Abstract
Background The abdomen remains the most preferable donor site for autologous breast reconstruction.
Many patients in this population will have had prior abdominal surgery, which is the
chief risk factor for having a ventral hernia. While prior studies have examined the
impact of prior abdominal surgery on breast reconstruction, limited data exist on
the management of patients with a preexisting ventral hernia. The objective of this
study was to investigate outcomes of performing ventral hernia repair concurrent with
abdominally based microsurgical breast reconstruction.
Methods A 5-year retrospective review of patients undergoing abdominally based microsurgical
breast reconstruction was performed. The experimental group consisted of patients
with a preexisting ventral hernia that was repaired at the time of breast reconstruction,
and was compared with a historical cohort of patients without preexisting hernias.
Results There were a total of 18 and 225 patients in the experimental and control groups,
respectively. There was a higher incidence of prior abdominal surgery in the experimental
group (p = 0.0008), but no other differences. Mean follow-up was 20.5 ± 5.2 months. There
were no instances of recurrent hernia or flap loss in the experimental group. No significant
differences were observed between the experimental and control groups in the incidence
of donor-site complications (27.8 vs. 20.9%, respectively; p = 0.55), recipient site complications (27.8 vs. 24.0%, respectively; p = 0.78), operative time (623 ± 114 vs. 598 ± 100 minutes, respectively; p = 0.80), or length of stay (3.4 ± 0.5 vs. 3.1 ± 0.4 days, respectively; p = 0.98).
Conclusion Concurrent ventral hernia repair at the time of abdominally based microsurgical breast
reconstruction appears to be safe and effective. Larger studies are needed to further
define this relationship.
Keywords
breast reconstruction - hernia - hernia repair
