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01-09-2020 | Incision

Extraction-site incisional hernia after laparoscopic colorectal surgery: should we carry out a study about prophylactic mesh closure?

Authors: Oscar Cano-Valderrama, Rodrigo Sanz-López, Inmaculada Domínguez-Serrano, Jana Dziakova, Vanesa Catalán, Mikel Rojo, Mauricio García-Alonso, José M. Mugüerza, Antonio J. Torres

Published in: Surgical Endoscopy | Issue 9/2020

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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Title: Extraction-site incisional hernia after laparoscopic colorectal surgery: should we carry out a study about prophylactic mesh closure?
Authors: Oscar Cano-Valderrama
Rodrigo Sanz-López
Inmaculada Domínguez-Serrano
Jana Dziakova
Vanesa Catalán
Mikel Rojo
Mauricio García-Alonso
José M. Mugüerza
Antonio J. Torres
Publication date: 01-09-2020
Publisher: Springer US
Keywords: Incision
Incisional Hernia
Published in: Surgical Endoscopy / Issue 9/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-07194-y

At a glance: The STEP trials

Springer Medicine

Extraction-site incisional hernia after laparoscopic colorectal surgery: should we carry out a study about prophylactic mesh closure?

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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