Impact of obesity severity on early and late outcomes following elective incisional hernia repair: A prospective cohort study
Sudhanshu Somvanshi, Deepak Pankaj, Nitesh Kumar, Fnu Kritika, Vibhuti Bhushan, Ashutosh Kumar, Prashant Kumar, Sweta MuniAbstract
BACKGROUND:
Obesity is a well-recognized risk factor for incisional hernia formation and is associated with increased postoperative morbidity after abdominal wall reconstruction. However, the influence of obesity severity on short- and long-term outcomes following elective incisional hernia repair remains inadequately defined.
MATERIALS AND METHODS:
This prospective observational study included 101 obese patients (body mass index [BMI] ≥ 30 kg/m 2 ) undergoing elective incisional hernia repair over 18 months. Perioperative, postoperative, and long-term outcomes were evaluated, and multivariable logistic regression was performed to identify independent predictors of surgical site infection and hernia recurrence.
RESULTS:
Among the 101 patients with obesity, 48 (47.5%) had Grade I, 30 (29.7%) had Grade II, and 23 (22.8%) had Grade III obesity. Increasing obesity severity was significantly associated with higher rates of surgical site infection (6.3% vs. 16.7% vs. 34.8%;
CONCLUSIONS:
Increasing BMI was associated with greater wound morbidity, prolonged hospitalization, and higher recurrence after incisional hernia repair. Maintaining an adequate mesh-to-defect ratio may reduce recurrence, particularly in severe obesity, while laparoscopic repair demonstrated favorable perioperative outcomes.