Port-site transversus abdominis fascia closure reduced the incidence of incisional hernia following retroperitoneal laparoscopic nephrectomy

Takei, Akemi; Sazuka, Tomokazu; Nakamura, Koki; Nihei, Naoki; Ichikawa, Tomohiko

doi:10.1007/s10029-016-1508-4

Cited by 6 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yet an ILDH after retroperitoneal laparoscopic radical nephrectomy can still occur at the extraction site incision, with an estimated incidence of 11%. 9 In the modern era of minimally invasive surgery, extraction incisions are significantly smaller owing to earlier detection of renal cell carcinoma (consequently favorable stage Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. *ORCID ID (https://orcid.org/0000-0002-8767-5195).…”

Section: Introductionmentioning

confidence: 99%

Incisional Lumbodorsal Hernias Following Retroperitoneal Robotic Partial Nephrectomies for Small Renal Masses at a High-Volume Tertiary Referral Center

Chow

Wahba

Phillips

et al. 2021

Journal of Endourology

View full text Add to dashboard Cite

Introduction: Herein we evaluate the incidence of incisional lumbodorsal hernia (ILDH) after retroperitoneal robotic partial nephrectomy (RRPN) and associated patient-specific and tumor-specific risk factors. Furthermore, we aim to evaluate the role of routine lumbodorsal fascial closure for the prevention of ILDH. Methodology: This is a retrospective review of our robotic partial nephrectomy database of all RRPNs performed at Washington University School of Medicine from 2000 to 2020. Postoperative imaging was reviewed for evidence of ILDH. A clinically significant hernia was defined as the protrusion of visceral organ(s) through the lumbodorsal fascia. Patient and tumor characteristics, and fascial closure techniques were analyzed to determine predictors of ILDH. Results: In total, 150 patients underwent RRPN between 2007 and 2020 with an average follow-up of 4.9 (1-37) months. Twelve (8%) ILDHs were identified. Ten (6.7%) patients had herniated retroperitoneal fat whereas 2 (1.3%) patients had herniated colon. All were asymptomatic and managed conservatively. On matched cohort comparison, patients with ILDH had larger tumors than patients without an incisional hernia (3.9 cm vs 2.8 cm, p = 0.029). In general, patient factors were no different between patients with and without ILDH. However, coronary artery disease (CAD) was more prevalent in patients with ILDH (33.3% vs 10.9%, p = 0.028). Patients with ILDH were more likely to have a port site extended for specimen extraction (66.7% vs 38.2%, p = 0.069). Lumbodorsal fascial closure and type of suture material were not associated with prevention of ILDH ( p = 0.545, p = 0.637). Conclusion:The radiographic incidence of lumbar incisional hernias after RRPN without routine fascial closure of the extraction incision was 8%. All were asymptomatic and did not require surgical repair. Larger tumor size and CAD were associated with ILDH.

show abstract

Section: Introductionmentioning

confidence: 99%