Risk Factors for Incisional Hernia in Children

Tanaka, Keiichiro; Misawa, Takeyuki; Ashizuka, Shuichi; Yoshizawa, Jyoji; Akiba, Tadashi; Ohki, Takao

doi:10.1007/s00268-017-4434-4

Cited by 9 publications

(7 citation statements)

References 18 publications

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“…In our opinion, the clinical significance of IHs in infants undetectable by physical examination is doubtful. Smaller hernias have been reported to close without necessitating surgery, as is also the case in congenital umbilical hernias 7 . Since most IHs develop within a year after surgery it is desirable to plan an extra repeat visit at least a year after surgery as part of the research protocol 6 .…”

Section: Discussionmentioning

confidence: 89%

“…Still, this seems to be in line with previous cohort studies that focused on incisional hernia specifically in pediatric patients. These studies opted that the www.nature.com/scientificreports/ occurrence of IH seems to be more related to specific diagnosis instead of mode of surgery 6,7 . Within the included studies type of incision was only scarcely reported.…”

Section: Discussionmentioning

confidence: 99%

“…Transverse incisions have been shown to have a lower incidence of IH compared to midline incision in adults 66,67 . Previous studies suggested that the acquired newborn abdominal diseases necrotizing enterocolitis and pyloromyotomy are at higher risk for the development of IH 7,68 . Our review shows that the congenital abdominal wall defects gastroschisis and omphalocele should be added to this list.…”

Section: Discussionmentioning

confidence: 99%

“…For obvious reasons though, taking measures to prevent smoking and obesity in the infantile cohort would not aid in lowering IH rate 5 . The studies that do report IH in the paediatric population reported an incidence between 0.7 and 3.2% [6][7][8][9] . During the last decades major advancements have been made in the postnatal care of neonates with congenital anomalies.…”

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confidence: 99%

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Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Schattenkerk

Musters

Nijssen

et al. 2020

Sci Rep

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Incisional hernia (IH) in children could result in life-threatening complications, including incarceration and bowel strangulation. The incidence and risk factors of IH in infants are scarcely reported. Since IH-correction may require extensive surgery and a long recovery program, identifying infants and birth defects at risk, may lead to a different approach during the primary surgery. Therefore, the aim of this review is to systematically review the available data on the incidence of IH following surgery for congenital anomalies in infants. All studies describing IH were considered eligible. PubMed and Embase were searched and risk of bias was assessed. Primary outcome was the incidence of IH, secondary outcomes were difference in IH occurrence between disease severity (complex vs simple) and closure method (SILO vs primary closure) in gastroschisis patients. A meta-analysis was performed to pool the reported incidences in total and per congenital anomaly separately. Subgroup analysis within gastroschisis articles was performed. The 50 included studies represent 3140 patients. The pooled proportion of IH was 0.03 (95% CI 0.02–0.05; I2 = 79%, p ≤ 0.01) all anomalies combined. Gastroschisis (GS) reported highest pooled proportion 0.10 (95% CI 0.06–0.17; n = 142/1273; I2 = 86%; p ≤ 0.01). SILO closure (OR 3.09) and simple gastroschisis, i.e. without additional anomalies, (OR 0.18) were of significant influence. This review reports the incidence of IH in infants with different congenital abdominal anomalies, of which gastroschisis reported the highest risk. In GS patients, complex GS and SILO closure are risk factors for IH development.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Schattenkerk

Musters

Nijssen

et al. 2020

Sci Rep

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“…Studies that do report on IH in the paediatric population in general report an incidence between one and three percent [6][7][8][9][10] . These studies suggested that those suffering from necrotizing enterocolitis (NEC) and infantile hypertrophic pyloric stenosis (PS) are potentially more at risk for the development of IH.…”

Section: Introductionmentioning

confidence: 99%

Incisional hernia after abdominal surgery in infants: A retrospective analysis of incidence and risk factors

Schattenkerk

Musters

Coultre

et al. 2021

Journal of Pediatric Surgery

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Incisional hernia (IH) is a complication following abdominal surgery extensively studied in adults but less so in infants. This study aimed to identify the incidence, high risk diseases and risk factors of IH following abdominal surgery in infants. Methods: Infants undergoing abdominal surgery before the age of three years in our tertiary centre between 1998 and 2018 were included. Patient demographics, peri-operative details and the course during follow up were retrospectively extracted from patient records. Multivariate logistic regression was performed to identify risk factors. Results: The incidence of incisional hernia was 5.2% (107/2055). Necrotizing enterocolitis (12%), gastroschisis (19%), and omphalocele (17%) had the highest incidences of IH. Wound infection (OR: 5.3, 95%-CI:2.9-9.5), preterm birth (OR: 4.2, 95%-CI:2.6-6.7) and history of stoma (OR 1.7, 95%-CI:1.1-2.8) were significant risk factors for IH. Whilst age at surgery, surgical approach and total number of operations did not significantly influence IH development. The IH resolved in 15% (16/107) without surgery. Conclusion: One in twenty infants experiences IH following abdominal surgery, which is higher than previously described. Understanding the incidence of IH and associated risk factors will allow physicians to identify infants that may be at increased risk for IH and to possibly act pre-emptively.

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Abdomen

Mayer¹,

Sorge²,

Lacher³

2020

Kinderchirurgie Für Pädiater

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Risk Factors for Incisional Hernia in Children

Abstract: The incidence of IH in children is significantly lower than that in adults, and the above three risk factors were revealed. Before abdominal surgery, we recommend that pediatric surgeons should mention the risk of developing IH when the patient has the above risk factors.

Cited by 9 publications

References 18 publications

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Incisional hernia after abdominal surgery in infants: A retrospective analysis of incidence and risk factors

Abdomen

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