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Huynh D, Shao J. Tobacco cessation prior to elective abdominal wall reconstruction: A smoking gun? Am J Surg 2024; 229:50-51. [PMID: 38123385 DOI: 10.1016/j.amjsurg.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Desmond Huynh
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Jenny Shao
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
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Christou N, Drissi F, Naumann DN, Blazquez D, Mathonnet M, Gillion JF. Unplanned readmissions after hernia repair. Hernia 2023; 27:1473-1482. [PMID: 37880418 DOI: 10.1007/s10029-023-02876-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/28/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR30) rate. The main goal of our study was to analyze the UR30 following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR). METHODS A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021. RESULTS The overall incidence of UR30 was 1.32%. This included 160/18,042 (0.87%) for GHR, 41/4012 (1.02%) for PVHR, and 145/3754 (3.86%) for IVHR. The leading cause of UR30 was postoperative complications (POC). The nature of the predominant complications varied among the three categories. The correlation between UR30 and POC (and risk factors for POC) was strong in GHR but was not in IVHR due to a 'protective' longer LOS in this subgroup. As the LOS has decreased over the last years, this has 'mechanically' resulted in an increase in the occurrence of UR30, but not in a rise of POC, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings. CONCLUSION Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the POC but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs' and nurses' shortage in France.
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Affiliation(s)
- N Christou
- Service de chirurgie digestive, endocrinienne et générale, CHU de Limoges, Avenue Martin Luther King, 87042, Limoges Cedex, France.
- Unité de Chirurgie Viscérale et Digestive, Ramsay Santé, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France.
| | - F Drissi
- Clinique de chirurgie digestive et endocrinienne (CCDE), institut des maladies de l'appareil digestif (IMAD), Hôtel Dieu, CHU de Nantes, Place Ricordeau, 44093, Nantes Cedex 1, France
- Unité de Chirurgie Viscérale et Digestive, Ramsay Santé, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France
| | - D N Naumann
- University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TH, UK
- Unité de Chirurgie Viscérale et Digestive, Ramsay Santé, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France
| | - D Blazquez
- Clinique des Noriets, 12 Rue des Noriets, 94400, Vitry-sur-Seine, France
- Unité de Chirurgie Viscérale et Digestive, Ramsay Santé, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France
| | - M Mathonnet
- Service de chirurgie digestive, endocrinienne et générale, CHU de Limoges, Avenue Martin Luther King, 87042, Limoges Cedex, France
- Unité de Chirurgie Viscérale et Digestive, Ramsay Santé, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France
| | - J-F Gillion
- Clinique de chirurgie digestive et endocrinienne (CCDE), institut des maladies de l'appareil digestif (IMAD), Hôtel Dieu, CHU de Nantes, Place Ricordeau, 44093, Nantes Cedex 1, France
- Unité de Chirurgie Viscérale et Digestive, Ramsay Santé, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France
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