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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-12-2016 | Gastrointestinal Oncology

Cancer Survivorship: Defining the Incidence of Incisional Hernia After Resection for Intra-Abdominal Malignancy

Authors: Rebeccah B. Baucom, MD, Jenny Ousley, MD, Gloria B. Beveridge, BA, Sharon E. Phillips, MSPH, Richard A. Pierce, MD, PhD, FACS, Michael D. Holzman, MD, MPH, FACS, Kenneth W. Sharp, MD, FACS, William H. Nealon, MD, FACS, Benjamin K. Poulose, MD, MPH, FACS

Published in: Annals of Surgical Oncology | Special Issue 5/2016

Login to get access

Abstract

Background

Cancer survivorship focuses largely on improving quality of life. We aimed to determine the rate of ventral incisional hernia (VIH) formation after cancer resection, with implications for survivorship.

Methods

Patients without prior VIH who underwent abdominal malignancy resections at a tertiary center were followed up to 2 years. Patients with a viewable preoperative computed tomography (CT) scan and CT within 2 years postoperatively were included. Primary outcome was postoperative VIH on CT, reviewed by a panel of surgeons uninvolved with the original operation. Factors associated with VIH were determined using Cox proportional hazards regression.

Results

1847 CTs were reviewed among 491 patients (59 % men), with inter-rater reliability 0.85 for the panel. Mean age was 60 ± 12 years; mean follow-up time 13 ± 8 months. VIH occurred in 41 % and differed across diagnoses: urologic/gynecologic (30 %), colorectal (53 %), and all others (56 %) (p < 0.001). Factors associated with VIH (adjusting for stage, age, adjuvant therapy, smoking, and steroid use) included: incision location [flank (ref), midline, hazard ratio (HR) 6.89 (95 %CI 2.43–19.57); periumbilical, HR 6.24 (95 %CI 1.84–21.22); subcostal, HR 4.55 (95 %CI 1.51–13.70)], cancer type [urologic/gynecologic (ref), other {gastrointestinal, pancreatic, hepatobiliary, retroperitoneal, and others} HR 1.86 (95 %CI 1.26–2.73)], laparoscopic-assisted operation [laparoscopic (ref), HR 2.68 (95 %CI 1.44–4.98)], surgical site infection [HR 1.60 (95 %CI 1.08–2.37)], and body mass index [HR 1.06 (95 %CI 1.03–1.08)].

Conclusions

The rate of VIH after abdominal cancer operations is high. VIH may impact cancer survivorship with pain and need for additional operations. Further studies assessing the impact on QOL and prevention efforts are needed.
Literature
1.
Expertise in Cancer Survivorship Research. National Cancer Institute, Office of Cancer Survivorship. 2016.
2.
Israelsson LA, Jonsson T. Incisional hernia after midline laparotomy: a prospective study. Eur J Surg. 1996;162:125–9.PubMed
3.
4.
Yamada T, Okabayashi K, Hasegawa H et al. Age, Preoperative Subcutaneous Fat Area, and open laparotomy are risk factors for incisional hernia following colorectal cancer surgery. Ann Surg Oncol. 2015;23(2):236–41.
5.
Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg. 1985;72:70–1.CrossRefPubMed
6.
Krpata DM, Schmotzer BJ, Flocke S et al. Design and initial implementation of herqles: a hernia-related quality-of-life survey to assess abdominal wall function. J Am Coll Surg. 2012;215:63–-42.CrossRefPubMed
7.
Heniford BT, Walters AL, Lincourt AE, Novitsky YW, Hope WW, Kercher KW. Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg. 2008;206:638–44.CrossRefPubMed
8.
Colavita PD, Tsirline VB, Belyansky I et al. Prospective, long-term comparison of quality of life in laparoscopic versus open ventral hernia repair. Ann Surg. 2012;256:714–23.CrossRefPubMed
9.
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
10.
11.
Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed). 1982;284:931–3.CrossRef
12.
Montalti R, Mimmo A, Rompianesi G et al. Early use of mammalian target of rapamycin inhibitors is an independent risk factor for incisional hernia development after liver transplantation. Liver Transpl. 2012;18:188–94.CrossRefPubMed
13.
Kurmann A, Visth E, Candinas D, Beldi G. Long-term follow-up of open and laparoscopic repair of large incisional hernias. World J Surg. 2011;35:297–301.CrossRefPubMed
14.
Israelsson LA, Jonsson T, Knutsson A. Suture technique and wound healing in midline laparotomy incisions. Eur J Surg. 1996;162:605–9.PubMed
15.
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;210:210–9.CrossRefPubMed
16.
Gawande A. Being mortal: medicine and what matters in the end. New York: Metropolitan Books. 2014.
17.
Luijendijk RW, Hop WC, van den Tol MP et al. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med. 2000;343:392–8.CrossRefPubMed
18.
Muysoms FE, Deerenberg EB, Peeters E et al. Recommendations for reporting outcome results in abdominal wall repair: results of a Consensus meeting in Palermo, Italy, 28–30 June 2012. Hernia 2013;17:423–33.CrossRefPubMed
19.
20.
Itatsu K, Yokoyama Y, Sugawara G et al. Incidence of and risk factors for incisional hernia after abdominal surgery. Br J Surg. 2014;101:1439–47.CrossRefPubMed
21.
van Ramshorst GH, Eker HH, Hop WC, Jeekel J, Lange JF. Impact of incisional hernia on health-related quality of life and body image: a prospective cohort study. Am J Surg. 2012;204:144–50.CrossRefPubMed
22.
Muysoms FE, Antoniou SA, Bury K et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015;19:1–24.CrossRefPubMed
23.
Bickenbach KA, Karanicolas PJ, Ammori JB et al. Up and down or side to side? a systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery. Am J Surg. 2013;206:400–9.CrossRefPubMed
24.
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;144:1056–9.CrossRefPubMed
25.
Deerenberg EB, Harlaar JJ, Steyerberg EW et al. Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. Lancet. 2015.386(10000):1254–60.CrossRefPubMed
Metadata
Title
Cancer Survivorship: Defining the Incidence of Incisional Hernia After Resection for Intra-Abdominal Malignancy
Authors
Rebeccah B. Baucom, MD
Jenny Ousley, MD
Gloria B. Beveridge, BA
Sharon E. Phillips, MSPH
Richard A. Pierce, MD, PhD, FACS
Michael D. Holzman, MD, MPH, FACS
Kenneth W. Sharp, MD, FACS
William H. Nealon, MD, FACS
Benjamin K. Poulose, MD, MPH, FACS
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5546-z

Other articles of this Special Issue 5/2016

Annals of Surgical Oncology 5/2016 Go to the issue

Head and Neck Oncology

The Therapeutic Benefit of Radical Resection for T4b Oral Cavity Squamous Cell Carcinoma with Partial or Complete Response After Radical Chemo-Intensity-Modulated Radiotherapy (IMRT)

Gastrointestinal Oncology

Quality-of-Life Evaluation After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Urologic Oncology

The Preoperative Neutrophil-to-lymphocyte Ratio is a Novel Biomarker for Predicting Worse Clinical Outcomes in Non-muscle Invasive Bladder Cancer Patients with a Previous History of Smoking

Breast Oncology

Predictors of Surgical Margin Following Breast-Conserving Surgery: A Large Population-Based Cohort Study

Breast Oncology

Contrast-Enhanced Digital Mammography in the Surgical Management of Breast Cancer

Gastrointestinal Oncology

Usefulness of Surgical Apgar Score on Predicting Survival After Surgery for Gastric Cancer