Umbilical incisional hernias (M3): are trocar-site hernias different? Comparative analysis of the EVEREG registry⋆.
Complicaciones
Complications
Hernia de trócar
Hernia incisional
Hernia registry
Incisional hernia
Incisional hernia repair
Recurrence
Recurrencia
Registro hernia
Reparación hernia incisional
Trocar hernia
Journal
Cirugia espanola
ISSN: 2173-5077
Titre abrégé: Cir Esp (Engl Ed)
Pays: Spain
ID NLM: 101771152
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
12
11
2020
accepted:
24
01
2021
pubmed:
27
5
2022
medline:
22
6
2022
entrez:
26
5
2022
Statut:
ppublish
Résumé
Incisional hernia (HI), in open and laparoscopic surgery, is a very frequent complication. HI located in the umbilical region are called M3. The main aim of this study is to compare HI produced by the placement of an umbilical laparoscopic trocar (M3T) with those located in M3 in open surgery (M3O) in terms of basal characteristics, complications and recurrences; and secondarily the identification of risk factors. Cross-sectional observational study based on the national prospective registry EVEREG during the period of July 2012-June 2018. The main variables were recurrences and postoperative complications. Both groups (M3T and M3O) were compared. Multiple logistic regression was performed to identify the risk factors of the entire cohort. 882 had a follow-up time longer than 12 months. M3O group presented superior ASA-Class, more complex HI and previous repair. It also presented a higher recurrence rate at 12 and 24 months (8.6% vs. 2.5%; P < 0,0001 and 9.3% vs. 2.9%; P < 0.0001) and higher postoperative complications rate (21.9% vs. 14.6 %; P = 0.02). Previous repair, intervention length and associated procedures requirement were identified as risk factors for postoperative complications. Absence of a specialist present during surgery, previous repair, and the absence of complications were identified as risk factors for recurrence. In the PSM analysis no differences were detected in of complications and recurrences. HI M3O is more complex than M3T. The complexity is not related to the origin of the hernia but to its characteristics and those of the patient.
Sections du résumé
BACKGROUND
BACKGROUND
Incisional hernia (HI), in open and laparoscopic surgery, is a very frequent complication. HI located in the umbilical region are called M3. The main aim of this study is to compare HI produced by the placement of an umbilical laparoscopic trocar (M3T) with those located in M3 in open surgery (M3O) in terms of basal characteristics, complications and recurrences; and secondarily the identification of risk factors.
METHOD
METHODS
Cross-sectional observational study based on the national prospective registry EVEREG during the period of July 2012-June 2018. The main variables were recurrences and postoperative complications. Both groups (M3T and M3O) were compared. Multiple logistic regression was performed to identify the risk factors of the entire cohort.
RESULTS
RESULTS
882 had a follow-up time longer than 12 months. M3O group presented superior ASA-Class, more complex HI and previous repair. It also presented a higher recurrence rate at 12 and 24 months (8.6% vs. 2.5%; P < 0,0001 and 9.3% vs. 2.9%; P < 0.0001) and higher postoperative complications rate (21.9% vs. 14.6 %; P = 0.02). Previous repair, intervention length and associated procedures requirement were identified as risk factors for postoperative complications. Absence of a specialist present during surgery, previous repair, and the absence of complications were identified as risk factors for recurrence. In the PSM analysis no differences were detected in of complications and recurrences.
CONCLUSIONS
CONCLUSIONS
HI M3O is more complex than M3T. The complexity is not related to the origin of the hernia but to its characteristics and those of the patient.
Identifiants
pubmed: 35618203
pii: S2173-5077(22)00148-X
doi: 10.1016/j.cireng.2022.05.023
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
336-344Investigateurs
Antonio Utrera González
(A)
José M Capitán Vallvey
(JM)
Matías Pradas
(M)
Daniel Pérez Gomar
(D)
Manuel Bustos
(M)
Francisco Antonio Herrera Fernández
(FA)
Juan A Blanco
(JA)
Joaquim Robres Puig
(J)
Rafael Villalobos
(R)
Dolors Güell Puigcercos
(D)
José María Puigcercós Fusté
(JM)
Vicente Ayuso Osuna
(V)
Marta Piñol
(M)
Carles Olona Casas
(C)
Francisco Martínez Ródenas
(F)
Jordi Comajuncosas
(J)
Enric Sebastián Valverde
(E)
Sara Amador
(S)
Jaume Gelonch
(J)
Helena Vallverdú
(H)
Magda Abelló Sala
(M)
Antonio Veres Gómez
(A)
Rosa Gamón
(R)
Pedro García Peche
(P)
Miguel González Valverde
(M)
Miguel Ángel Martín Blanco
(MÁ)
Ramón J Ferri
(RJ)
Elena Martí Ciñat
(E)
Providencia García Pastor
(P)
Carlos Montero
(C)
Miguel Ángel Lorenzo Liñán
(MÁ)
Vicente Barbero
(V)
Miguel Ángel Morlan
(MÁ)
José María Jover
(JM)
Isabel Delgado Lillo
(I)
María Mercedes Sanz Sánchez
(MM)
Leire Zarain Obrador
(L)
Alejandro Lusilla
(A)
Juan Jesús Cabeza Gómez
(JJ)
Antonio López
(A)
Teresa Butrón
(T)
Guillermo Supelano Eslait
(G)
José Luis Álvarez Conde
(JL)
Baltasar Pérez Saborido
(B)
Mario Rodríguez López
(M)
Santiago Revuelta Álvarez
(S)
Pedro Trillo Parejo
(P)
José Luis Rodicio
(JL)
Antonio Blanco
(A)
Agustín Juan Cano Maldonado
(AJ)
Ángel Zorraquino González
(Á)
Esther Guisasola
(E)
Fernando Fernández
(F)
Javier Granell
(J)
Juan Antonio Bellido Luque
(JA)
Juan Manuel Rueda Pérez
(JM)
Mª Pilar Anaya Reig
(MP)
Rafael Gómez Sabater
(R)
Rosa Ana García Díaz
(RA)
Verónica Alonso
(V)
Informations de copyright
Copyright © 2021 AEC. Published by Elsevier España, S.L.U. All rights reserved.