Associated Risks of Obesity and/or Metabolic Syndrome with Intra-operative or Post-Operative Occurrences in Patients with Open Ventral Hernia Repair

Maytham Hameed Al-Qanbar

doi:10.11648/j.js.20170504.12

Abstract

Metabolic syndrome and obesity are increasing in incidence worldwide and they carry with them a lot of health issues that might directly affect individuals or might be associated with higher risk of surgical complications represented in this study by open ventral hernia repair. A cohort study of 132 patients admitted electively for open ventral hernia repair to the surgical wards at Al-Sader teaching hospital in Najaf /Iraq from December 1st/ 2015 to October 1st/ 2016. All patients were followed for intra-operative occurrences and followed for 2 weeks postoperatively for any early post-operative complications. Of the total 132 patients, there were 44 patients (33.3%) having metabolic syndrome and there were 68 obese patients (66.6%) of which 37 having metabolic syndrome (54.4%). There was no significant association between intra-operative occurrences or early post-operative complications in obese patients with or without metabolic syndrome but there was a significant association between intra-operative occurrences and metabolic syndrome in patients having body mass index (BMI) below 30 Kg/m2. Diabetes was the only significant factor for early postoperative wound complications whether the patient had metabolic syndrome or not.

Highlights

A ventral hernia can be defined as a protrusion of viscera through a defect or a hole in the anterior abdominal wall
A cohort study of patients with ventral hernia for assessment of the risk of perioperative complications for those who were obese with MS, those who were obese without MS compared to those who were non-obese with non-metabolic syndrome in order to assess the obesity and metabolic syndrome as risk factors for perioperative morbidity
Hypotension was the most common intra-operative occurrence (13.5%) reported in patients with metabolic syndrome with Body mass index (BMI) ≥ 30 followed by hypertension (8.1%) and the least were bradycardia and decrease O2 saturation both of which was 2.7%

Summary

Introduction

A ventral hernia can be defined as a protrusion of viscera through a defect or a hole in the anterior abdominal wall. This term includes epigastric, para-umbilical, umbilical and incisional hernias. Obesity and metabolic syndrome (MS) on the other hand are rising health problems variably affecting different societies like 35% of USA population, 8.4% of Japanese population and 24.5% of Chinese population are affected with MS. Inflammation and oxidative stress accompanying adipocytes hypertrophy secondary to surplus of fat storage lead to excess release of proinflammatory cytokines like interleukin-1 (IL-1), interleukin-6 (IL-6) (one third of total IL-6 concentration come from adipose tissue), Maytham Hameed Al-Qanbar: Associated Risks of Obesity and/or Metabolic Syndrome with Intra-operative or

Methods

Results

Discussion

Conclusion