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01-06-2013

Postoperative surgical site infections after ventral/incisional hernia repair: a comparison of open and laparoscopic outcomes

Authors: Christodoulos Kaoutzanis, Stefan W. Leichtle, Nicolas J. Mouawad, Kathleen B. Welch, Richard M. Lampman, Robert K. Cleary

Published in: Surgical Endoscopy | Issue 6/2013

Abstract

Background

The purpose of this study was to compare the incidence of postoperative surgical site infections (SSIs), operative times (OTs), and length of hospital stay (LOS) after open and laparoscopic ventral/incisional hernia repair (VIHR) using multicenter, prospectively collected data.

Methods

The incidence of postoperative SSIs, OTs, and LOS was determined for cases of VIHR in the American College of Surgeons’ National Surgical Quality Improvement Program database in 2009 and 2010. Open and laparoscopic techniques were compared using a propensity score model to adjust for differences in patient demographics, characteristics, comorbidities, and laboratory values.

Results

A total of 26,766 cases met the inclusion criteria; 21,463 cases were open procedures (reducible, n = 15,520 [72 %]; incarcerated/strangulated, n = 5,943 [28 %]), and 5,303 cases were laparoscopic procedures (reducible, n = 3,883 [73 %]; incarcerated/strangulated, n = 1,420 [27 %]). Propensity score adjusted odds ratios (ORs) were significantly different between open and laparoscopic VIHR for reducible and incarcerated/strangulated hernias with regard to superficial SSI (OR 5.5, p < 0.01 and OR 3.1, p < 0.01, respectively), deep SSI (OR 6.9, p < 0.01, and OR 8.0, p < 0.01, respectively) and wound disruption (OR 4.6, p < 0.01 and OR 9.3, p = 0.03, respectively). The risk for organ/space SSI was significantly greater for open operations among reducible hernias (OR 1.9, p = 0.02), but there was no significant difference between the open and laparoscopic repair groups for incarcerated/strangulated hernias (OR 0.8, p = 0.41). The OT was significantly longer for laparoscopic procedures, both for reducible (98.5 vs. 84.9 min, p < 0.01) and incarcerated/strangulated hernias (96.4 vs. 81.2 min, p < 0.01). LOS (mean, 95 % confidence interval) was significantly longer for open repairs for both reducible (open = 2.79, 2.59–3.00; laparoscopic = 2.39, 2.20–2.60; p < 0.01) and incarcerated/strangulated (open = 2.64, 2.55–2.73; laparoscopic = 2.17, 2.02–2.33; p < 0.01) hernias.

Conclusions

Laparoscopic VIHR for reducible and incarcerated/strangulated hernias is associated with shorter LOS and decreased risk for superficial SSI, deep SSI, and wound disruption, but longer OTs when compared to open repair.

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Title: Postoperative surgical site infections after ventral/incisional hernia repair: a comparison of open and laparoscopic outcomes
Authors: Christodoulos Kaoutzanis
Stefan W. Leichtle
Nicolas J. Mouawad
Kathleen B. Welch
Richard M. Lampman
Robert K. Cleary
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 6/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-012-2743-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postoperative surgical site infections after ventral/incisional hernia repair: a comparison of open and laparoscopic outcomes

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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