Incisional Hernia After Laparoscopic-Assisted Right Hemicolectomy.
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
pubmed:
21
8
2019
medline:
16
7
2020
entrez:
21
8
2019
Statut:
ppublish
Résumé
Different approaches used for laparoscopic right colectomy have different advantages and disadvantages. This study aims to determine the incidence and clinical relevance of IH after LARHC as the preferred technique in an experienced setting and to assess which factors are correlated with the development of IH. Between January 2012 and December 2016, all consecutive patients who underwent LARHC were included. Data were obtained in accordance with the Dutch ColoRectal Audit, and IH was scored based on physical examination and imaging at standard follow-up. Logistic regression analysis was used to identify risk factors for IH. A total of 170 patients underwent LARHC. In the same period, 64 patients had an open RHC. IH after LARHC was seen in 24 patients after a median time of 7 months (14%). Only four of these patients underwent operative IH repair (2%). Interestingly, a trend for more IH was seen between two surgeons. Multivariable analysis identified BMI [OR 1.08 (95% CI 1.00-1.15) P = 0.043], a history of smoking [OR 2.14 (95% CI 1.03-4.41) P = 0.040], and surgical site infection [OR 2.99 (95% CI 1.28-7.00) P = 0.012] as risk factors for IH. IH incidence after LARHC was considerable, but few were clinically relevant IHs. The IH incidence should be included in shared decision making. The low clinically relevant IH rate does in our opinion not outweigh possible advantages of LARHC.
Sections du résumé
BACKGROUND
Different approaches used for laparoscopic right colectomy have different advantages and disadvantages. This study aims to determine the incidence and clinical relevance of IH after LARHC as the preferred technique in an experienced setting and to assess which factors are correlated with the development of IH.
METHODS
Between January 2012 and December 2016, all consecutive patients who underwent LARHC were included. Data were obtained in accordance with the Dutch ColoRectal Audit, and IH was scored based on physical examination and imaging at standard follow-up. Logistic regression analysis was used to identify risk factors for IH.
RESULTS
A total of 170 patients underwent LARHC. In the same period, 64 patients had an open RHC. IH after LARHC was seen in 24 patients after a median time of 7 months (14%). Only four of these patients underwent operative IH repair (2%). Interestingly, a trend for more IH was seen between two surgeons. Multivariable analysis identified BMI [OR 1.08 (95% CI 1.00-1.15) P = 0.043], a history of smoking [OR 2.14 (95% CI 1.03-4.41) P = 0.040], and surgical site infection [OR 2.99 (95% CI 1.28-7.00) P = 0.012] as risk factors for IH.
CONCLUSION
IH incidence after LARHC was considerable, but few were clinically relevant IHs. The IH incidence should be included in shared decision making. The low clinically relevant IH rate does in our opinion not outweigh possible advantages of LARHC.
Identifiants
pubmed: 31428835
doi: 10.1007/s00268-019-05131-7
pii: 10.1007/s00268-019-05131-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3172-3178Références
Br J Surg. 1993 Oct;80(10):1284-6
pubmed: 8242299
Arch Surg. 2005 Feb;140(2):119-23
pubmed: 15723991
N Engl J Med. 2004 May 13;350(20):2050-9
pubmed: 15141043
Ann Surg. 2007 Dec;246(6):1010-4; discussion 1014-5
pubmed: 18043103
World J Surg Oncol. 2017 Dec 04;15(1):215
pubmed: 29202820
Hernia. 2004 Aug;8(3):177-81
pubmed: 14997364
Lancet. 2002 Jun 29;359(9325):2224-9
pubmed: 12103285
Arch Surg. 2008 Aug;143(8):762-7; discussion 768
pubmed: 18711036
JAMA. 2002 Jan 16;287(3):321-8
pubmed: 11790211
Ann Surg. 2013 Jul;258(1):1-7
pubmed: 23728278
Eur J Surg Oncol. 2013 Oct;39(10):1063-70
pubmed: 23871573
Lancet. 2015 Sep 26;386(10000):1254-1260
pubmed: 26188742
Surg Endosc. 2016 Sep;30(9):3823-9
pubmed: 26659237
J Clin Oncol. 2007 Jul 20;25(21):3061-8
pubmed: 17634484
Surg Oncol. 2013 Mar;22(1):1-13
pubmed: 23116767
Surg Endosc. 2017 Jan;31(1):64-77
pubmed: 27287905
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Dis Colon Rectum. 2016 Aug;59(8):743-50
pubmed: 27384092
Colorectal Dis. 2012 Aug;14(8):e447-69
pubmed: 22540533
Ann Surg. 2010 May;251(5):843-56
pubmed: 20395846
Surg Endosc. 2008 Aug;22(8):1769-80
pubmed: 18437486
Hernia. 2009 Aug;13(4):407-14
pubmed: 19495920
Br J Surg. 2014 Oct;101(11):1439-47
pubmed: 25123379
Can J Surg. 2015 Feb;58(1):63-8
pubmed: 25621913
Chir Ital. 2008 Jan-Feb;60(1):1-7
pubmed: 18389741
Ann Surg. 2008 Jul;248(1):1-7
pubmed: 18580199
J Laparoendosc Adv Surg Tech A. 2016 May;26(5):343-8
pubmed: 26919037
Int J Surg. 2012;10(6):290-5
pubmed: 22564829