Outcomes after Ventral Hernia Repair with Concurrent Panniculectomy: A Large Database Review.

Abstract

Patients with large pannus and ventral hernias may benefit from undergoing panniculectomy performed concurrently with open ventral hernia repair (VHR-PAN). However, there have been concerns related to increased surgical site occurrences (SSOs) when adding a panniculectomy. This study aimed to evaluate outcomes of open VHR with and without panniculectomy using a large hernia-specific database. The Abdominal Core Health Quality Collective database was queried from 2012 to 2023 for patients who underwent VHR-only vs VHR-PAN. Patient and surgical characteristics were described and compared. Short-term outcomes including surgical site infection, SSO, and SSO requiring procedural intervention were compared. Patient-reported outcomes and hernia recurrence were compared at 1 year. Logistic regression was used to identify risks associated with the above outcomes. A total of 28,140 patients underwent open VHR, with panniculectomy data (yes or no) available for 2,108 patients, including 870 who underwent VHR-PAN. Patients who underwent VHR-PAN were more likely to be female (78.3% vs 64.8%, p < 0.0001), have a BMI greater than 40 (21.0% vs 7.8%, p < 0.0001), and have a larger median hernia width (10.0 [7.0 to 15.0] vs 8.0 [3.0 to 13.0], p < 0.0001). In a matched analysis, there was no significant difference in surgical site infection, SSO, SSO requiring procedural intervention, or 1-year hernia recurrences rates in the VHR-PAN group (p < 0.05). This study demonstrated that VHR with concurrent panniculectomy is not significantly associated with an increased risk of complications. Concurrent panniculectomy can be considered for selected patients needing VHR.