Exhortation to lose weight prior to complex ventral hernia repair: Nudge or noodge?

Paddy Ssentongo; Colin G DeLong; Anna E Ssentongo; Eric M Pauli; David I Soybel

doi:10.1016/j.amjsurg.2019.04.013

Exhortation to lose weight prior to complex ventral hernia repair: Nudge or noodge?

Am J Surg. 2020 Jan;219(1):136-139. doi: 10.1016/j.amjsurg.2019.04.013. Epub 2019 Apr 19.

Authors

Paddy Ssentongo¹, Colin G DeLong², Anna E Ssentongo³, Eric M Pauli², David I Soybel⁴

Affiliations

¹ Center for Neural Engineering, Department of Engineering, Science and Mechanics, The Pennsylvania State University, University Park, PA, 16802, USA; Department of Public Health Sciences, Penn State Hershey College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
² Department of Surgery, Penn State Hershey College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
³ Department of Surgery, Penn State Hershey College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Public Health Sciences, Penn State Hershey College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
⁴ Department of Surgery, Penn State Hershey College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA. Electronic address: dsoybel@pennstatehealth.psu.edu.

PMID: 31036255
DOI: 10.1016/j.amjsurg.2019.04.013

Abstract

Background: Exercise and weight loss are recommended for patients with obesity undergoing elective complex ventral hernia repair (cVHR).

Methods: Weight and BMI trajectory data on 230 obese patients undergoing cVHR from 2012 to 2017 were retrospectively analyzed from 12 months prior to first visit with the hernia surgeon to 12 months after surgery.

Results: One year prior to initial visit, 76 (33%) patients had lost > 1kg/m², 98 (43%) had gained> 1kg/m², and 56 (24%) had no change in body mass index (BMI). Between initial visit and operation, 53 (23%) lost >1kg/m², 43 (19%) gained, and 134 (58%) had no change. Post-operative hyperglycemia was associated with BMI> 40kg/m² at time of operation. Twelve months post-operatively, 69 (35%) had lost >1kg/m², while 52 (26%) had gained, and 108 (47%) had no change.

Conclusions: Exhortations for pre-operative and post-operative weight management are not often successful or sustainable, implying a need for individualized holistic approaches.

Keywords: Elective complex ventral hernia repair; Obesity; Weight loss; Weight trajectory.

MeSH terms

Adult
Aged
Body Mass Index
Directive Counseling*
Female
Hernia, Ventral / complications*
Herniorrhaphy*
Humans
Male
Middle Aged
Obesity / complications*
Obesity / therapy*
Preoperative Period
Retrospective Studies
Risk Factors
Weight Loss*