Authors: Brett L Ecker Lindsay E Y Kuo Kristina D Simmons John P Fischer Jon B Morris Rachel R Kelz
Publish Date: 2015/06/20
Volume: 30, Issue: 3, Pages: 906-915
Abstract
There is still considerable debate regarding the best operative approach to ventral hernia repair Using two large statewide databases this study sought to evaluate the longitudinal outcomes and associated costs of laparoscopic and open ventral hernia repairAll patients undergoing elective ventral hernia repair from 2007–2011 were identified from inpatient discharge data from California and New York Inhospital morbidity inhospital mortality incidence of readmission and incidence of revisional ventral hernia repair were evaluated as a function of surgical technique The associated costs of medical care for laparoscopic versus open ventral hernia repair were evaluate for both the index procedure and all subsequent admissions and procedures within the study periodA total of 13567 patients underwent elective ventral hernia repair with mesh 9228 69 underwent OVHR and 4339 31 underwent LVHR At time of the index procedure LVHR was associated with a lower incidence of reoperation OR 029 CI 012–058 p = 0001 wound disruption OR 035 CI 016–078 p = 001 wound infection OR 050 CI 025–070 p 0001 blood transfusion OR 047 CI 036–061 p 0001 ARDS OR 074 CI 054–099 p 005 and total index visit complications OR 072 CI 064–080 p 0001 LVHR was associated with significantly fewer readmissions OR 081 CI 075–088 p 0001 and a lower risk for revisional VHR OR 075 CI 064–088 p 0001 LVHR was associated with lower total costs at 1 year 3451 CI 1892–5011 p 0001Open ventral hernia repair was associated with a higher incidence of perioperative complications postoperative readmissions and need for revisional hernia repair when compared to laparoscopic ventral hernia repair even when controlling for patient sociodemographics In congruence open ventral hernia repair was associated with higher costs for both the index hernia repair and tallied over the length of followup for readmissions and revisional hernia repairThis project was made possible by a SAGES Research Award given to Lindsay E Y Kuo The New York Statewide Planning and Research Cooperative System and the California State Inpatient Databases from the Healthcare Cost and Utilization Project are the sources of the data used herein they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors
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