Incidence of and Risk Factors for Incisional Hernia After Hepatectomy for Colorectal Liver Metastases

Maki, Hisaji; Kim, Bradford J.; Kawaguchi, Yoshikuni; Fernandez-Placencia, Ramiro; Haddad, Antony; Panettieri, Elena; Newhook, Timothy E.; Baumann, Donald P.; Santos, David A.; Cao, Hop S. Tran; Chun, Yun Shin; Tzeng, Ching Wei D.; Vauthey, Jean‐Nicolas; Vreeland, Timothy J.

doi:10.1007/s11605-023-05777-8

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“…The IH rate for OLR was 10% and 19% at 1 and 3 years, respectively. The reported incidence of IH after OLR for CRLM in the literature is 8%−41% at 1 year [ 6 , 19 ], and 34.9%−59.2% IH at 5 years [ 4 , 19 ]. The latter study reported by Nilsson et al [ 4 ] had an older cohort, which could explain their higher incidence.…”

Section: Discussionmentioning

confidence: 99%

Incidence of incisional hernia following liver surgery for colorectal liver metastases. Does the laparoscopic approach reduce the risk? A comparative study

Hassan,

Arujunan,

Mohamed

et al. 2024

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims No reports to compare incisional hernia (IH) incidence between laparoscopic and open colorectal liver metastases (CRLM) resections have previously been made. This is the first comparative study. Methods Single-center retrospective review of patients who underwent CRLM surgery between January 2011 and December 2018. IH relating to liver surgery was confirmed by computed tomography. Patients were divided into laparoscopic liver resection (LLR) and open liver resection (OLR) groups. Data collection included age, sex, presence of diabetes mellitus, steroid intake, history of previous hernia or liver resection, subcutaneous and peri-renal fat thickness, preoperative creatinine and albumin, American Society of Anesthesiologists (ASA) score, major liver resection, surgical site infection, synchronous presentation, and preoperative chemotherapy. Results Two hundred and forty-seven patients were included with a mean follow-up period of 41 ± 29 months (mean ± standard deviation). Eighty seven (35%) patients had LLR and 160 patients had OLR. No significant difference in the incidence of IH between LLR and OLR was found at 1 and 3 years, respectively ([10%, 19%] vs. [10%, 19%], . = 0.95). On multivariate analysis, previous hernia history (hazard ratio [HR], 2.22; 95% confidence interval [CI], 1.56–4.86) and subcutaneous fat thickness (HR, 2.22; 95% CI, 1.19–4.13) were independent risk factors. Length of hospital stay was shorter in LLR (6 ± 4 days vs. 10 ± 8 days, . < 0.001), in comparison to OLR. Conclusions In CRLM, no difference in the incidence of IH between LLR and OLR was found. Previous hernia and subcutaneous fat thickness were risk factors. Further studies are needed to assess modifiable risk factors to develop IH in LLR.

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