Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2016

01-02-2016 | Colorectal Cancer

Age, Preoperative Subcutaneous Fat Area, and Open Laparotomy are Risk Factors for Incisional Hernia following Colorectal Cancer Surgery

Authors: Toru Yamada, MD, Koji Okabayashi, MD, Hirotoshi Hasegawa, MD, PhD, Masashi Tsuruta, MD, PhD, Yuta Abe, MD, PhD, Takashi Ishida, MD, Shimpei Matsui, MD, Yuko Kitagawa, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Special Issue 2/2016

Login to get access

Abstract

Background

Although incisional hernia (IH) is a common complication of abdominal surgery, the incidence rate and risk factors are not well known. The objectives of this study are to determine the incidence rate of IH following colorectal cancer surgery and to describe the associated risk factors.

Methods

Between 2005 and 2010, patients who underwent surgery to treat colorectal cancer were examined. The diagnosis of IH was performed by CT scan, and the visceral fat area (VFA) and subcutaneous fat area (SFA) at the level of the umbilicus were calculated using a 3D-image analysis system. Survival analysis was used to assess the incidence and risk factors of IH.

Results

A total of 626 patients (326 open, 300 laparoscopic) were included in this study, with median follow-up of 54 (range 2–97) months. Forty patients were diagnosed with postoperative IH, and the cumulative, 5-year incidence of IH was 7.3 %. Univariate analysis revealed that age, body mass index, waist circumference, hip circumference, open laparotomy, wound infection, VFA, and SFA were significantly associated with incidence of IH. Multivariate analysis revealed that age [hazard ratio (HR) 1.043 (1.005–1.083), p = 0.027], open laparotomy [HR 4.410 (1.018–19.095), p = 0.047], and SFA [HR 1.013 (1.004–1.022), p = 0.005] were significant risk factors for developing IH.

Conclusions

Higher age and SFA, along with open surgery, are risk factors for developing IH.
Literature
1.
Burger JW, Lange JF, Halm JA, Kleinrensink GJ, Jeekel H. Incisional hernia: early complication of abdominal surgery. World J Surg. 2005;29(12):1608–13.CrossRefPubMed
2.
3.
Bhangu A, Fletcher L, Kingdon S, Smith E, Nepogodiev D, Janjua U. A clinical and radiological assessment of incisional hernias following closure of temporary stomas. Surgeon. 2012;10(6):321–5.CrossRefPubMed
4.
Claes K, Beckers R, Heindryckx E, 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.CrossRefPubMed
5.
6.
Hall KA, Peters B, Smyth SH, et al. Abdominal wall hernias in patients with abdominal aortic aneurysmal versus aortoiliac occlusive disease. Am J Surg. 1995;170(6):572–5; discussion 575–6.CrossRefPubMed
7.
Israelsson LA, Jonsson T. Incisional hernia after midline laparotomy: a prospective study. Eur J Surg. 1996;162(2):125–9.PubMed
8.
Veljkovic R, Protic M, Gluhovic A, Potic Z, Milosevic Z, Stojadinovic A. Prospective clinical trial of factors predicting the early development of incisional hernia after midline laparotomy. J Am Coll Surg. 2010;210(2):210–9.CrossRefPubMed
9.
10.
Cobb WS, Carbonell AM, Snipes GM, et al. Incisional hernia risk after hand-assisted laparoscopic surgery. Am Surg. 2012;78(8):864–9.PubMed
11.
Mingoli A, Puggioni A, Sgarzini G, et al. Incidence of incisional hernia following emergency abdominal surgery. Ital J Gastroenterol Hepatol. 1999;31(6):449–53.PubMed
12.
Biondo S, Pares D, Kreisler E, et al. Anastomotic dehiscence after resection and primary anastomosis in left-sided colonic emergencies. Dis Colon Rectum. 2005;48(12):2272–80.CrossRefPubMed
13.
Watanabe J, Tatsumi K, Ota M, et al. The impact of visceral obesity on surgical outcomes of laparoscopic surgery for colon cancer. Int J Colorectal Dis. 2014;29(3):343–51.CrossRefPubMed
14.
Armstrong CP, Dixon JM, Duffy SW, Elton RA, Davies GC. Wound healing in obstructive jaundice. Br J Surg. 1984;71(4):267–70.CrossRefPubMed
15.
Makela JT, Kiviniemi H, Juvonen T, Laitinen S. Factors influencing wound dehiscence after midline laparotomy. Am J Surg. 1995;170(4):387–90.CrossRefPubMed
16.
Henriksen NA, Yadete DH, Sorensen LT, Agren MS, Jorgensen LN. Connective tissue alteration in abdominal wall hernia. Br J Surg. 2011;98(2):210–9.CrossRefPubMed
17.
Duepree HJ, Senagore AJ, Delaney CP, Fazio VW. Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy. J Am Coll Surg. 2003;197(2):177–81.CrossRefPubMed
18.
Andersen LP, Klein M, Gogenur I, Rosenberg J. Incisional hernia after open versus laparoscopic sigmoid resection. Surg Endosc. 2008;22(9):2026–9.CrossRefPubMed
19.
Halm JA, Lip H, Schmitz PI, Jeekel J. Incisional hernia after upper abdominal surgery: a randomised controlled trial of midline versus transverse incision. Hernia. 2009;13(3):275–80.CrossRefPubMedPubMedCentral
20.
Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J. Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials. Cancer Treat Rev. 2008;34(6):498–504.CrossRefPubMed
21.
Taylor GW, Jayne DG, Brown SR, et al. Adhesions and incisional hernias following laparoscopic versus open surgery for colorectal cancer in the CLASICC trial. Br J Surg. 2010;97(1):70–8.CrossRefPubMed
22.
Callery MP, Strasberg SM, Soper NJ. Complications of laparoscopic general surgery. Gastrointest Endosc Clin N Am. 1996;6(2):423–44.PubMed
23.
Lumley J, Stitz R, Stevenson A, Fielding G, Luck A. Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes. Dis Colon Rectum. 2002;45(7):867–72; discussion 872–65.CrossRefPubMed
24.
Berthou JC, Charbonneau P. Elective laparoscopic management of sigmoid diverticulitis. Results in a series of 110 patients. Surg Endosc. 1999;13(5):457–60.CrossRefPubMed
25.
Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515–29.CrossRefPubMedPubMedCentral
26.
Montz FJ, Holschneider CH, Munro MG. Incisional hernia following laparoscopy: a survey of the American Association of gynecologic laparoscopists. Obstet Gynecol. 1994;84(5):881–4.PubMed
27.
Justinger C, Slotta JE, Schilling MK. Incisional hernia after abdominal closure with slowly absorbable versus fast absorbable, antibacterial-coated sutures. Surgery. 2012;151(3):398–403.CrossRefPubMed
28.
Millbourn D, Cengiz Y, Israelsson LA. Effect of stitch length on wound complications after closure of midline incisions: a randomized controlled trial. Arch Surg. 2009;144(11):1056–9.CrossRefPubMed
Metadata
Title
Age, Preoperative Subcutaneous Fat Area, and Open Laparotomy are Risk Factors for Incisional Hernia following Colorectal Cancer Surgery
Authors
Toru Yamada, MD
Koji Okabayashi, MD
Hirotoshi Hasegawa, MD, PhD
Masashi Tsuruta, MD, PhD
Yuta Abe, MD, PhD
Takashi Ishida, MD
Shimpei Matsui, MD
Yuko Kitagawa, MD, PhD, FACS
Publication date
01-02-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 2/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4462-y

Other articles of this Special Issue 2/2016

Annals of Surgical Oncology 2/2016 Go to the issue

Gastrointestinal Oncology

Overexpression of Lysophosphatidylcholine Acyltransferase 1 and Concomitant Lipid Alterations in Gastric Cancer

Gastrointestinal Oncology

Tumor-Associated Macrophages Extend Along Lymphatic Flow in the Pre-metastatic Lymph Nodes of Human Gastric Cancer

Colorectal Cancer

Visualization of Lymph/Blood Flow in Laparoscopic Colorectal Cancer Surgery by ICG Fluorescence Imaging (Lap-IGFI)

Author Disclosure Summary

Japanese Society of Gastroenterological Surgery Article Series Disclosure Index

Gastrointestinal Oncology

Preoperative Cardiac Risk Assessment and Surgical Outcomes of Patients with Gastric Cancer

Gastrointestinal Oncology

The Expression of Melanoma-Associated Antigen D2 Both in Surgically Resected and Serum Samples Serves as Clinically Relevant Biomarker of Gastric Cancer Progression