Abstract:
IMPORTANCE:This study analyzes a role of laparoscopy in obese patients with ventral hernia. OBJECTIVE:To evaluate the outcomes of laparoscopic compared with open ventral hernia repair (VHR) in obese patients. DESIGN:Retrospective cohort analysis. SETTING:Nationwide hospital survey. PARTICIPANTS:Obese patients undergoing VHR from 2008 through 2009 were selected from the Nationwide Inpatient Sample database. MAIN OUTCOMES AND MEASURES:Data analysis included intraoperative and postoperative complications, length of stay, and total hospital charges. Additional patient demographics, including insurance, median income, and locations, were analyzed. RESULTS:Of the 47,661 obese patients who underwent VHR during the study period, laparoscopic VHR increased more than 4-fold, from 1547 of 23,917 (6.5%) to 6629 of 23,704 (28.0%) (P < .001). Laparoscopic VHR was associated with a lower overall complication rate (6.3% vs 13.7%; P < .001), shorter median length of stay (3 vs 4 days; P < .001), and lower mean total hospital charges ($40,387 vs $48,513; P < .001). Multivariable logistic regression analysis identified a predictive variable for laparoscopic VHR: private insurance (odds ratio, 1.20; 95% CI, 1.15-1.27; P < .001). Ventral hernias with a gangrenous bowel were less likely to undergo laparoscopic VHR (odds ratio, 0.14; 95% CI, 0.06-0.34; P < .001). CONCLUSIONS AND RELEVANCE:In the era of laparoscopy, the overall use of laparoscopic VHR in obese patients has increased significantly and appears to be safe, with a shorter stay and a lower cost of care.
journal_name
JAMA Surgjournal_title
JAMA surgeryauthors
Lee J,Mabardy A,Kermani R,Lopez M,Pecquex N,McCluney Adoi
10.1001/jamasurg.2013.1395subject
Has Abstractpub_date
2013-08-01 00:00:00pages
723-6issue
8eissn
2168-6254issn
2168-6262pii
1696120journal_volume
148pub_type
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