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Sex-based outcomes after elective open abdominal wall reconstruction: a propensity score-matched analysis
Samantha W Kerr1, Gregory T Scarola1, Sullivan A Ayuso2
1Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Surgical Endoscopy
|July 23, 2026
Summary
Female and male patients had similar outcomes after abdominal wall reconstruction (AWR) when controlling for health factors. Standardized care may reduce sex-based differences in hernia repair results.
Area of Science:
- General Surgery
- Hernia Repair
- Abdominal Wall Reconstruction (AWR)
Background:
- Emerging evidence suggests potential sex-based differences in abdominal wall reconstruction (AWR) outcomes.
- Some studies indicate higher complication rates for female patients compared to males.
Purpose of the Study:
- To compare perioperative and long-term outcomes between female and male patients undergoing elective hernia repair.
- To investigate if sex-based differences in AWR outcomes persist after adjusting for confounding factors.
Main Methods:
- Prospective database query of adult patients undergoing elective, open AWR at a tertiary center.
- Propensity-score matching (1:1) for females versus males based on key demographic and clinical variables.
- Standard statistical analyses to compare outcomes between matched groups.
Main Results:
- 319 matched pairs (females vs. males) were analyzed after propensity-score matching.
- No significant differences were observed in overall wound complications (15.4% vs. 16.6%) or hernia recurrence rates (1.9% vs. 1.3%) between sexes.
- Average length of stay and follow-up duration were similar between female and male patients.
Conclusions:
- In a tertiary AWR program, sex-based differences in short-term and long-term outcomes were not significant after adjusting for comorbidities and operative factors.
- Standardized preoperative optimization and operative management may attenuate observed sex-based differences in AWR outcomes.