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Abstract Background Prehabilitation is known to enhance postoperative outcomes after different surgical procedures, but no such evidence is found in abdominal wall surgery. Our aim is to analyse the complications and need for reconsultation in patients undergoing weight optimization prior to abdominal wall hernia surgery. Methods Prospective observational study including all patients diagnosed with complex abdominal wall hernia and IMC 30 kg/m2 between January 2019 and December 2022. Patients were included in a pre-intervention weight optimization circuit. The need for reconsultation to the emergency room or outpatient clinic during the prehabilitation period was analysed, as well as the surgical results and post-surgical complications of those patients who underwent elective or emergency hernia repair. Results 83 patients were included (56 female, mean age 62 years, 18 patients with Charlson ≥3). The primary hernia defect averaged 7.9 cm (SD 3.9), with 4.8% having a primary ventral hernia and 37.2% having recurrent hernias. During prehabilitation, 22.9% of patients reconsulted in the outpatient clinic, while 31.3% consulted in the emergency service. 37.3% underwent surgical hernia repair, with 12.9% of them requiring emergency surgery. Postoperative complications, classified according to the Clavien-Dindo system as IIIa, occurred in 6.2% of cases. One patient (3.2%) required readmission after emergency hernia repair. After a median follow-up of 15 months, a recurrence rate of 3.2% was observed in the emergency hernia repair group. Conclusion Preoperative weight loss prehabilitation is associated to high outpatient-clinic consultation, emergency consultation and emergency hernia repair rates. Patients with a need for emergency surgery have worse postoperative outcomes.
Jaume-Bottcher et al. (Wed,) studied this question.