R AlMarzooqi1, S Tish2, L Tastaldi2, A Fafaj2, M Olson3, T Stewart3, A Prabhu2, D Krpata2, C Petro2, M Rosen2. 1. Comprehensive Hernia Center, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA. rahaalm@live.com. 2. Comprehensive Hernia Center, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA. 3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Abstract
PURPOSE: Unlike routine ventral hernia repair, abdominal wall reconstruction (AWR) can results in large pieces of mesh and extensive manipulation of the intra-abdominal contents, rendering subsequent laparoscopic cholecystectomy challenging. This study addresses the additional wound morbidity of concomitant cholecystectomy. METHODS: The Americas Hernia Society Quality Collaborative (AHSQC) was retrospectively reviewed and logistic regression modeling was used to control for multiple covariates. Patients that underwent open AWR with cholecystectomy were compared to a similar group of patients undergoing uncomplicated, open, clean, AWR alone. RESULTS: 130 patients undergoing concomitant cholecystectomy were compared to a control group of 6440 patients. The addition of a cholecystectomy did not cause a significant change in wound morbidity (SSI: p = 0.16; SSOPI: p = 0.65). CONCLUSIONS: This study noted that a concomitant cholecystectomy does not increase the wound morbidity as compared to an uncomplicated, clean, AWR. This provides support for consideration of routine cholecystectomy in patients with cholelithiasis undergoing AWR.
PURPOSE: Unlike routine ventral hernia repair, abdominal wall reconstruction (AWR) can results in large pieces of mesh and extensive manipulation of the intra-abdominal contents, rendering subsequent laparoscopic cholecystectomy challenging. This study addresses the additional wound morbidity of concomitant cholecystectomy. METHODS: The Americas Hernia Society Quality Collaborative (AHSQC) was retrospectively reviewed and logistic regression modeling was used to control for multiple covariates. Patients that underwent open AWR with cholecystectomy were compared to a similar group of patients undergoing uncomplicated, open, clean, AWR alone. RESULTS: 130 patients undergoing concomitant cholecystectomy were compared to a control group of 6440 patients. The addition of a cholecystectomy did not cause a significant change in wound morbidity (SSI: p = 0.16; SSOPI: p = 0.65). CONCLUSIONS: This study noted that a concomitant cholecystectomy does not increase the wound morbidity as compared to an uncomplicated, clean, AWR. This provides support for consideration of routine cholecystectomy in patients with cholelithiasis undergoing AWR.
Entities:
Keywords:
Abdominal wall reconstruction; Americas hernia society; Cholecystectomy; Quality collaborative; Surgical site infection; Surgical site occurrence; Wound morbidity
Authors: Andrzej Lehmann; Jacek Piątkowski; Mariusz Nowak; Marek Jackowski; Maciej Pawlak; Mieczysław Witzling; Maciej Smietański Journal: Pol Przegl Chir Date: 2014-02