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Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications.

Publication ,  Journal Article
Papageorge, CM; Funk, LM; Poulose, BK; Phillips, S; Rosen, MJ; Greenberg, JA
Published in: Surg Endosc
November 2017

BACKGROUND: Laparoscopic ventral hernia repair (LVHR) is associated with decreased wound morbidity compared to open repair. It remains unclear whether primary fascial closure (PFC) offers any benefit in reducing postoperative seroma compared to bridged repair. We hypothesized that PFC would have no effect on seroma formation following LVHR. METHODS: A retrospective cohort study was performed using data from the prospectively maintained Americas Hernia Society Quality Collaborative. All patients undergoing LVHR from 2013 to 2016 were included. The primary outcome was seroma formation, diagnosed either clinically or radiographically. Secondary outcomes included surgical site infections (SSI), surgical site occurrences (SSO), and SSO requiring intervention. Patient characteristics and outcomes were compared between groups with univariate analysis using Pearson's chi-squared or Wilcoxon tests. Multivariable logistic regression controlling for patient and hernia characteristics was then performed to investigate the independent effect of PFC on seroma formation. RESULTS: 1280 patients were included in the study. 69% (n = 887) underwent PFC. Patients undergoing bridged repairs had slightly larger defects and were more likely to have a recurrent hernia. The overall rate of seroma formation was 10.4% (n = 133). There was no association on univariate analysis between PFC and wound complications. Similarly, on multivariable analysis, PFC had no significant effect on the risk of seroma formation (OR 0.87, 95% CI 0.58-1.31). CONCLUSIONS: PFC does not decrease the risk of short-term wound complications. Given that prior studies have also suggested no difference in hernia recurrence, PFC does not appear to improve postoperative outcomes for patients undergoing LVHR.

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Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

November 2017

Volume

31

Issue

11

Start / End Page

4551 / 4557

Location

Germany

Related Subject Headings

  • Treatment Outcome
  • Surgical Wound Infection
  • Surgery
  • Seroma
  • Retrospective Studies
  • Registries
  • Recurrence
  • Middle Aged
  • Male
  • Logistic Models
 

Citation

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ICMJE
MLA
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Papageorge, C. M., Funk, L. M., Poulose, B. K., Phillips, S., Rosen, M. J., & Greenberg, J. A. (2017). Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications. Surg Endosc, 31(11), 4551–4557. https://doi.org/10.1007/s00464-017-5515-z
Papageorge, Christina M., Luke M. Funk, Benjamin K. Poulose, Sharon Phillips, Michael J. Rosen, and Jacob A. Greenberg. “Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications.Surg Endosc 31, no. 11 (November 2017): 4551–57. https://doi.org/10.1007/s00464-017-5515-z.
Papageorge CM, Funk LM, Poulose BK, Phillips S, Rosen MJ, Greenberg JA. Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications. Surg Endosc. 2017 Nov;31(11):4551–7.
Papageorge, Christina M., et al. “Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications.Surg Endosc, vol. 31, no. 11, Nov. 2017, pp. 4551–57. Pubmed, doi:10.1007/s00464-017-5515-z.
Papageorge CM, Funk LM, Poulose BK, Phillips S, Rosen MJ, Greenberg JA. Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications. Surg Endosc. 2017 Nov;31(11):4551–4557.
Journal cover image

Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

November 2017

Volume

31

Issue

11

Start / End Page

4551 / 4557

Location

Germany

Related Subject Headings

  • Treatment Outcome
  • Surgical Wound Infection
  • Surgery
  • Seroma
  • Retrospective Studies
  • Registries
  • Recurrence
  • Middle Aged
  • Male
  • Logistic Models