Top

Published in:

Open Access 01-12-2023 | Computed Tomography | Research

Retrospective study of an incisional hernia after laparoscopic colectomy for colorectal cancer

Authors: Toshinori Kobayashi, Hisanori Miki, Nobuyuki Yamamoto, Soushi Hori, Masahiko Hatta, Yuki Hashimoto, Hiromi Mukaide, Makoto Yamasaki, Kentaro Inoue, Mitsugu Sekimoto

Published in: BMC Surgery | Issue 1/2023

Abstract

Purpose

This study aimed to examine the incidence of incisional hernia (IH) in elective laparoscopic colorectal surgery (LC) using regulated computed tomography (CT) images at intervals every 6 months.

Methods

We retrospectively examined the diagnosis of IH in patients who underwent LC for colorectal cancer at Kansai Medical University Hospital from January 2014 to August 2018. The diagnosis of IH was defined as loss of continuity of the fascia in the axial CT images.

Results

470 patients were included in the analysis. IH was diagnosed in 47 cases at 1 year after LC. The IH size was 7.8 cm² [1.3–55.6]. In total, 38 patients with IH underwent CT examination 6 months after LC, and 37 were already diagnosed with IH. The IH size was 4.1 cm² [0–58.9]. The IH size increased in 17 cases between 6 months and 1 year postoperatively, and in 1 case, a new IH occurred. 47%(18/38) of them continued to grow until 1 year after LC. A multivariate analysis was performed on the risk of IH occurrence. SSI was most significantly associated with IH occurrence (OR:5.28 [2.14–13.05], p = 0.0003).

Conclusion

IH occurred in 10% and 7.9% at 1 year and 6 months after LC. By examining CT images taken for the postoperative surveillance of colorectal cancer, we were able to investigate the occurrence of IH in detail.

Available only for authorised users

Fukuoka H, et al. The risk factors for incisional hernia after laparoscopic colorectal Surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group. Surg Endosc. 2021;35:3471–8. https://doi.org/10.1007/s00464-020-07794-z.CrossRefPubMed

Petersson J, et al. Bowel obstruction and ventral hernia after laparoscopic versus open Surgery for rectal cancer in a randomized trial (COLOR II). Ann Surg. 2019;269:53–7. https://doi.org/10.1097/SLA.0000000000002790.CrossRefPubMed

Benlice C, et al. Impact of the specific extraction-site location on the risk of incisional hernia after laparoscopic colorectal resection. Dis Colon Rectum. 2019;59:743–50. https://doi.org/10.1097/DCR.0000000000000632.CrossRef

Jensen KK, et al. Incisional hernias after open versus laparoscopic Surgery for colonic cancer: a nationwide cohort study. Surg Endosc. 2016;30:4469–79. https://doi.org/10.1007/s00464-016-4779-z.CrossRefPubMed

Kuhry E, et al. Long-term results of laparoscopic Colorectal cancer resection. Cochrane Database Syst Rev John Wiley & Sons Ltd. 2008;2. https://doi.org/10.1002/14651858.CD003432.pub2. no. 2:CD003432.

Lee L, Abou-Khalil, et al. Incidence of incisional hernia in the specimen extraction site for laparoscopic colorectal Surgery: systematic review and meta-analysis. Surg Endosc. 2017;31:5083–93. https://doi.org/10.1007/s00464-017-5573-2.CrossRefPubMed

Hidalgo MP et al. Incisional hernia in patients at risk: can it be prevented? Hernia 15, no. 4:371–5. https://doi.org/10.1007/s10029-011-0794-0 (2011).

García-Ureña MÁ, et al. Randomized controlled trial of the use of a large-pore polypropylene mesh to prevent incisional hernia in colorectal Surgery. Ann Surg. 2015;261:876–81. https://doi.org/10.1097/SLA.0000000000001116.CrossRefPubMed

Lee L, et al. High incidence of symptomatic incisional hernia after midline extraction in laparoscopic colon resection. Surg Endosc. 2012;26:3180–5. https://doi.org/10.1007/s00464-012-2311-7.CrossRefPubMed

10.

Bhangu A, et al. Systematic review and meta-analysis of prophylactic mesh placement for prevention of incisional hernia following midline laparotomy. Hernia. 2013;17:445–55. https://doi.org/10.1007/s10029-013-1119-2.CrossRefPubMed

11.

Timmermans L, et al. Meta-analysis of primary mesh augmentation as prophylactic measure to prevent incisional hernia. Dig Surg S Karger AG. 2013;30:401–9. https://doi.org/10.1159/000355956.CrossRef

12.

Kurmann A, et al. Implantation of prophylactic nonabsorbable intraperitoneal mesh in patients with Peritonitis is safe and feasible. World J Surg. 2013;37:1656–60. https://doi.org/10.1007/s00268-013-2019-4.CrossRefPubMed

13.

Jairam AP, et al. 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. 2017;390:567–76. https://doi.org/10.1016/S0140-6736(17)31332-6.CrossRefPubMed

14.

Kohler A, et al. Effectiveness of prophylactic intraperitoneal mesh implantation for prevention of incisional hernia in patients undergoing open abdominal Surgery: a randomized clinical trial. JAMA Surg. 2019;154:109–15. https://doi.org/10.1001/jamasurg.2018.4221.CrossRefPubMed

15.

Grove TN et al. Measuring quality of life in patients with abdominal wall hernias: a systematic review of available tools. Hernia, vol. 25. Springer-Verlag Italia s.r.l. 25, no. 2:491–500. https://doi.org/10.1007/s10029-020-02210-w (2021).

16.

Kroese LF et al. Comparing different modalities for the diagnosis of incisional hernia: a systematic review. Hernia, vol. 22. Springer-Verlag France 22, no. 2:229–242. https://doi.org/10.1007/s10029-017-1725-5 (2018).

17.

Deerenberg EB, et al. Articles small bites versus large bites for closure of abdominal midline incisions (stitch): a double-blind, multicentre, randomised controlled trial. Lancet. 2015;26(10000):1254–60. https://doi.org/10.1016/s0140-6736(15)60459-7.CrossRef

18.

Paskar Sv. DD, “Closure methods for laparotomy incisions for preventing incisional hernias and other wound complications,“ Cochrane Database of Systematic Reviews. Patel. John Wiley Sons Ltd vol. 2017 11. https://doi.org/10.1002/14651858.CD005661.pub2 (2017).

19.

Hashiguchi Y et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol. 2020;25(1):1–42. https://doi.org/10.1007/s10147-019-01485-z (2020).

20.

Jensen KK, et al. The impact of incisional hernia on mortality after colonic cancer resection. Surg Endosc. 2017;31(5):2149–54. https://doi.org/10.1007/s00464-016-5212-3.CrossRefPubMed

21.

Sun K, et al. The prognostic significance of the prognostic nutritional index in cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol. 2014;140:1537–49. https://doi.org/10.1007/s00432-014-1714-3.CrossRefPubMed

22.

Baucom RB, et al. Comparative evaluation of dynamic abdominal Sonography for Hernia and computed tomography for characterization of Incisional Hernia. JAMA Surg. 2014;149(6):591–6. https://doi.org/10.1001/jamasurg.2014.36.CrossRefPubMed

23.

Sauerland S, et al. Obesity is a risk factor for recurrence after incisional hernia repair. Hernia. 2004;8(1):42–6. https://doi.org/10.1007/s10029-003-0161-x.CrossRefPubMed

24.

Udayasiri DK, et al. Laparoscopic compared with open resection for Colorectal cancer and long-term incidence of adhesional intestinal obstruction and incisional hernia: a systematic review and meta-analysis. Dis Colon Rectum. 2020;63(1):101–12. https://doi.org/10.1097/DCR.0000000000001540.CrossRefPubMed

25.

Claes K, et al. Retrospective observational study on the incidence of incisional hernias after colorectal carcinoma resection with follow-up CT scan. Hernia. 2014;18:797–802. https://doi.org/10.1007/s10029-014-1214-z.CrossRefPubMed

26.

Jensen KK, et al. Long-term impact of incisional hernia on quality of life after colonic cancer resection. Hernia. 2020;24:265–72. https://doi.org/10.1007/s10029-019-01978-w.CrossRefPubMed

27.

den Hartog FPJ, et al. The incidence of extraction site incisional hernia after minimally invasive colorectal Surgery: a systematic review and meta-analysis. Colorectal Dis. 2023;25(4):586–99. https://doi.org/10.1111/codi.16455.CrossRef

28.

Benlice C, et al. Impact of the specific extraction-site location on the risk of Incisional Hernia after laparoscopic colorectal resection. Dis Colon Rectum. 2016;59(8):743–50. https://doi.org/10.1097/dcr.0000000000000632.CrossRefPubMed

29.

Santos DA, et al. Chemotherapy and Abdominal Wall Closure technique increase the probability of postoperative ventral Incisional Hernia in patients with Colon Cancer. Am Surg. 2023;89(1):98–107. https://doi.org/10.1177/00031348211011149.CrossRefPubMed

30.

Yoshino T, et al. Final analysis of 3 Versus 6 months of adjuvant oxaliplatin and fluoropyrimidine-based therapy in patients with stage III Colon Cancer: the Randomized Phase III ACHIEVE trial. J Clin Oncol. 2022;10(29):3419–29. https://doi.org/10.1200/jco.21.02628.CrossRef

31.

Yothers G, et al. Oxaliplatin as adjuvant therapy for colon Cancer: updated results of NSABP C-07 trial, including survival and subset analyses. J Clin Oncol. 2011;29(28):3768–74. https://doi.org/10.1200/jco.2011.36.4539.CrossRefPubMedPubMedCentral

32.

André T, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon Cancer in the MOSAIC trial. J Clin Oncol. 2009;27(19):3109–16. https://doi.org/10.1200/jco.2008.20.6771.CrossRefPubMed

Title: Retrospective study of an incisional hernia after laparoscopic colectomy for colorectal cancer
Authors: Toshinori Kobayashi
Hisanori Miki
Nobuyuki Yamamoto
Soushi Hori
Masahiko Hatta
Yuki Hashimoto
Hiromi Mukaide
Makoto Yamasaki
Kentaro Inoue
Mitsugu Sekimoto
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Computed Tomography
Computed Tomography
Published in: BMC Surgery / Issue 1/2023
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-023-02229-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Retrospective study of an incisional hernia after laparoscopic colectomy for colorectal cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

The effect of double W tension-reduced suture technique on the abdominal scars following the da Vinci robot-assisted gastrectomy for severely obese patients

Comparison of the efficacy of ETS with different segments for palmar, axillary and plantar hyperhidrosis

Surgical management of complex perianal fistula revisited in a systematic review: a critical view of available scientific evidence

Construction and validation of machine learning models for sepsis prediction in patients with acute pancreatitis

Efficacy of prophylactic negative pressure wound therapy after open ventral hernia repair: a systematic review meta-analysis

Testicular salvageability and its predictors among patients with testicular torsion in a resource limited setting: a multicentre longitudinal study