Hernia

, Volume 20, Issue 2, pp 249–256 | Cite as

Enhanced recovery after giant ventral hernia repair

  • K. K. Jensen
  • T. L. Brondum
  • H. Harling
  • H. Kehlet
  • L. N. Jorgensen
Original Article

Abstract

Purpose

Giant ventral hernia repair is associated with a high risk of postoperative morbidity and prolonged length of stay (LOS). Enhanced recovery (ERAS) measures have proved to lead to decreased morbidity and LOS after various surgical procedures, but never after giant hernia repair. The current study prospectively examined the results of implementation of an ERAS pathway including high-dose preoperative glucocorticoid, and compared the outcome with patients previously treated according to standard care (SC).

Methods

Consecutive patients who underwent giant ventral hernia repair were included. Pain, nausea and fatigue were registered prospectively in all patients treated according to ERAS, as well as continuous measurement of transcutaneous capillary oxygen saturation. Postoperative morbidity and LOS were compared between patients treated according to ERAS and a historic group treated with SC.

Results

A total of 32 patients were included. Postoperative LOS was decreased after the introduction of the ERAS pathway compared with SC (median 3.0 vs. 5.5 days, P = 0.003). Scores of pain, nausea and fatigue were low, while mean oxygen saturation during the first three postoperative days was 0.92. There were no differences when comparing readmission (5 vs. 2, P = 0.394), postoperative complications (7 vs. 4, P = 0. 458), or reoperation (5 vs. 1, P = 0.172) in ERAS versus controls.

Conclusions

The current study suggests that an ERAS pathway including preoperative high-dose glucocorticoid may lead to low scores of pain, fatigue and nausea after giant ventral hernia repair with reduced LOS compared with patients treated according to SC.

Keywords

Hernia Enhanced recovery Glucocorticoid Recovery 

Notes

Compliance with ethical standards

Conflict of interest

KJ declares no conflict of interest. TB declares no conflict of interest. HH declares no conflict of interest. HK declares no conflict of interest. LJ declares no conflict of interest.

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Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  • K. K. Jensen
    • 1
  • T. L. Brondum
    • 1
  • H. Harling
    • 1
  • H. Kehlet
    • 2
  • L. N. Jorgensen
    • 1
  1. 1.Digestive Disease Center, Bispebjerg HospitalUniversity of CopenhagenCopenhagen NVDenmark
  2. 2.Section of Surgical Pathophysiology, RigshospitaletUniversity of CopenhagenCopenhagen ØDenmark

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