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16-01-2024 | Incisional Hernia | Original Article

The enigma of incisional hernia prediction unraveled: external validation of a prognostic model in colorectal cancer patients

Authors: C. Amro, L. Smith, J. Shulkin, J. R. McGraw, N. Hill, R. B. Broach, J. Torkington, J. P. Fischer

Published in: Hernia | Issue 2/2024

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Abstract

Purpose

Accurate prediction of hernia occurrence is vital for surgical decision-making and patient management, particularly in colorectal surgery patients. While a hernia prediction model has been developed, its performance in external populations remain to be investigated. This study aims to validate the existing model on an external dataset of patients who underwent colorectal surgery.

Methods

The “Penn Hernia Calculator” model was externally validated using the Hughes Abdominal Repair Trial (HART) data, a randomized trial comparing colorectal cancer surgery closure techniques. The data encompassed demographics, comorbidities, and surgical specifics. Patients without complete follow-up were omitted. Model performance was assessed using key metrics, including area under the curve (AUC-ROC and AUC-PR) and Brier score. Reporting followed the TRIPOD consensus.

Results

An external international dataset consisting of 802 colorectal surgery patients were identified, of which 674 patients with up to 2 years follow-up were included. Average patient age was 68 years, with 63.8% male. The average BMI was 28.1. Prevalence of diabetes, hypertension, and smoking were 15.7%, 16.3%, and 36.5%, respectively. Additionally, 7.9% of patients had a previous hernia. The most common operation types were low anterior resection (35.3%) and right hemicolectomy (34.4%). Hernia were observed in 24% of cases by 2-year follow-up. The external validation model revealed an AUC-ROC of 0.66, AUC-PR of 0.72, and a Brier score of 0.2.

Conclusion

The hernia prediction model demonstrated moderate performance in the external validation. Its potential generalizability, specifically in those undergoing colorectal surgery, may suggest utility in identifying and managing high-risk hernia candidates.
Literature
12.
go back to reference den Hartog FPJ, van Egmond S, Poelman MM, Menon AG, Kleinrensink GJ, Lange JF et al (2023) The incidence of extraction site incisional hernia after minimally invasive colorectal surgery: a systematic review and meta-analysis. Colorectal Dis 25:586–599. https://doi.org/10.1111/codi.16455CrossRef den Hartog FPJ, van Egmond S, Poelman MM, Menon AG, Kleinrensink GJ, Lange JF et al (2023) The incidence of extraction site incisional hernia after minimally invasive colorectal surgery: a systematic review and meta-analysis. Colorectal Dis 25:586–599. https://​doi.​org/​10.​1111/​codi.​16455CrossRef
19.
go back to reference Jairam AP, Timmermans L, Eker HH, Pierik R, van Klaveren D, Steyerberg EW et al (2017) Prevention of incisional hernia with prophylactic onlay and sublay mesh reinforcement versus primary suture only in midline laparotomies (PRIMA): 2-year follow-up of a multicentre, double-blind, randomised controlled trial. Lancet 390:567–576. https://doi.org/10.1016/s0140-6736(17)31332-6CrossRefPubMed Jairam AP, Timmermans L, Eker HH, Pierik R, van Klaveren D, Steyerberg EW et al (2017) Prevention of incisional hernia with prophylactic onlay and sublay mesh reinforcement versus primary suture only in midline laparotomies (PRIMA): 2-year follow-up of a multicentre, double-blind, randomised controlled trial. Lancet 390:567–576. https://​doi.​org/​10.​1016/​s0140-6736(17)31332-6CrossRefPubMed
Metadata
Title
The enigma of incisional hernia prediction unraveled: external validation of a prognostic model in colorectal cancer patients
Authors
C. Amro
L. Smith
J. Shulkin
J. R. McGraw
N. Hill
R. B. Broach
J. Torkington
J. P. Fischer
Publication date
16-01-2024
Publisher
Springer Paris
Published in
Hernia / Issue 2/2024
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-023-02947-0

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