Rısk Factors For Trocar Site Hernias Following Laparoscopic Cholecycstectomy

Abstract

Introduction: Laparoscopic cholecystectomy (LC) remains the gold standard surgical method for cholelithiasis. The objective of this study was to evaluate risk factors for the development of a trocar site hernia following an LC. Materials and Methods:All of the patients who underwent an LC between 2014 and 2017 at the Kartal Research and Education Hospital were included in the study. Clinical data were collected retrospectively and possible causes of a trocar site hernia were analyzed. Age, gender, the method of suturing trocar sites, open or closed trocar insertion technique, body mass index (BMI), surgical site infection occurrence, associated diseases, and follow-up times were recorded.Results: A total of 340 patients were included in this study. In the group, 254 were female (74%). The mean age was 48.4±14 years (range: 19-90 years). The mean follow-up time was 31.9±12.7 days. A trocar site hernia developed in 20 (5.9%) patients, and the mean age was 62.5±12.8 years (p=0.0001). Six (35.2%) of 17 patients with a postoperative surgical site infection developed a hernia (p=0.0001). In all, 35 patients had diabetes and 6 diabetic patients (17.1%) developed a hernia (p=0.003). The mean BMI was 31.2±6.1 kg/m2 in the presence of a hernia and 27.9±4 kg/m 2 in the absence of a hernia (p=0.001). Conclusion:This study examined age, BMI, diabetes, surgical site infection, trocar insertion method, and the technique used for the closure of fascia as possible risk factors in the development of trocar site hernia. Multivariate analysis revealed that only age, diabetes, BMI, and wound site infection were significant.