Staged versus concurrent ventral hernia repair with metabolic bariatric surgery: a systematic review and meta-analysis of comparative studies.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-04-04 DOI:10.1007/s10029-025-03320-z

Ali Esparham, Shahab Shahabi, Erfan Sheikhbahaei, Shiva Safari, Hamidreza Zefreh

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引用次数: 0

Abstract

Introduction: This study compares the outcomes of concurrent metabolic bariatric surgery (MBS) and ventral hernia repair (VHR) vs. staged VHR approach after MBS.

Method: We systematically searched four main databases with relevant keywords. Two independent authors screened and included studies that compared these two approaches. The I² statistic was utilized to evaluate heterogeneity among the studies; if exceeded 50%, a random effects analysis was conducted, while fixed effects analysis was employed for those without severe heterogeneity.

Results: 7 studies with 9244 and 11,961 patients in concurrent and staged groups were included, respectively. Our results showed that the rate of mesh infection was significantly higher in concurrent VHR (3.6% vs. 1.9%, OR: 2.18, p < 0.001), and mortality was insignificantly lower in staged VHR (0.3% vs. 0.1%, OR: 1.70, p = 0.09). Although surgical site infection, seroma, bowel obstruction, hernia recurrence, and reoperation were higher in the staged group, comparisons were statistically insignificant (all p > 0.05). Furthermore, hematoma, venous thromboembolic events, and wound dehiscence had nearly the same rates.

Conclusion: Both approaches are viable options, depending on individual patient circumstances (age, BMI, hernia size, hernia-related symptoms, sac with or without intestinal loops) and surgical preferences (type of MBS, with or without mesh, type of mesh) highlighting the importance of individualized surgical planning for optimization of outcomes and minimizing risks in this specific patient population.

Registration: The protocol of this study was submitted to PROSPERO and received the registration code CRD42023444310.

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.