Abstract
Aim:
This study aims to perform a comprehensive systematic review and meta-analysis to evaluate the impact of anticoagulation (AC) therapy on clinical outcomes during ventral hernia repair (VHR).
Materials and Methods:
A thorough online search was conducted using PubMed, Cochrane, and Embase databases. Studies comparing the use of AC therapy following VHR were included. The results analyzed were bleeding-related reoperation, hemorrhagic/thrombotic complications, length of stay, and transfusion rates. Statistical analysis was performed with Review Manager 5.4 using a random-effects model.
Results:
From 1278 records, 4 studies were included, encompassing 41,868 patients (anticoagulants use = 4804; no AC = 32,649), with 25% on anticoagulant therapy submitted to minimally invasive surgery (MIS). Additionally, 90% of patients using anticoagulants underwent mesh placement. Overall analysis showed increased hemorrhagic/thrombotic complications (risk ratios [RR]: 2.3; 95% confidence interval [CI]: 1.13–4.8; P = .02), bleeding-related reoperation (RR: 6.5; 95% CI: 4.3–9.9; P < .00001), and longer hospital stays (mean difference: 1.69 days; 95% CI: .66 to 2.72 days; P = .001) in patients using anticoagulant medications. However, there was no increased risk of transfusion (RR: 2.14; 95% CI: 0.58–7.95; P = .26) between groups.
Conclusions:
The use of anticoagulant therapy following VHR is associated with increased hemorrhagic/thrombotic complications, bleeding-related reoperations, prolonged hospitalization, and similar transfusion rates. Further research is still required to validate these findings and explore the impact of MIS on anticoagulated patients following VHR.
Get full access to this article
View all access options for this article.