Abstract
Background
Obesity predisposes patients to abdominal wall hernias. Patients undergoing bariatric surgery are not uncommonly found to have ventral hernias. Synchronous ventral hernia repair (S-VHR) has been reported in 2–5 % of patients undergoing bariatric surgery. Studies reporting on the outcomes of S-VHR are limited by sample size. The aim of this study was to assess the effect of S-VHR on surgical site infection (SSI) rate.
Methods
The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2010 to 2011 was queried using Current Procedural Terminology codes for bariatric surgery. Data on patient demographics, comorbidities, procedural events, and postoperative occurrences were analyzed. Thirty-day mortality and morbidity were assessed. Comparisons between laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) were performed.
Results
We identified 17,117 patients who underwent RYGB or SG. S-VHR was performed in 503 (2.94 %) patients. S-VHR was independently associated with SSI (odds ratios (OR) 1.65, 95 % confidence interval (CI) 1.06–2.58), but not overall morbidity (OR 1.33, 95 % CI 0.96–1.86). Four hundred thirty-three patients with RYGB and 70 with SG had S-VHR. Serious morbidity (3.5 vs. 5.7 %, p = 0.32) and overall morbidity (8.3 vs. 8.6 %, p = 0.942) were similar. After controlling for baseline comorbidities, there was no significant effect of procedure type on SSI (OR 0.38, 95 % CI 0.05–2.91).
Conclusions
S-VHR is associated with an increase in SSI but not overall morbidity. There is no significant difference in the SSI rate between RYGB and SG. Larger studies are needed to definitively assess a potential difference in the wound infection rate between RYGB and SG.
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Acknowledgments
Since this study was performed using de-identified nationwide data, informed consent was not obtained for the purposes of this research.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Conflict of Interest
Konstantinos Spaniolas, Keven R. Kasten, Anthony B. Mozer, Megan E. Sippey, William H.H. Chapman, Walter J. Pories, and John R. Pender IV have no conflict of interest to declare. The authors report no grant support or additional acknowledgments.
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Spaniolas, K., Kasten, K.R., Mozer, A.B. et al. Synchronous Ventral Hernia Repair in Patients Undergoing Bariatric Surgery. OBES SURG 25, 1864–1868 (2015). https://doi.org/10.1007/s11695-015-1625-7
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DOI: https://doi.org/10.1007/s11695-015-1625-7