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Sublay or onlay incisional hernia repair along with abdominoplasty: which is better? Long-term results
Ist Teil von
Hernia : the journal of hernias and abdominal wall surgery, 2019-08, Vol.23 (4), p.757-765
Ort / Verlag
Paris: Springer Paris
Erscheinungsjahr
2019
Quelle
MEDLINE
Beschreibungen/Notizen
Purpose
Estimation and comparison of results after incisional hernia repair (IHR) modo onlay or sublay with abdominoplasty in patients who lost the weight following Roux-en-Y Gastric Bypass (RYGB). Analysis and comparison of changes in quality of life (QL) of these patients prior to RYGB, before and after simultaneous IHR and abdominoplasty.
Methods
Clinical analysis involved 40 patients with abdominal disfigurement (following RYGB and massive weight loss) after one-time IHR sublay method with abdominoplasty—group 1 or IHR onlay method with abdominoplasty—group 2. We evaluated postoperative results and long-term QL changes (DAS24, SF-36 scales).
Results
We noted abnormal wound healing (2), pneumonia (3) and dysesthesia (3) in patients from group 1, and abnormal wound healing (2), seroma (2), pneumonia (2), and dysesthesia (4) in group 2. Quality of life was improved in the functional, esthetic and psychological aspects.
Conclusions
One stage incisional hernia repair by onlay as well as sublay method with abdominoplasty are safe surgical methods improving the functioning of patients after major weight loss following RYGB. Sublay hernia repair and abdominoplasty was connected with longer time of the: operation, drainage, analgesic agents use, time to mobilization and to full oral diet than the onlay method. Significant improvement of the quality of life was noted after every subsequent step of surgical treatment in both groups. Reduction of the risk of BMI re-growth after bariatric surgery is related to the need for constant, specialized care for these patients at every stage of follow-up after bariatric surgery.