Evidence map›Paper›PMID 39289227›Full record

ArticleSurgical endoscopy2024

Concurrent minimally invasive bariatric surgery and ventral hernia repair with mesh; Is it safe? Propensity score matching analysis using the 2015-2022 MBSAQIP database.

Jennifer Brown, Jorge Cornejo, Alba Zevallos, Joaquin Sarmiento, Jocelyn Powell, Fatemeh Shojaeian, Farzad Mokhtari-Esbuie, Gina Adrales, Christina Li, Raul Sebastian

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Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Jennifer BrownDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Jorge CornejoDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Alba ZevallosDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.ORCID 0000-0001-5567-9733
Joaquin SarmientoDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Jocelyn PowellDepartment of Surgery, Sinai Hospital, Baltimore, MD, USA.
Fatemeh ShojaeianDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Farzad Mokhtari-EsbuieDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Gina AdralesDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Christina LiDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Raul SebastianDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA. Rsebast04@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is a risk factor for the development of ventral hernias. Approximately eight percent of patients undergoing bariatric surgery have a concomitant ventral hernia. However, the optimal timing of hernia repair in these patients is debated. Concerns regarding mesh insertion in a potentially contaminated field are often cited by opponents of a combined approach. Our study compares 30-day outcomes of bariatric surgery with concurrent ventral hernia repair with mesh versus bariatric surgery alone.

methodsUsing the 2015-2022 MBSAQIP database, patients aged 18-65 years who underwent minimally invasive sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) with or without concurrent ventral hernia repair with mesh (VHR-M) were identified. 30-day postoperative outcomes were compared between patients who underwent SG or RYGB with VHR-M versus SG or RYGB alone. 1:1 propensity score matching was performed using 26 preoperative characteristics to adjust confounders.

resultsAmong 1,236,644 patients who underwent SG (n = 871,326) or RYGB (n = 365,318), 3,121 underwent SG + VHR-M and 2,321 RYGB + VHR-M. The concurrent approach had longer operative times, in SG + VHR-M (86.06 ± 42.78 vs. 73.80 ± 38.45 min, p < 0.001), and in RYGB + VHR-M (141.91 ± 58.68 vs. 128.47 ± 62.37 min, p < 0.001). The RYGB + VHR-M cohort had higher rates of reoperations (3.2% vs. 2.1%, p = 0.024). Overall, 30-day outcomes, and bariatric-specific complications such as mortality, unplanned ICU admissions, surgical site complications, cardiac, pulmonary, renal complications, anastomotic leaks, postoperative bleeding, and intestinal obstruction were similar between SG + VHR-M or RYGB + VHR-M groups versus SG or RYGB alone.

conclusionBariatric surgery performed concurrently with VHR-M is safe and feasible and does not excessively prolong operative times. However, patients undergoing RYGB with VHR-M do have a higher rate of reoperations, therefore a staged VHR is recommended. On the other hand, concurrent SG and VHR-M may benefit after an appropriate individualized risk stratification assessment.

Indexed as

Bariatric SurgeryHernia, VentralHerniorrhaphyPropensity ScoreSurgical MeshAdolescentAdultAgedDatabases, FactualFemaleGastrectomyGastric BypassHumansMaleMiddle AgedMinimally Invasive Surgical ProceduresBariatric surgeryGastric bypassMinimally invasive surgerySleeve gastrectomyVentral hernia

Identifiers

PMID39289227

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.