B Pokala1,2, P R Armijo2, L Flores2,3, D Hennings1,2, D Oleynikov4,5. 1. Minimally Invasive and Bariatric Surgery, Department of Surgery, General Surgery, 986246 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-6246, USA. 2. Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE, USA. 3. College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA. 4. Minimally Invasive and Bariatric Surgery, Department of Surgery, General Surgery, 986246 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-6246, USA. doleynik@unmc.edu. 5. Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE, USA. doleynik@unmc.edu.
Abstract
PURPOSE: Many publications have focused on single-surgeon or single-center data, comparing surgical approach in inguinal hernia repair. This study evaluated outcomes in patients who underwent open (OIHR), laparoscopic (LIHR) or robotic (RIHR) inguinal hernia repair using a national database. METHODS: The Vizient clinical database was queried using ICD-9 and ICD-10 procedure and diagnosis codes for RIHR, LIHR, and OIHR from 2013 to 2017. Elective procedures classified as minor or moderate risk severity were included. Complications, 30-day readmission, mortality, LOS, and intra-hospital opiate utilization were analyzed using IBM SPSS v.23.0. RESULTS: 3547 patients (OIHR: N = 2413, LIHR: N = 540, RIHR: N = 594) were included in the study. Majority were male (OIHR 84.1%, LIHR 80.4%, RIHR 95.3%), ≥ 51 years (OIHR 81.5%, LIHR 81.7%, RIHR 95.3%), and Caucasian (OIHR 75.7%, LIHR 77.0%, RIHR 81.5%). RIHR had the least overall complications (0.67%) compared to LIHR (4.44%) and OIHR (3.85%), p < 0.05. OIHR had the highest postoperative infection rate (8.33%), versus LIHR (0.56%) and RIHR (0.0%), p < 0.05. OIHR had longer length of stay (3.57 ± 4.1 days) when compared to both groups (LIHR 2.2 ± 2.13 days, RIHR 1.75 ± 1.62 days), p < 0.001. OIHR had higher 30-day readmission rates (3.61%) compared to RIHR (0.84%), p = 0.001. Mortality was similar between groups (OIHR 0.21%, LIHR 0.19%, RIHR 0.17%), p = 0.081. Opiate use was higher with OIHR (96.0%), compared to both LIHR (93.1%), and RIHR (93.8%), p = 0.004. CONCLUSION: RIHR outcomes were improved compared to OIHR or LIHR. OIHR had the highest rate of opiate use, there was no difference between LIHR and RIHR. Further studies are needed to determine the role of RIHR and to assess whether surgeon or patient selection contributes to outcomes.
PURPOSE: Many publications have focused on single-surgeon or single-center data, comparing surgical approach in inguinal hernia repair. This study evaluated outcomes in patients who underwent open (OIHR), laparoscopic (LIHR) or robotic (RIHR) inguinal hernia repair using a national database. METHODS: The Vizient clinical database was queried using ICD-9 and ICD-10 procedure and diagnosis codes for RIHR, LIHR, and OIHR from 2013 to 2017. Elective procedures classified as minor or moderate risk severity were included. Complications, 30-day readmission, mortality, LOS, and intra-hospital opiate utilization were analyzed using IBM SPSS v.23.0. RESULTS: 3547 patients (OIHR: N = 2413, LIHR: N = 540, RIHR: N = 594) were included in the study. Majority were male (OIHR 84.1%, LIHR 80.4%, RIHR 95.3%), ≥ 51 years (OIHR 81.5%, LIHR 81.7%, RIHR 95.3%), and Caucasian (OIHR 75.7%, LIHR 77.0%, RIHR 81.5%). RIHR had the least overall complications (0.67%) compared to LIHR (4.44%) and OIHR (3.85%), p < 0.05. OIHR had the highest postoperative infection rate (8.33%), versus LIHR (0.56%) and RIHR (0.0%), p < 0.05. OIHR had longer length of stay (3.57 ± 4.1 days) when compared to both groups (LIHR 2.2 ± 2.13 days, RIHR 1.75 ± 1.62 days), p < 0.001. OIHR had higher 30-day readmission rates (3.61%) compared to RIHR (0.84%), p = 0.001. Mortality was similar between groups (OIHR 0.21%, LIHR 0.19%, RIHR 0.17%), p = 0.081. Opiate use was higher with OIHR (96.0%), compared to both LIHR (93.1%), and RIHR (93.8%), p = 0.004. CONCLUSION: RIHR outcomes were improved compared to OIHR or LIHR. OIHR had the highest rate of opiate use, there was no difference between LIHR and RIHR. Further studies are needed to determine the role of RIHR and to assess whether surgeon or patient selection contributes to outcomes.
Authors: Eric J Charles; J Hunter Mehaffey; Carlos A Tache-Leon; Peter T Hallowell; Robert G Sawyer; Zequan Yang Journal: Surg Endosc Date: 2017-10-24 Impact factor: 4.584
Authors: M Miserez; E Peeters; T Aufenacker; J L Bouillot; G Campanelli; J Conze; R Fortelny; T Heikkinen; L N Jorgensen; J Kukleta; S Morales-Conde; P Nordin; V Schumpelick; S Smedberg; M Smietanski; G Weber; M P Simons Journal: Hernia Date: 2014-03-20 Impact factor: 4.739
Authors: Adam de Havenon; Shadi Yaghi; Eva A Mistry; Alen Delic; Samuel Hohmann; Ernie Shippey; Eric Stulberg; David Tirschwell; Jennifer A Frontera; Nils H Petersen; Mohammad Anadani Journal: J Neurointerv Surg Date: 2020-09-28 Impact factor: 8.572