title: Defining surgical outcomes and quality of life in massive ventral hernia repair: an international multicenter prospective study.
abstract: BACKGROUND
  Our goal was to set criteria for massive ventral hernia and to compare surgical outcomes and quality of life after ventral hernia repair (VHR).
  
  
  METHODS
  The International Hernia Mesh Registry was queried for patients undergoing VHR from 2007 to 2013. Defect was categorized as massive if the width or length was greater than 15 cm or area greater than 150 cm(2). Massive VHR was compared to regular VHR.
  
  
  RESULTS
  A total of 878 patients underwent VHR: 436 open, 442 laparoscopic with 13 deaths (1.5%) and 45 hernia recurrences (5.1%). Of those, 158 patients (18%) met criteria for massive VHR. Massive VHR patients had longer length of stay (LOS) and operative time and more hematomas, wound infections, wound complications, and pneumonias (P < .05). On multivariate analysis, LOS was longer, and early postoperative pain and activity limitation were greater in massive VHRs (P < .01). Massive VHR in the laparoscopic approach resulted in greater long-term mesh sensation (P < .01).
  
  
  CONCLUSIONS
  VHR in massive hernias have increased rates of complications and longer LOS.
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
authors.forename: Samuel W
authors.initials: SW
authors.lastname: Ross
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
authors.forename: Blair A
authors.initials: BA
authors.lastname: Wormer
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
authors.forename: Mimi
authors.initials: M
authors.lastname: Kim
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
authors.forename: Bindhu
authors.initials: B
authors.lastname: Oommen
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
authors.forename: Joel F
authors.initials: JF
authors.lastname: Bradley
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Lincourt
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA.
authors.forename: Vedra A
authors.initials: VA
authors.lastname: Augenstein
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Carolinas Hernia Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28204, USA. Electronic address: Todd.Heniford@carolinashealthcare.org.
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D005060:Europe / Q000453:epidemiology; D005260:Female; D006406:Hematoma / Q000453:epidemiology; D006555:Hernia, Ventral / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009656:North America / Q000453:epidemiology; D061646:Operative Time; D010147:Pain Measurement; D011014:Pneumonia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D012720:Severity of Illness Index; D013526:Surgical Mesh
keywords: Abdominal wall reconstruction; Carolinas Comfort Scale; Hernia defect size; International Hernia Mesh Registry; Quality of life; Ventral hernia repair