Propensity score matching analysis of short-term outcomes in robotic ventral hernia repair for patients with a body mass index above and below 35kg/m2.

Abstract

The purpose of this study was to compare perioperative complications after robotic ventral hernia repair between patients with non-obese, class-I obesity with those with class-II or class-III obesity. Obesity is a growing epidemic and is considered as an independent risk factor for a multitude of perioperative complications. Laparoscopic ventral hernia repair has been shown as a safe and feasible approach in population with elevated body mass index (BMI). This study compared overall perioperative complications and surgical site events (SSEs) after robotic ventral hernia repair (RVHR) between patients with a BMI 35kg/m2 or more and patients with a BMI lower than 35kg/m2. A retrospective cohort analysis was conducted with one-to-one propensity score matching (PSM) method to obtain balanced groups evaluating patients who underwent RVHR between February 2012 and June 2019 in a single institution. Preoperative, intraoperative, and postoperative variables were reviewed. Postoperative complications and morbidity were assessed using the Clavien-Dindo classification and comprehensive complication index (CCI®) score system. SSEs were compared. Our unmatched sample included 526 patients with an average BMI of 31.2kg/m2. Of these, 29.8% (n = 160) patients were in high-BMI group (range 35-59.2). After PSM, 142 patients were assigned to each group. Both groups experienced similar complication rates during 90days. Clavien-Dindo grades, CCI® scores, and SSEs did not differ between the two groups. RVHR in class-II and class-III obese patients is safe, feasible, and effective. In addition to this, it has comparable short-term outcomes with those non-obese and class-I obese patients.