However, these patients have an elevated risk of major complications with this risk being higher among patients undergoing VHR and LRYGB. Bariatric surgeons should consider these risks when choosing to perform VHR at the time of bariatric surgery.

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Notes

  1. This paper has been accepted for lecture presentation at the DDW 2019 SSAT plenary session on May 21, 2019 at the San Diego Convention Centre in San Diego, CA, USA.

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Authors and Affiliations

  1. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada

    Muhammad Moolla

  2. Department of Surgery, University of Alberta, University of Alberta Hospital, 8440 112 Street NW, Edmonton, Alberta, T6G 2B7, Canada

    Jerry Dang, Aryan Modasi, Simon Byrns, Daniel W. Birch & Shahzeer Karmali

  3. Wexner Medical Center, The Ohio State University, Columbus, OH, USA

    Noah Switzer

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Contributions

SK, DB, JD, and SB led study conceptualization with input from other authors. Data analysis and interpretation of results were performed by JD with the assistance of MM. MM and JD drafted the manuscript in consultation with AM, SB, NS, DB, and SK. All authors reviewed, suggested changes in analyses and presentation, and approved the final manuscript.

Corresponding author

Correspondence to Jerry Dang.

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Conflict of Interest

Muhammad Moolla and Drs. Dang, Modasi, Byrns, Switzer, Birch, and Karmali have no conflicts of interest or financial ties to disclose.Footnote 1

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Moolla, M., Dang, J., Modasi, A. et al. Concurrent Laparoscopic Ventral Hernia Repair with Bariatric Surgery: a Propensity-Matched Analysis. J Gastrointest Surg 24, 58–66 (2020). https://doi.org/10.1007/s11605-019-04291-0

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  • DOI: https://doi.org/10.1007/s11605-019-04291-0

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