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Journal of Gastrointestinal Surgery

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01-04-2008 | ssat plenery presentation

Umbilical Herniorrhapy in Cirrhosis: Improved Outcomes with Elective Repair

Authors: Stephen H. Gray, Catherine C. Vick, Laura A. Graham, Kelly R. Finan, Leigh A. Neumayer, Mary T. Hawn

Published in: Journal of Gastrointestinal Surgery | Issue 4/2008

Abstract

Objective

This study was undertaken to examine the effect of cirrhosis on elective and emergent umbilical herniorrhapy outcomes.

Methods

Procedures were identified from the Veterans’ Affairs National Surgical Quality Improvement Program at 16 hospitals. Medical records and operative reports were physician abstracted to obtain preoperative and intraoperative variables.

Results

Of the 1,421 cases reviewed, 127 (8.9%) had cirrhosis. Cirrhotics were more likely to undergo emergent repair (26.0% vs. 4.8%, p < 0.0001), concomitant bowel resection (8.7% vs. 0.8%, p < 0.0001), return to operating room (7.9% vs. 2.5%, p = 0.0006), and increased postoperative length of stay (4.0 vs. 2.0 days, p = 0.01). Best-fit regression models found cirrhosis was not a significant predictor of postoperative complications. Significant predictors of complications were emergent case (OR 5.4; 95% CI 3.1–9.4), diabetes (OR 2.1; 95% CI 1.2–3.8), congestive heart failure (OR 4.0; 95% CI 1.4–11.4), and chronic obstructive pulmonary disease (OR 2.0; 95% CI 1.1–3.6). Among emergent repairs, cirrhosis (OR 4.4; 95% CI 1.3–14.3) was strongly associated with postoperative complications.

Conclusion

Elective repair in cirrhotics is associated with similar outcomes as in patients without cirrhosis. Emergent repair in cirrhotics is associated with worse outcomes. Early elective repair may improve the overall outcomes for patients with cirrhosis.

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Title: Umbilical Herniorrhapy in Cirrhosis: Improved Outcomes with Elective Repair
Authors: Stephen H. Gray
Catherine C. Vick
Laura A. Graham
Kelly R. Finan
Leigh A. Neumayer
Mary T. Hawn
Publication date: 01-04-2008
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 4/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0496-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Umbilical Herniorrhapy in Cirrhosis: Improved Outcomes with Elective Repair

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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