D74. Comparative Effectiveness Analysis of Ventral Hernia Repair with Panniculectomy: Evaluating Efficacy With and Without External Oblique Release

PURPOSE: As obesity rates climb, concurrent VHR and panniculectomy procedures increase. Yet, data on combined anterior component separation using external oblique release (EOR) and panniculectomy outcomes are limited. This study assesses the long-term results of VHR and Panniculectomy with and without EOR. METHODS: A retrospective review from 2016-2022 was done on patients who underwent VHR with EOR and panniculectomy. Propensity-scored matching considered age, BMI, comorbidities, and mesh type. Exclusions were made for parastomal hernias. RESULTS: A total of 223 patients were identified; 156 were matched (78 Bilateral EOR:78 without). Median age and BMI were 58 years and 37.8 kg/m2, respectively. The majority of patients were female in both cohorts (70.5% vs. 75.%, p>0.05). There was a significant difference in hernia defect size (409.1cm2±188.5cm2 vs. 268.2cm2±192.4cm2), procedure duration (min;270±92 vs. 240±132), and number of drains utilized (2.7 vs 2.4)(p>0.05). There were no differences between the groups regarding type of mesh used, hernia recurrence, surgical site occurrences, emergency department visits, or reoperations (p>0.05). However, patients who underwent VHR with EOR demonstrated a significant association with VTE (14.3% vs. 3.8%, p<0.05) and readmissions (38.5% vs 20.8%, p<0.05). This group also demonstrated to be an independent predictor of readmissions (AOR 6.9, p<0.05) with a mean follow up of 53 months. CONCLUSION: Concurrent VHR with EOR and panniculectomy is a viable procedure, demonstrating low recurrence and complication rates over long-term follow-up. However, due to the prolonged nature of the procedures, increased vigilance is needed given the higher association with VTE and readmissions.