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World Journal of Surgery

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01-04-2019 | Original Scientific Report

Anastomotic Leakage After Stoma Reversal Combined with Incisional Hernia Repair

Authors: Niklas N. Baastrup, Morten F. S. Hartwig, Peter-Martin Krarup, Lars N. Jorgensen, Kristian K. Jensen

Published in: World Journal of Surgery | Issue 4/2019

Abstract

Background

Stoma reversal in patients with an incisional hernia represents a clinical dilemma, as it remains unknown whether hernia repair should be concomitantly employed. We aimed at examining postoperative complications and mortality in patients undergoing stoma reversal with or without concomitant hernia repair.

Methods

This study included all patients subjected to stoma reversal between 2010 and 2016 at our institution. Patients were grouped according to conductance of concomitant incisional hernia repair or not. The primary outcome was anastomotic leak (AL). Secondary outcomes were surgical site occurrences (SSO), overall surgical complications, 90-day mortality and overall survival.

Results

In total, 142 patients were included of whom 18 (13%) underwent concomitant hernia repair. The incidence of AL was significantly higher in patients subjected to concomitant hernia repair (four out of 18 [22.2%]) compared with patients undergoing stoma reversal alone (three out of 124 [2.4%], P = 0.002). Additional variables associated with AL were duration of surgery (P < 0.001) and ischemic heart disease (P = 0.039). Twenty-two patients (15.5%) developed a SSO: eight (44.4%) in the hernia repair group and 14 (11.3%) in the non-hernia repair group (P < 0.001). In the multivariable analysis, concomitant hernia repair remained significantly associated with development of postoperative complications (OR = 5.92, 95% CI = 1.54–25.96, P = 0.012).

Conclusions

Compared with stoma reversal alone, incisional hernia repair concomitant with stoma reversal was associated with a higher incidence of AL and other complications.

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Title: Anastomotic Leakage After Stoma Reversal Combined with Incisional Hernia Repair
Authors: Niklas N. Baastrup
Morten F. S. Hartwig
Peter-Martin Krarup
Lars N. Jorgensen
Kristian K. Jensen
Publication date: 01-04-2019
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 4/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4866-5

At a glance: The STEP trials

Springer Medicine

Anastomotic Leakage After Stoma Reversal Combined with Incisional Hernia Repair

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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