The risk factors for incisional hernia after laparoscopic colorectal surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group

Risk factors of incisional hernia at the umbilical specimen extraction site in patients with laparoscopic colorectal cancer surgery

“…In the present study, IH was diagnosed in 52 of the 202 patients (25.7%) by CT. This rate seemed to be relatively high compared with a previous report involving diagnoses by CT images (6%-15%) [3][4][5][6][7][8][9]. These reports included a relatively short follow-up period of at least 6 to 12 months [4][5][6].…”

“…Our study demonstrated that an increased BMI, SFA, VFA, and decreased skeletal muscle area were significantly correlated with the incidence of IH in a univariate analysis. Even though those factors were not independent risk factors, there have been supportive previous reports regarding such obesity-related factors [7,8]. Yamamoto et al [7] and Fukuoka et al [8] reported that VFA of > 100-110 cm 2 was an independent risk factor for IH, and the intraabdominal pressure in obese patients is considered to depend more strongly on a direct mass effect from the intraabdominal adipose tissue itself [18].…”

“…Thus, these procedures should be considered separately in terms of risk factors for IH. A number of risk factors for IH after laparoscopic colorectal surgery have been reported, including female sex, a high BMI, umbilical hernia, incision length, periumbilical midline incision, surgical site infection, and the VFA [4,5,7,8]. However, the incidence of IH does not seem to be markedly different in recent studies compared with earlier ones.…”

“…The exclusion criteria were as follows: nonresection of the primary tumor, open surgery and conversion to open surgery, surgery without transumbilical specimen extraction, a history of abdominal surgery at the umbilical site before the surgery, and a history of abdominal surgery during the follow-up period. We excluded cases involving patients with open surgery and conversion to open surgery according to several previous studies of IH after laparoscopic colorectal surgery [7][8][9]. In addition, we also excluded cases involving patients with a history of abdominal surgery at the umbilical site before the surgery to investigate the relationship between the preoperative presence of umbilical hernia and the postoperative occurrence of IH, because the preoperative presence of umbilical hernia and IH are similar conditions.…”

“…The incidence of the IH after laparoscopic colorectal surgery is reported to be 6%-15% [3][4][5][6][7][8][9]. Even in cases with a limited, short incision, laparoscopic colorectal surgery was not significantly associated with a reduced incidence of IH in comparison to open surgery [3,10].…”