Hernia最新文献

{"title":"Impact of abdominal compliance on surgical stress and postoperative recovery in laparoscopic groin hernia repair: a retrospective cohort study.","authors":"Shoichi Kinoshita, Chisato Hara, Yayoi Matsumoto, Kohei Fukuoka, Kenji Nakagawa, Daisuke Hokuto, Hiroyuki Kuge, Tomohide Mukogawa","doi":"10.1007/s10029-024-03232-4","DOIUrl":"10.1007/s10029-024-03232-4","url":null,"abstract":"<p><strong>Purpose: </strong>The role of abdominal compliance in pneumoperitoneum is not fully understood. This study aimed to clarify the association between abdominal wall stretching tendency and surgical stress in laparoscopic groin hernia repair.</p><p><strong>Methods: </strong>We conducted a retrospective single-center cohort study, evaluating 51 patients who underwent elective transabdominal preperitoneal groin hernia repair. Abdominal compliance was assessed using the abdominal compliance index (ACI; insufflated intra-abdominal volume [L] / body surface area [m²]) at 8 mmHg intra-abdominal pressure. Surgical stress and recovery were evaluated with patient-reported outcome measures (PROMs), including QOR-15 and pain visual analog scale (VAS) scores. Associations between ACI, PROMs, and clinical outcomes were analyzed.</p><p><strong>Results: </strong>The median ACI was 1.229 L/m² (0.369-2.091). Eleven patients (21.6%) above the 75th percentile cutoff (1.576 L/m²) were categorized as high ACI. While body constitution was similar between groups, the high ACI group had significantly greater insufflated intra-abdominal volume (2.88 L vs. 1.89 L, P < 0.0001). Pre-operative QOR-15 scores were similar. However, on postoperative day 1, the high ACI group had significantly lower QOR-15 scores (90.2 vs. 110.1, P = 0.017), with subcategory analysis showing reduced physical well-being. Multivariate analysis indicated that high ACI was a significant predictor of poorer QOR. The high ACI group also reported higher, though not statistically significant, postoperative pain.</p><p><strong>Conclusion: </strong>Abdominal walls with greater elasticity, which stretch excessively under pneumoperitoneum, were more susceptible to surgical stress. Further studies are warranted to evaluate the efficacy of tailored pneumoperitoneum pressure adjustment based on abdominal compliance to mitigate surgical stress.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"40"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased length of incarcerated small bowel as a risk factor for intestinal necrosis in obturator hernia.","authors":"Yoshiyuki Kiyasu, Naoki Oka, Makio Mike, Hiroshi Kusanagi","doi":"10.1007/s10029-024-03234-2","DOIUrl":"https://doi.org/10.1007/s10029-024-03234-2","url":null,"abstract":"<p><strong>Background: </strong>Incarcerated obturator hernia (OH) is a rare type of pelvic wall hernia. With the increasing adoption of reduction techniques for incarcerated OH, it is crucial to assess the extent of damage to the incarcerated intestine. This study aimed to identify objective risk factors for intestinal necrosis based on computed tomography (CT) findings.</p><p><strong>Methods: </strong>From October 2004 to June 2013, data from consecutive patients diagnosed with incarcerated OH at Kameda Medical Center were collected. All patients underwent laparotomy and were classified into either the viable group (no incarceration-related intestinal damage) or the necrosis group (incarceration-related intestinal damage present). Patient characteristics and CT findings were retrieved retrospectively, including incarcerated intestine length, obturator canal width, and precise location of incarceration. Multivariate logistic regression with backward elimination was performed to identify risk factors for intestinal necrosis.</p><p><strong>Results: </strong>A total of 37 patients were included, with 25 in the viable group and 12 in the necrosis group. Multivariate analysis revealed that increased incarcerated intestine length on CT was significantly associated with necrosis (p = 0.004; odds ratio, 1.19 per 1-mm increase; 95% confidence interval, 1.06-1.34), outweighing other factors such as white blood cell count, C-reactive protein levels, and time from onset to hospital arrival.</p><p><strong>Conclusion: </strong>Length of the incarcerated small bowel on CT may be a potential risk factor for intestinal necrosis in patients with OH.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"38"},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications for treatment of incidental obturator hernia encountered during transabdominal preperitoneal repair (TAPP).","authors":"Akihiro Nakamura, Yoshikuni Harada, Hideyuki Oyama, Kaori Tadamura, Hiroshi Moro, Gaku Kigawa, Takahiro Umemoto, Kenichi Matsuo, Kuniya Tanaka","doi":"10.1007/s10029-024-03224-4","DOIUrl":"https://doi.org/10.1007/s10029-024-03224-4","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify indications for treating incidental obturator hernia (IOH) detected during laparoscopic groin hernia repair by comparing features of IOH with obturator hernia (OH) complicated by incarceration.</p><p><strong>Methods: </strong>Twenty patients who underwent laparoscopic OH repair between January 2017 and July 2024 were included in this retrospective study. They were divided into groups with incarceration or a past history of incarceration (the OH group) or without incarceration (the IOH group). Univariate analysis was performed, and ROC curves were constructed with the cut-off values representing indications for treating IOH.</p><p><strong>Results: </strong>Thirteen patients comprised the IOH group (bilateral in one), while seven comprised the OH group (all unilateral). Univariate analysis selected high age, low body mass index (BMI), and a large orifice as risk factors for incarceration. Cut-off values of these variables were age 89 years (area under curve, 0.816), BMI 17.7 kg/m² (0.939), and orifice diameter 12 mm (0.796). Age of at least 89 years and BMI of 18 or less were more common in the incarceration group (P = 0.004, P = 0.007), and all patients in the incarceration group had orifices at least 12 mm in diameter. Assigning the 3 variables 1 point each, the OH group had significantly higher scores of at least 2 points (P < 0.001).</p><p><strong>Conclusion: </strong>High age, low BMI, and large orifice diameter may be considered useful indicators for treating IOH. Two or more of these factors could place a patient at high risk for incarceration and show need for treatment of IOH.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"37"},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of smoking on ventral and inguinal hernia repair: a systematic review and meta-analysis.","authors":"Carlos André Balthazar da Silveira, Ana Caroline Rasador, Diego L Lima, Julia Kasmirski, João P G Kasakewitch, Raquel Nogueira, Flavio Malcher, Prashanth Sreeramoju","doi":"10.1007/s10029-024-03122-9","DOIUrl":"10.1007/s10029-024-03122-9","url":null,"abstract":"<p><strong>Purpose: </strong>Individual studies indicate poorer outcomes for smokers after hernia repair. Previous meta-analyses have examined the impact of smoking on specific outcomes such as recurrence and surgical site infection, but there has been a lack of comprehensive consensus or systematic review on this subject. Addressing this gap, our study undertakes a systematic review and meta-analysis to assess the impact of smoking on the outcomes of ventral hernia repair (VHR) and inguinal hernia repair.</p><p><strong>Source: </strong>A thorough search of Cochrane Central, Scopus, SciELO, and PubMed/MEDLINE, focusing on studies that examined the effect of smoking on inguinal and VHR outcomes was conducted. Key outcomes evaluated included recurrence, reoperation, surgical site occurrences (SSO), surgical site infection (SSI), and seroma.</p><p><strong>Principal findings: </strong>Out of 3296 screened studies, 42 met the inclusion criteria. These comprised 25 studies (69,295 patients) on VHR and 17 studies (204,337 patients) on inguinal hernia repair. The analysis revealed that smokers had significantly higher rates of recurrence (10.4% vs. 9.1%; RR 1.48; 95% CI [1.15; 1.90]; P < 0.01), SSO (13.6% vs. 12.7%; RR 1.44; 95% CI [1.12; 1.86]; P < 0.01) and SSI (6.6% vs. 4.2%; RR 1.64; 95% CI [1.38; 1.94]; P < 0.01) following VHR. Additionally, smokers undergoing inguinal hernia repair showed higher recurrence (9% vs. 8.7%; RR 1.91; 95% CI [1.21; 3.01]; P < 0.01), SSI (0.6% vs. 0.3%; RR 1.6; 95% CI [1.21; 2.0]; P < 0.001), and chronic pain (9.9% vs. 10%; RR 1.24; 95% CI [1.06; 1.45]; P < 0.01) rates. No significant differences were observed in seroma (RR 2.63; 95% CI [0.88; 7.91]; P = 0.084) and reoperation rates (RR 1.48; 95% CI [0.77; 2.85]; P = 0.236) for VHR, and in reoperation rates (RR 0.99; 95% CI [0.51; 1.91]; P = 0.978) for inguinal hernias between smokers and non-smokers. Analysis using funnel plots and Egger's test showed the absence of publication bias in the study outcomes.</p><p><strong>Conclusion: </strong>This comprehensive meta-analysis found statistically significant increases in recurrence rates, and immediate postoperative complications, such as SSO and SSI following inguinal and VHR. Also, our subgroup analysis suggests that the MIS approach seems to be protective of adverse outcomes in the smokers group. However, our findings suggest that these findings are not of clinical relevance, so our data do not support the necessity of smoking cessation before hernia surgery. More studies are needed to elucidate the specific consequences of smoking in both inguinal and ventral hernia repair.</p><p><strong>Prospero registration: </strong>ID CRD42024517640.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2079-2095"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes after open posterior component separation via transversus abdominis release (TAR) for incisional hernia repair. A systematic review and meta-analysis.","authors":"Emmanuel E Sadava, Francisco Laxague, Agustin C Valinoti, Cristian A Angeramo, Francisco Schlottmann","doi":"10.1007/s10029-024-03142-5","DOIUrl":"10.1007/s10029-024-03142-5","url":null,"abstract":"<p><strong>Purpose: </strong>Given its potential advantages, open Transversus Abdominis Release (oTAR) has been proposed as a durable solution for complex AWR. However, its applicability in different scenarios remains uncertain. We aimed to analyze the current available evidence and determine surgical outcomes after oTAR.</p><p><strong>Methods: </strong>We performed a systematic electronic search on oTAR in PubMed/Medline, Embase, and Cochrane Central Register of Controlled Trials databases. Postoperative morbidity and recurrence rates were included as primary endpoints and Quality of life (QoL) was included as secondary endpoint. A random-effect model was used to generate a pooled proportion with 95% confidence interval (CI) between all studies.</p><p><strong>Results: </strong>A total of 22 studies with 4,910 patients undergoing oTAR were included for analysis. Mean hernia defect and mesh area were 394 (140-622) cm² and 1065 (557-2206) cm², respectively. Mean follow-up was 19.7 (1-32) months. The weighted pooled proportion of recurrence, overall morbidity, surgical site occurrences (SSO), surgical site infection (SSI), surgical site occurrences requiring procedural intervention (SSOPI), major morbidity and mortality were: 6% (95% CI, 3-10%), 34% (95% CI, 26-43%), 22% (95% CI, 16-29%), 11% (95% CI, 8-16%), 4% (95% CI, 3-7%), 6% (95% CI, 4-10%) and 1% (95% CI, 1-2%), respectively. A significant improvement in QoL after oTAR was reported among studies.</p><p><strong>Conclusion: </strong>Open TAR is an effective technique for complex ventral hernias as it is associated with low recurrence rate and a significant improvement in QoL. However, the relatively high morbidity rates observed emphasize the necessity of further patients' selection and optimization to improve outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2097-2109"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment to: Cost analysis of open versus robot-assisted ventral hernia repair.","authors":"Lars Nannestad Jorgensen, Jacob Rosenberg","doi":"10.1007/s10029-024-03131-8","DOIUrl":"10.1007/s10029-024-03131-8","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2427-2428"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesh versus suture for elective primary umbilical hernia open repair: a systematic review and meta-analysis.","authors":"Ana Caroline Dias Rasador, Carlos André Balthazar da Silveira, Diego Laurentino Lima, Raquel Nogueira, Flavio Malcher, Prashanth Sreeramoju, Leandro T Cavazzola","doi":"10.1007/s10029-024-03106-9","DOIUrl":"10.1007/s10029-024-03106-9","url":null,"abstract":"<p><strong>Purpose: </strong>Recent guidelines indicate the use of mesh in UHR for defects > 1 cm, as it reduces recurrence, with 10% recurrence rate compared to up to 54.5% with primary closure. However, Nguyen et al. shows that primary closure is still widely performed in UHR, especially for small defects (1-2 cm), for which there is no published data to determine the optimal approach. In addition, previous meta-analysis by Madsen et al. comparing mesh repair with primary closure in UHR didn't exclude emergency conditions and recurrent hernias; also, didn't report subgroup analysis on hernia defect size. Thus, we aimed to perform a systematic review and meta-analysis comparing the mesh repairs vs. primary closure of the defect in an open elective primary UHR.</p><p><strong>Methods: </strong>We searched for studies comparing mesh with suture in open UHR in PubMed, Scopus, Cochrane, Scielo, and Lilacs from inception until October 2023. Studies with patients ≤ 18 years old, with recurrent or emergency conditions were excluded. Outcomes were recurrence, seroma, hematoma, wound infection, and hospital length of stay. Subgroup analysis was performed for: (1) RCTs only, and (2) hernia defects smaller than 2 cm. We used RevMan 5.4. for statistical analysis. Heterogeneity was assessed with I² statistics, and random effect was used if I² > 25%.</p><p><strong>Results: </strong>2895 studies were screened and 56 were reviewed. 12 studies, including 4 RCTs, 1 prospective cohort, and 7 retrospective cohorts were included, comprising 2926 patients in total (47.6% in mesh group and 52.4% in the suture group). Mesh repair showed lower rates of recurrence in the overall analysis (RR 0.50; 95% CI 0.31 to 0.79; P = 0.003; I² = 24%) and for hernia defects smaller than 2 cm (RR 0.56; 95% CI 0.34 to 0.93; P = 0.03; I² = 0%). Suture repair showed lower rates of seroma (RR 1.88; 95% CI 1.07 to 3.32; P = 0.03; I² = 0%) and wound infection (RR 1.65; 95%CI 1.12 to 2.43; P = 0.01; I² = 15%) in the overall analysis, with no differences after performing subgroup analysis of RCTs. No differences were seen regarding hematoma and hospital length of stay.</p><p><strong>Conclusion: </strong>The use of mesh during UHR is associated with significantly lower incidence of recurrence in a long-term follow-up compared to the suture repair, reinforcing the previous indications of the guidelines. Additionally, despite the overall analysis showing higher risk of seroma and wound infection for the mesh repair, no differences were seen after subgroup analysis of RCTs.</p><p><strong>Study registration: </strong>A review protocol for this systematic review and meta-analysis was registered at PROSPERO (CRD42024476854).</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2069-2078"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early outcomes of robotic modified retromuscular Sugarbaker technique for end colostomy parastomal hernia repair.","authors":"Alberto G Barranquero, Yolanda Maestre González, Cristina Gas Ruiz, Marta Sadurni Gracia, Jorge Juan Olsina Kissler, Rafael Villalobos Mori","doi":"10.1007/s10029-024-03152-3","DOIUrl":"10.1007/s10029-024-03152-3","url":null,"abstract":"<p><strong>Aim: </strong>The modified retromuscular Sugarbaker or Pauli technique is a technique for parastomal hernia repair, which requires the dissection of the retromuscular space and a transversus abdominis release for stoma lateralization and placement of a retromuscular mesh. Given the limited evidence regarding the robotic approach to this technique, this study aims to evaluate the outcomes of this newly introduced procedure, focusing on the rate of 30-day complications and recurrence rates.</p><p><strong>Methods: </strong>Retrospective case series report. Patients included underwent an elective robotic modified retromuscular Sugarbaker technique for the repair of a parastomal hernia associated with an end colostomy. All surgeries were performed at a tertiary referral center from September 2020 to December 2023.</p><p><strong>Results: </strong>A total of 21 patients underwent a robotic modified retromuscular Sugarbaker in our study. The parastomal hernias operated on were classified according to the European Hernia Society as 9.5% (2/21) type I, 52.4% (11/21) type II, 23.8% (5/21) type III, 14.3% (3/21) type IV. Early complications observed included 14.3% (3/21) seroma, 9.5% (2/21) surgical site infection, 19% (4/21) postoperative ileus, and one case of large bowel obstruction due to colitis (4.8%), which was managed conservatively. No Clavien-Dindo grade III complications were reported. The overall recurrence rate was 9.5% (2/21) with a median follow-up of 12.5 months (IQR: 3.9-21.3). Both recurrences occurred during the early phases of the learning curve and were possibly attributed to insufficient lateralization of the stoma.</p><p><strong>Conclusion: </strong>Robotic modified retromuscular Sugarbaker for parastomal hernia repair is a challenging procedure with promising early outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2235-2243"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for the diagnosis of occult inguinal hernias using a modified Delphi technique.","authors":"Krystle Henderson, Steven Chua, Joseph Hasapes, Kaustubh Shiralkar, Jonah Stulberg, Varaha Tammisetti, Chakradhar Thupili, Todd Wilson, Julie Holihan","doi":"10.1007/s10029-024-03177-8","DOIUrl":"10.1007/s10029-024-03177-8","url":null,"abstract":"<p><strong>Background: </strong>Occult inguinal hernias are inguinal hernias that are not felt on physical exam but can often be seen on imaging. Their diagnosis can be challenging, leading to unnecessary surgeon referrals, undue patient stress, and even unneeded surgery. The aim of this project was to develop recommendations for the diagnosis of occult inguinal hernias using a modified Delphi technique.</p><p><strong>Methods: </strong>Iterative rounds of surveys were administered to an expert panel of surgeons and radiologists. Panelists were asked to rate potential hernia-related topics by levels of importance. Items with 80% agreement were included for further discussion. Panelists were asked to provide their opinion on each included subject. A virtual meeting was conducted to discuss areas without agreement and determine final recommendations.</p><p><strong>Results: </strong>Three surgeons and five radiologists participated. There was strong agreement that dynamic ultrasound is a good first/confirmatory imaging choice. There was agreement that the radiology reports for studies assessing inguinal hernias should include hernia contents (80%) and hernia size (100%). Information that should be provided to the radiologist when ordering an imaging study include indication for study, patient symptoms, prior hernia surgery. Items that should be included in a radiology report include whether the presence of an inguinal hernia was assessed, hernia contents, size of defect, +/- hernia type.</p><p><strong>Conclusions: </strong>This collaboration between surgeons and radiologists creates a diagnostic imaging pathway and standardizing imaging reporting which will be used to improve the diagnosis of occult inguinal hernias. Future studies testing these recommendations in a prospective study are warranted.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2387-2391"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of surgeon-patient sex discordance on ventral hernia repair outcomes.","authors":"Claiborne J Lucas, M Wes Love, Jeremy A Warren, William S Cobb, Alfredo M Carbonell","doi":"10.1007/s10029-024-03100-1","DOIUrl":"10.1007/s10029-024-03100-1","url":null,"abstract":"<p><strong>Purpose: </strong>Concordance is an important dimension of the physician-patient relationship that may be linked to health care disparities. The purpose of this study was to determine if sex discordance between surgeon and patient impacts surgical outcomes.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data obtained from the Abdominal Core Health Quality Collaborative (ACHQC) registry was performed on all patients who underwent ventral hernia repair. Surgical site occurrences (SSO), surgical site infections (SSI), surgical site occurrence requiring procedural intervention (SSOPI) and 30-day readmission rates were recorded.</p><p><strong>Results: </strong>Female patients operated on by male surgeons have increased odds of having an SSI/SSO (OR 1.099, 95% CI 1.022-1.181), SSOPI (OR 1.156, 95% CI 1.031-1.297), and readmission (OR 1.259, 95% CI 1.128-1.406) when compared to male patients operated on by male surgeons. There was no significant difference in adverse outcomes between patient groups when operated on by female surgeons.</p><p><strong>Conclusion: </strong>Sex discordance between surgeon and patient is associated with increased odds adverse outcomes when male surgeons operate on female patients.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2159-2164"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}