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Textbook Outcomes for Incisional Hernia: W3 EVEREG Database Analysis
Carmen Zaragoza Zaragoza1,2,3, Álvaro Gomis-Martín1, Juan Jesús Rubio-García1,2
1From the General Surgery Department, Hospital Universitario Dr Balmis, Alicante, Spain (Zaragoza Zaragoza, Gomis-Martín, Rubio-García, Parra Chiclano, Villodre Tudela, Manuel Ramia).
Textbook outcome (TO) in W3 incisional hernia repair was achieved in 76% of patients. Prolonged hospital stay was the main factor for nonachievement, while factors like laparoscopic approach and clean surgery predicted TO.
Area of Science:
- Surgical outcomes research
- Hernia repair analysis
- Patient recovery metrics
Background:
- The "textbook outcome" (TO) signifies an ideal postoperative course after surgery.
- TO in incisional hernia repair remains understudied.
- This study investigates TO in W3 incisional hernia repair.
Purpose of the Study:
- Determine the rate of textbook outcome (TO) in W3 incisional hernia repair.
- Analyze variables associated with achieving TO in this patient cohort.
- Establish novel criteria for TO in W3 incisional hernia repair.
Main Methods:
- Retrospective observational study using the EVEREG registry (2012-2022).
- Defined TO as: hospital stay <8 days, no Clavien-Dindo ≥IIIa complications, and no 30-day mortality or readmission.
- Compared patient characteristics between TO and non-TO groups using logistic regression.
Main Results:
- 2763 patients were analyzed; 75.97% achieved TO.
- Prolonged hospital stay was the primary reason for nonachievement.
- Laparoscopic approach, clean surgery, non-biological mesh, elective surgery, and specific patient parameters predicted TO.
Conclusions:
- Proposed novel TO criteria for W3 incisional hernia repair.
- Achieved a 76% TO rate in the studied population.
- TO serves as a valuable composite measure for quality improvement and inter-hospital comparisons.
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