Incisional hernia after open resections for colorectal liver metastases – incidence and risk factors

Nilsson, Jan; Holka, Peter Strandberg; Sturesson, Christian

doi:10.1016/j.hpb.2016.02.001

Cited by 25 publications

(27 citation statements)

References 28 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of incisional hernia depends not only on patient- and surgeon-related factors but also on the method of detection. Henriksen et al reported an incidence of 25.9% on patients who were examined by an experienced surgeon [ 22 ], whereas J Nilsson et al reported an incidence of 30.5% on patients regularly examined with CT scans after surgery for liver metastases of colorectal cancer [ 23 ]. The women in our study were not screened for incisional hernia.…”

Section: Discussionmentioning

confidence: 99%

Incisional hernias following open gynecological surgery: a population-based study

Bewö

Österberg

Löfgren

et al. 2019

Arch Gynecol Obstet

View full text Add to dashboard Cite

Introduction Incisional hernia is a common and costly complication following abdominal surgery. The incidence of incisional hernia after gynecological surgery is not as well studied as that after general surgery. Materials and methods The Swedish National Quality Register for Gynecological Surgery (GynOp) collects preoperative, intraoperative, and postoperative information regarding gynecological surgery. Data were extracted from 2006 to 2014. The National Patient Register (NPR) contains physicians’ data from both public and private hospitals. Univariate and multivariate Cox proportional hazard analyzes were performed on risk factors. Results Between 2006 and 2014, 39,312 women undergoing open surgery were registered in GynOp. The NPR recorded 526 patients who were diagnosed with or had undergone surgery for incisional hernia. The mean follow-up was 2.8 years. Five years after surgery the cumulative incidence of incisional hernias was 2.0% (95% confidence interval 1.8–2.2%). In multivariate Cox proportional hazard analysis obesity (BMI > 30), age > 60 years, midline incision, smoking, kidney, liver, and pulmonary disease were found to predict an increased risk for incisional hernias (all p < 0.05). Conclusions There is much to be gained if the patient can cease smoking and lose weight before undergoing abdominal surgery. The Pfannenstiel incision results in fewer incisional hernias and should be considered whenever possible.

show abstract

Section: Discussionmentioning

confidence: 99%

Incisional hernias following open gynecological surgery: a population-based study

Bewö

Österberg

Löfgren

et al. 2019

Arch Gynecol Obstet

View full text Add to dashboard Cite

show abstract

“…The association and causality between chemotherapy and IH is poorly described. Both pre- and postoperative chemotherapy is described as having a compromising effect on wound healing, thus described in retrospective studies [ 12 , 13 ]. The intraoperative HIPEC administration is therefore hypothetically thought to increase the risk of IH and yet not described as an independent risk factor.…”

Section: Discussionmentioning

confidence: 99%

“…Several risk factors for developing IHs have been described: a previous IH, open surgery, placement of incision, closing technique, wound infection and dehiscence, and obesity [ 6 , 11 ]. Additionally, smoking and use of preoperative steroids and cytostatic drugs/chemotherapy have been suggested to increase the risk of IHs [ 12 ]. This causality has been suggested to be due to its association with a delayed healing process of the abdominal wound [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Incisional hernia and its impact on health-related quality of life after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a national prospective cohort study

et al. 2018

View full text Add to dashboard Cite

BackgroundTo evaluate the incidence of incisional hernia (IH) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) and its impact on health-related quality of life (HRQoL).MethodFrom June 2006 until June 2016, 152 patients were followed after CRS + HIPEC at Aarhus University Hospital, a single national center. Patients were seen postoperatively in an outpatient clinic at 3, 6, 12, 18, 24, 36 48, and 60 months. Clinical examinations at these follow-up visits were used to evaluate IH events prospectively. The incidence of IH was estimated using competing risk analysis and is presented as the cumulative incidence proportion (CIP). We expected the incidence to be 15% at 12 months. HRQoL was assessed at 12 months by the Short Form (SF-36) questionnaire, which we used to compare patients with an IH to patients without an IH.ResultsThe median follow-up time was 16.6 months [range 0.9–62.0]. During this period, 14/152 (9.2%) patients developed an IH. The 1-year CIP was 5.9% [95% CI 2.9; 10.4] (n = 8), and the 2-year CIP was 9.2% [95% CI 5.3; 14.5] (n = 14). Patients with an IH were significantly older (67 years [range 48–72]) compared to patients without IH (60 years [range 24–75], p ≤ 0.01). The rate of postoperative complications between patients with and without IH was comparable, except that a greater proportion of patients with IH had a fascial dehiscence (21.4%) compared to patients without an IH (3.6%). Reponses to the SF-36 show that patients with an IH report lower HRQoL with regard to Role-physical (mean difference − 32.9 [95% CI − 60.6; − 5.3]) and Role-emotional (mean difference − 20.2 [95% CI − 43.4; 3.1]), meaning a reduction in work and daily activities due to their physical and psychological health. We found no general decrease in HRQoL.ConclusionCRS + HIPEC do not increase the risk of IH as measured within 12 months postoperatively, contrary to expectations. However, patients with an IH report a limitation in daily activities, which can best be explained by changes in physical and psychological health. A larger cohort from multiple centres is necessary to verify our findings.

show abstract

“…The aim of this study was to assess the incidence of IH after laparotomy in hepatobiliary and pancreatic surgery. Incisional hernia was defined as a discontinuity in the abdominal fascia, shown as a protrusion of intraperitoneal structures through a defect in the incision site of the abdominal wall [4,12,1]. This complication of laparotomy can be diagnosed through physical examination, shown through medical records, or observation on the computed tomography (CT).…”

Section: Methodsmentioning

confidence: 99%

“…However, its incidence in hepatobiliary and pancreatic surgery is not known. Most of the available literature mentions its occurrence after hepatic metastasis resection [1], laparotomy [2,3], colorectal carcinoma [4] and liver transplantation [5][6][7]. Few articles refer to the incidence of IH in partial hepatectomy [8,9] and necrotizing pancreatitis [10].…”

Section: Introductionmentioning

confidence: 99%

Incisional hernia in hepatobiliary and pancreatic surgery: incidence and risk factors

Chen-Xu

Melo

Graça

et al. 2018

Hernia

View full text Add to dashboard Cite

Purpose. The occurrence of incisional hernia (IH) is one of the main complications after open abdominal surgery. However, its incidence in hepatobiliary and pancreatic surgery are not known. Studies on partial hepatectomy and necrotizing pancreatitis show that the incidence can reach up to 42%. This study aims at evaluating the incidence of IH and its risk factors. Methods. Patients submitted to open hepato-pancreato-biliary surgery at our Center between 2010 and 2016 were selected. IH was defined as discontinuity in the abdominal fascia reported during physical examination or on computed tomography. Variables analysed range from individual characteristics and medical history to surgical and postoperative aspects. Results. The cumulative incidence of IH was 14.6% at 36 months. In pancreatic patients, this incidence was 11.6%, while hepatobiliary patients presented an incidence of 16.0%, reaching 27,0% at 72 months. Cox regression showed that height (p=0.028), subcutaneous fat (p=0.037), wound dehiscence (p=0.001) and superficial surgical site infection (p=0.001) correlate positively with IH in pancreatic surgery patients. BMI (p=0.037) and perirenal fat (p=0.043) associated independently with IH in patients submitted to hepatobiliary surgery. Conclusions. Height, obesity and wound complications are risk factors for IH in patients submitted to pancreatic surgery, whereas obesity presents as risk factor in hepatobiliary surgery patients. The incidence of IH goes up to 12% in patients submitted to pancreatic surgery, while this risk is higher in the hepatobiliary group (27%). It is suggested the adoption of strategies in the clinical practice which prevent this high incidence, namely in high-risk patients.

show abstract

Incisional hernia after open resections for colorectal liver metastases – incidence and risk factors

Abstract: Prolonged preoperative chemotherapy and also preoperative bevacizumab were strong predictors for developing an incisional hernia. After an extended right subcostal incision, the hernia location was almost exclusively in the midline.

Cited by 25 publications

References 28 publications

Incisional hernias following open gynecological surgery: a population-based study

Incisional hernias following open gynecological surgery: a population-based study

Incisional hernia and its impact on health-related quality of life after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a national prospective cohort study

Incisional hernia in hepatobiliary and pancreatic surgery: incidence and risk factors

Contact Info

Product

Resources

About