Decision analysis model of incisional hernia after open abdominal surgery

Cheng, H; Rupprecht, F.C.; Jackson, DL; Berg, Thorsten; Seelig, M. G.

doi:10.1007/s10029-006-0176-1

Cited by 12 publications

(13 citation statements)

References 44 publications

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“…3 Ventral hernias can develop from heavy straining, increased age, acute injury or strain and an infection at the site of surgery. They can occur spontaneously or manifest years following the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

“…They can occur spontaneously or manifest years following the surgical procedure. The incidence of ventral site hernia development following abdominal surgery has been previously reported, 3 but the potential contributing factors associated with gynecologic cancer surgery have not been extensively studied. 9,10,13 Therefore, the purpose of this retrospective study was to identify the relevant prognostic factors inherent in early ventral hernia development following gynecologic cancer surgery.…”

Section: Discussionmentioning

confidence: 99%

“…2 In abdominal surgery, there appears to be a high incidence of hernias associated with vertical midline abdominal incisions, with a reported risk of 5-15%. 3,4 Moreover, an increased risk of ventral site hernia development may significantly coincide with an adverse health status. 5 Select surgical studies have attempted to address the specific factors that potentially contribute to the premature manifestation of ventral site hernias.…”

Section: Introductionmentioning

confidence: 99%

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Chemotherapy and patient co-morbidity in ventral site hernia development

et al. 2009

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Objective:The risk factors associated with early ventral site hernia development following cancer surgery are ill defined and associated with an undetermined incidence. Methods: We analyzed 1,391 gynecologic cancer patient charts to identify the number of post-operative ventral site hernias over a nearly 6 year period. The following study variables were noted for evaluation: patient demographics, disease co-morbidity (hypertension, cardiovascular disease, diabetes), body mass index (BMI), treatment (e.g., chemotherapy regimen), intra-operative (e.g., bleeding) and postoperative (e.g., infection) complications, time to hernia development and length of hospital stay. Results: Twenty-six gynecologic cancer patients who developed a post-operative ventral hernia and subsequently underwent herniorrhaphy by our gynecologic oncology service were identified. The patient group's overall time to initial hernia development was 11.23 months. Following a multiple regression analysis, we found that treatment (e.g., bevacizumab, liposomal doxorubicin or radiotherapy associated with compromised wound healing [p=0.0186] and disease co-morbidity [0.0432]) were significant prognostic indicators for an accelerated time to hernia development. Moreover, five patients underwent treatment associated with compromised wound healing and also had disease co-morbidity. In this sub-group, post-operative hernia development occurred more rapidly (3.8 months) than the overall group of patients. BMI and age did not impact time to hernia development (p＞0.05). Conclusion:In the present gynecologic cancer patient series, a tendency for early post-operative hernia development appeared to coincide with treatment associated with compromised wound healing and disease co-morbidity. Gynecologic cancer surgeons should anticipate this potential complication and consider employing prophylactic intra-operative mesh to potentially prevent this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Chemotherapy and patient co-morbidity in ventral site hernia development

et al. 2009

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“…Only two patients in the NCT group and three patients in the CT group had a follow up <12 months. The mean number of previous abdominal operations was two (range [1][2][3][4][5]. The mean defect size in the NCT group was 8 cm (range [3][4][5][6][7][8][9][10][11] and in the CT group it was 9 cm (range 4-12) with no statistically significant difference between the groups.…”

Section: Resultsmentioning

confidence: 91%

Chemotherapy does not adversely impact outcome following post‐incisional hernia repair with biomaterial mesh

Saied

David

LaBarbera

et al. 2015

Journal of Surgical Oncology

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Background: Patients receiving chemotherapy are at increased risk for developing recurrent or post-incisional hernias (PIH). Biological materials are an alternative to synthetic mesh in contaminated fields. The impact of chemotherapy on biomaterial tissue ingrowth and integration has not been well studied. Methods: From 2008 to 2011 patients who underwent PIH repair with biomaterial mesh (Biodesign 1 ) were selected. Patients were divided into two groups: those receiving chemotherapy (CT) and those not receiving chemotherapy (NCT). Results: Forty-five patients were identified, 28 (62%) in the NCT group and 17 (38%) in the CT group. Median follow up for NCT and CT groups were 27 and 17 months, respectively. A total of 9/45 (20%) surgical site infections (SSI) were diagnosed, with 6/28 (21%) in the NCT and 3/17 (18%) in the CT group (P ¼ 0.53). Seroma formation was seen in 5/28 (18%) of NCT patients and 4/17 (23%) in CT group (P ¼ 0.46). Overall hernia recurrence rate was 22%, and the rates of recurrence were similar among the CT 3/17 (18%) and NCT 7/28 (25%) groups (P ¼ 0.42). Conclusion: The use of perioperative chemotherapy did not increase the rate of wound complications following PIH repair with biologic mesh in this group of patients.

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“…Nowadays, the laparoscopic access was introduced and plays important role in the success outcome 3,4 . Thus, the systematic review on hernia repair is a hard task 5 . The consensus or a reliable algorithm to hernia treatment remains a challenge [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Animal model of chronic abdominal hernia in rabbit

Silva

Fagundes

Seidel³

et al. 2009

Acta Cir. Bras.

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Purpose: To create a feasible animal model of hernia that should be reliable to test the different types of mesh and/or surgical technique. Methods: Thirty six male New Zealand albino rabbits were submitted to surgical procedure to provoke a standard hole in the abdominal wall. A metallic frame measuring 3 cm length and 1 cm width was allocated longitudinally on the umbilicus scar and the comprehensive three squared centimeters area was resected. A continuous 4.0 polyamide was performed to closure the subcutaneous and skin. Results: During three weeks a score of signals/symptoms was performed to evaluate the wound and clinical conditions. No death or severe complications occurred. In the 3rd week the hernia ring and visceral adhesions were evaluated. Soft omental adherences were present in the hernial sac in all animals. The area of hernia ring ranged from 32.1±5.5 to 35.6±3.1 squared centimeter and the maximum was 39 cm 2 and the minimum was 30 cm 2 . The model results in protrusion which was similar to a human incisional hernia with hernia sac, visceral adhesions and fibrous healing ring. Conclusion: The model was more reliable to test further techniques or mesh on hernia repair. Key words: Hernia, Ventral. Hernia, Abdominal. Wound Healing. Animal Experimentation. Rabbits. RESUMO Objetivo:Criação de um modelo animal de hérnia que seja confiável para testar as diferentes técnicas e tipos de telas. Métodos: Trinta e seis coelhos foram submetidos a procedimento operatório que provocou uma falha na parede abdominal. Uma moldura metálica com 3 cm de comprimento e 1 cm de largura foi colocada longitudinalmente sobre a cicatriz umbilical e ressecada uma área de 3cm 2 . Uma sutura contínua de poliamida 4.0 fechou a tela subcutânea e pele. Resultados: durante três semanas o escore de sinais e sintomas foi coletado para avaliar as condições clínicas e da ferida operatória. Não ocorreram óbitos ou complicações graves. Na terceira semana o anel herniário e aderências peritoneais foram avaliadas. Aderências frouxas estavam presentes no saco herniário em todos os animais. A área do anel herniário variou de 32.1±5.5 a 35.6±3.1 cm 2 , com um máximo de 39 cm 2 e um mínimo de 30 cm 2 . O modelo resultou numa protrusão de vísceras semelhante ao que ocorre em hérnia incisional de humanos. Conclusão: O modelo é factível para testar técnicas operatórias ou telas na reconstrução de hérnias incisionais.

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Decision analysis model of incisional hernia after open abdominal surgery

Abstract: The additional treatment costs for incisional hernia should be taken into account when the costs of a surgery performed by open approach are compared with by laparoscopy.

Cited by 12 publications

References 44 publications

Chemotherapy and patient co-morbidity in ventral site hernia development

Chemotherapy and patient co-morbidity in ventral site hernia development

Chemotherapy does not adversely impact outcome following post‐incisional hernia repair with biomaterial mesh

Animal model of chronic abdominal hernia in rabbit

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