Jordi Comajuncosas1, Judit Hermoso1, Pere Gris1, Jaime Jimeno1, Rolando Orbeal1, Helena Vallverdú1, Jose Luis López Negre1, Joan Urgellés1, Laia Estalella1, David Parés2. 1. Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain. 2. Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, C/ Camí Vell de la Colònia 25, 08830 Sant Boi de Llobregat (Barcelona), Spain. Electronic address: david.pares@pssjd.org.
Abstract
BACKGROUND: Trocar site incisional hernia (TSIH) is a common complication after laparoscopic cholecystectomy. The aim of this study was to evaluate the prevalence of TSIH and analyze the influence of several risk factors for this complication in a prospective series. METHODS: From 2007 to 2008, a prospective observational study with 3 years of follow-up was performed including all consecutive patients with cholelithiasis who underwent elective laparoscopic cholecystectomy. A multivariate analysis was performed to identify risk factors for TSIH. RESULTS: Overall, 241 patients were included. During a median follow-up period of 46.8 months, 57 patients (25.9%) were diagnosed with umbilical TSIH by physical exam or ultrasound. The multivariate analysis revealed that incision enlargement (odds ratio [OR], 14.17; 95% confidence interval [CI], 3.61 to 55.51; P < .001), wound infection (OR, 5.62; 95% CI, 2.35 to 13.42; P < .001), diabetes mellitus (OR, 2.79; 95% CI, 1.05 to 7.37; P = .0038), and obesity (OR, 2.71; 95% CI, 1.28 to 5.75; P = .009) contributed to the risk for developing a TSIH. CONCLUSIONS: Umbilical TSIH is highly prevalent. This study identified several factors that could be useful to introduce preventive measures in high-risk patients.
BACKGROUND: Trocar site incisional hernia (TSIH) is a common complication after laparoscopic cholecystectomy. The aim of this study was to evaluate the prevalence of TSIH and analyze the influence of several risk factors for this complication in a prospective series. METHODS: From 2007 to 2008, a prospective observational study with 3 years of follow-up was performed including all consecutive patients with cholelithiasis who underwent elective laparoscopic cholecystectomy. A multivariate analysis was performed to identify risk factors for TSIH. RESULTS: Overall, 241 patients were included. During a median follow-up period of 46.8 months, 57 patients (25.9%) were diagnosed with umbilical TSIH by physical exam or ultrasound. The multivariate analysis revealed that incision enlargement (odds ratio [OR], 14.17; 95% confidence interval [CI], 3.61 to 55.51; P < .001), wound infection (OR, 5.62; 95% CI, 2.35 to 13.42; P < .001), diabetes mellitus (OR, 2.79; 95% CI, 1.05 to 7.37; P = .0038), and obesity (OR, 2.71; 95% CI, 1.28 to 5.75; P = .009) contributed to the risk for developing a TSIH. CONCLUSIONS: Umbilical TSIH is highly prevalent. This study identified several factors that could be useful to introduce preventive measures in high-risk patients.
Authors: Andrew P Rogers; Tiffany J Zens; Jonathan E Kohler; Hau D Le; Peter F Nichol; Charles M Leys Journal: J Laparoendosc Adv Surg Tech A Date: 2016-07-11 Impact factor: 1.878
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Authors: F Köckerling; H Hoffmann; F Mayer; K Zarras; W Reinpold; R Fortelny; D Weyhe; B Lammers; D Adolf; C Schug-Pass Journal: Hernia Date: 2020-10-19 Impact factor: 4.739