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04-12-2023 | Inguinal Hernia

Variability in surgical approaches to hernias in patients with ascites

Authors: Devon E. Cassidy, Zhihong Shao, Ryan Howard, Michael J. Englesbe, Justin B. Dimick, Dana A. Telem, Anne P. Ehlers

Published in: Surgical Endoscopy | Issue 2/2024

Abstract

Background

Hernias in patients with ascites are common, however we know very little about the surgical repair of hernias within this population. The study of these repairs has largely remained limited to single center and case studies, lacking a population-based study on the topic.

Study design

The Michigan Surgical Quality Collaborative and its corresponding Core Optimization Hernia Registry (MSQC-COHR) which captures specific patient, hernia, and operative characteristics at a population level within the state was used to conduct a retrospective review of patients with ascites undergoing ventral or inguinal hernia repair between January 1, 2020 and May 3, 2022. The primary outcome observed was incidence and surgical approach for both ventral and inguinal hernia cohorts. Secondary outcomes included 30-day adverse clinical outcomes as listed here: (ED visits, readmission, reoperation and complications) and surgical priority (urgent/emergent vs elective).

Results

In a cohort of 176 patients with ascites, surgical repair of hernias in patients with ascites is a rare event (1.4% in ventral hernia cohort, 0.2% in inguinal hernia cohort). The post-operative 30-day adverse clinical outcomes in both cohorts were greatly increased compared to those without ascites (ventral: 32% inguinal: 30%). Readmission was the most common complication in both inguinal (n = 14, 15.9%) and ventral hernia (n = 17, 19.3%) groups. Although open repair was most common for both cohorts (ventral: 86%, open: 77%), minimally invasive (MIS) approaches were utilized. Ventral hernias presented most commonly urgently/emergently (60%), and in contrast many inguinal hernias presented electively (72%).

Conclusion

A population-level, ventral and incisional hernia database capturing operative details for 176 patients with ascites. There was variation in the surgical approaches performed for this rare event and opportunities for optimization in patient selection and timing of repair.

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Title: Variability in surgical approaches to hernias in patients with ascites
Authors: Devon E. Cassidy
Zhihong Shao
Ryan Howard
Michael J. Englesbe
Justin B. Dimick
Dana A. Telem
Anne P. Ehlers
Publication date: 04-12-2023
Publisher: Springer US
Keywords: Inguinal Hernia
Ascites
Published in: Surgical Endoscopy / Issue 2/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10598-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Variability in surgical approaches to hernias in patients with ascites

Abstract

Background

Study design

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Study design

Results

Conclusion

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