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Background <p>Obesity is a risk factor for complications after abdominal hernia repair. Glucagon-like-peptide-1 (GLP-1) receptor agonists are effective weight loss medications that may help patients reach weight loss goals for surgery. In this study, we examine our outcomes utilizing GLP-1 agonists for preoperative weight loss in obese patients undergoing elective hernia repair. </p> Methods <p>A retrospective review identified obese patients who were prescribed GLP-1 agonists for weight loss in addition to lifestyle changes before elective hernia repair from 2021 to 2024. Patients were managed by a multidisciplinary team and asked to achieve a body mass index (BMI) ≤ 33&#xa0;kg/m<sup>2</sup> before surgery. Primary outcomes were preoperative mean percentage total weight loss (%TWL), mean BMI reduction, and time from GLP-1 agonist initiation to surgery. Secondary outcomes were 30-day morbidity and 30-day reoperation rates, hernia recurrence, and postoperative weight changes.</p> Results <p>A total of 70 patients with ventral/incisional, umbilical, parastomal, flank, and inguinal hernias were identified. 33 patients (47.1%) underwent surgery, 24 (34.3%) remain in active follow-up, and 13 (18.6%) were lost to follow-up (no clinic visit in 1&#xa0;year). For patients who underwent surgery, mean BMI on initial presentation was 37.4 ± 4.8&#xa0;kg/m<sup>2</sup>. After initiating GLP-1 therapy, mean preoperative %TWL was 14.0 ± 6.9%. Mean preoperative BMI reduction was 5.3 ± 3.5&#xa0;kg/m<sup>2</sup>, resulting in mean BMI at surgery of 32.0 ± 3.6&#xa0;kg/m<sup>2</sup>. Mean time from GLP-1 agonist initiation to surgery was 8.2 ± 4.9&#xa0;months. Patients available for 6-month postoperative follow-up (<i>N</i> = 7) maintained their preoperative weight loss (mean surgery BMI: 29.0 ± 2.8&#xa0;kg/m<sup>2</sup> vs. mean BMI at 6&#xa0;months: 28.5 ± 3.4&#xa0;kg/m<sup>2</sup>, <i>p</i> = 0.46). 30-day morbidity and reoperation rates were 9.1% and 6.1%, respectively. Hernia recurrence rate was 3.0% (<i>N</i> = 1) during a mean follow-up of 5.9 ± 12.1&#xa0;months.</p> Conclusion <p>GLP-1 receptor agonists can facilitate expeditious and durable preoperative weight loss for patients with obesity prior to elective abdominal wall hernia repair with low postoperative morbidity.</p>

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The new bridge to hernia surgery: achieving preoperative weight optimization with GLP-1 receptor agonists for abdominal wall hernia repair

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月2日

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  • Graham J. Spurzem,
  • Ryan C. Broderick,
  • Patricia Ruiz-Cota,
  • Amanda Rocha,
  • Edgardo Reyes,
  • Andres Fontaine-Nicola,
  • Agustina Altolaguirre,
  • Hannah M. Hollandsworth,
  • Bryan J. Sandler,
  • Eduardo Grunvald,
  • Garth R. Jacobsen

摘要

Background

Obesity is a risk factor for complications after abdominal hernia repair. Glucagon-like-peptide-1 (GLP-1) receptor agonists are effective weight loss medications that may help patients reach weight loss goals for surgery. In this study, we examine our outcomes utilizing GLP-1 agonists for preoperative weight loss in obese patients undergoing elective hernia repair.

Methods

A retrospective review identified obese patients who were prescribed GLP-1 agonists for weight loss in addition to lifestyle changes before elective hernia repair from 2021 to 2024. Patients were managed by a multidisciplinary team and asked to achieve a body mass index (BMI) ≤ 33 kg/m2 before surgery. Primary outcomes were preoperative mean percentage total weight loss (%TWL), mean BMI reduction, and time from GLP-1 agonist initiation to surgery. Secondary outcomes were 30-day morbidity and 30-day reoperation rates, hernia recurrence, and postoperative weight changes.

Results

A total of 70 patients with ventral/incisional, umbilical, parastomal, flank, and inguinal hernias were identified. 33 patients (47.1%) underwent surgery, 24 (34.3%) remain in active follow-up, and 13 (18.6%) were lost to follow-up (no clinic visit in 1 year). For patients who underwent surgery, mean BMI on initial presentation was 37.4 ± 4.8 kg/m2. After initiating GLP-1 therapy, mean preoperative %TWL was 14.0 ± 6.9%. Mean preoperative BMI reduction was 5.3 ± 3.5 kg/m2, resulting in mean BMI at surgery of 32.0 ± 3.6 kg/m2. Mean time from GLP-1 agonist initiation to surgery was 8.2 ± 4.9 months. Patients available for 6-month postoperative follow-up (N = 7) maintained their preoperative weight loss (mean surgery BMI: 29.0 ± 2.8 kg/m2 vs. mean BMI at 6 months: 28.5 ± 3.4 kg/m2, p = 0.46). 30-day morbidity and reoperation rates were 9.1% and 6.1%, respectively. Hernia recurrence rate was 3.0% (N = 1) during a mean follow-up of 5.9 ± 12.1 months.

Conclusion

GLP-1 receptor agonists can facilitate expeditious and durable preoperative weight loss for patients with obesity prior to elective abdominal wall hernia repair with low postoperative morbidity.