Does coagulopathy, anticoagulant or antithrombotic therapy matter in incisional hernia repair? Data from the Herniamed Registry

Surgical Endoscopy
Ralph F StaerklePhilipp Kirchhoff

Abstract

A considerable number of patients undergoing incisional hernia repair are on anticoagulant or antiplatelet therapy or have existing coagulopathy which may put them at higher risk for postoperative bleeding complications. Data about the optimal treatment of these patients are sparse. This analysis attempts to determine the rate of postoperative bleeding complications following incisional hernia repair and the consecutive rate of reoperation among patients with coagulopathy or receiving antiplatelet and anticoagulant therapy (higher risk group) compared to patients who do not have a higher risk (normal risk group). Out of the 43,101 patients documented in the Herniamed Registry who had an incisional hernia repair, 6668 (15.5%) were on anticoagulant or antithrombotic therapy or had existing coagulopathy. The implication of that higher risk profile for onset of postoperative bleeding was investigated in multivariable analysis. Hence, other influential variables were identified. The rate of postoperative bleeding in the higher risk group was 3.9% (n = 261) and significantly higher compared to the normal risk group at 1.6% (n = 564) (OR 2.001 [1.699; 2.356]; p < 0.001). Additionally, male gender, use of drains, larger defect size, op...Continue Reading

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Citations

Sep 28, 2018·Expert Review of Medical Devices·Uwe Klinge, Bernd Klosterhalfen
Aug 19, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Alberto SartoriJacopo Andreuccetti
Nov 23, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·F KöckerlingM P Simons
Dec 17, 2020·Frontiers in Surgery·Paul PatiniottGuy Maddern

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