Artikel ; Online: Extraction-site incisional hernia after laparoscopic colorectal surgery: should we carry out a study about prophylactic mesh closure?
2019 Band 34, Heft 9, Seite(n) 4048–4052
Abstract: Background: Prophylactic mesh closure has only scarcely been studied to avoid extraction-site incisional hernia after laparoscopic colorectal surgery. The aim was to analyze extraction-site incisional hernia incidence after laparoscopic colorectal ... ...
Abstract | Background: Prophylactic mesh closure has only scarcely been studied to avoid extraction-site incisional hernia after laparoscopic colorectal surgery. The aim was to analyze extraction-site incisional hernia incidence after laparoscopic colorectal surgery to assess if prophylactic mesh closure should be studied. Methods: A retrospective analytic cohort study was conducted in patients who had undergone laparoscopic colorectal surgery with an extraction-site incision. Extraction-site incisional hernia was diagnosed during clinical examination or imaging. Risk factors for extraction-site incisional hernia were analyzed. Results: Two hundred and twenty-five patients were included. More than 80% of the patients had a malignant disease. Ninety-two patients (40.9%) underwent right colectomy. Midline extraction-site incision was used in 86 (38.2%) patients. After a mean follow-up of 2.4 years, 39 (17.3%) patients developed an extraction-site incisional hernia. Midline extraction-site incision was associated with incisional hernia when compared to transverse and Pfannenstiel incision (39.5% vs. 3.6%, OR 17.5, p < 0.001). Surgery to repair an extraction-site incisional hernia was also more frequent in the group of patients with a midline incision (10.5% vs. 1.4%, OR 8.0, p = 0.002). In the multivariate analysis, incisional hernia was associated with body mass index, high blood pressure, and midline incision. Conclusions: Extraction-site incisional hernia was mainly related to midline incisions; therefore, midline incision should be avoided whenever possible. Studying prophylactic mesh closure for Pfannesnstiel or transverse incisions is needless, as these incisions have a low incisional hernia risk. |
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Mesh-Begriff(e) | Aged ; Blood Pressure ; Body Mass Index ; Colorectal Surgery/adverse effects ; Confidence Intervals ; Female ; Humans ; Incisional Hernia/epidemiology ; Incisional Hernia/etiology ; Incisional Hernia/physiopathology ; Laparoscopy/adverse effects ; Male ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Surgical Mesh/adverse effects |
Sprache | Englisch |
Erscheinungsdatum | 2019-10-15 |
Erscheinungsland | Germany |
Dokumenttyp | Journal Article |
ZDB-ID | 639039-0 |
ISSN | 1432-2218 ; 0930-2794 |
ISSN (online) | 1432-2218 |
ISSN | 0930-2794 |
DOI | 10.1007/s00464-019-07194-y |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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