José Antonio Pereira1, Miguel Pera2, Manuel López-Cano3, Marta Pascual4, Sandra Alonso4, Silvia Salvans4, Marta Jiménez-Toscano4, Alba González-Martín4, Luis Grande-Posa2. 1. Departmento de Cirugía General y Digestiva, Parc de Salut Mar, Hospital del Mar, Barcelona, España; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, España. Electronic address: 86664@parcdesalutmar.cat. 2. Departmento de Cirugía General y Digestiva, Parc de Salut Mar, Hospital del Mar, Barcelona, España; Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, España. 3. Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, España; Departamento de Cirugía General, Hospital Universitari Vall d'Hebrón, Barcelona, España. 4. Departmento de Cirugía General y Digestiva, Parc de Salut Mar, Hospital del Mar, Barcelona, España.
Abstract
OBJECTIVES: To determine the incidence of incisional hernia (IH) in the extraction incision (EI) in colorectal resection for cancer. To analyze whether the location of the incision has any relationship with the incidence of hernias and whether mesh could be useful for prevention in high-risk patients. METHODS: Retrospective review of the colon and rectal surgery database from January 2015 to December 2016. Data were classified into 2groups, transverse (TI) and midline incision (MI), and the latter was divided into 2subgroups (mesh [MIM] and suture [MIS]). Patients were classified using the HERNIAscore. Hernias were diagnosed by clinical and/or CT examination. RESULTS: A total of 182 out of 210 surgical patients were included. After a median follow-up of 13.0 months, 39 IH (21.9%) were detected, 23 of which (13.4%) were in the EI; their frequency was lower in the TI group (3.4%) and in the MIM group (5.9%) than in the MIS group (29.5%; p=0.007). The probability of developing IH in the MIS group showed an OR=11.7 (95%CI: 3.3-42.0) compared to the TI group and 4.3 (IC 95%: 1.1-16.3) versus the MIM group. CONCLUSIONS: The location of the incision is relevant to avoid incisional hernias. Transverse incisions should be used as the first option. When a midline incision is needed, a prophylactic mesh could be considered in high risk patients because it is safe and associated with low morbidity.
OBJECTIVES: To determine the incidence of incisional hernia (IH) in the extraction incision (EI) in colorectal resection for cancer. To analyze whether the location of the incision has any relationship with the incidence of hernias and whether mesh could be useful for prevention in high-risk patients. METHODS: Retrospective review of the colon and rectal surgery database from January 2015 to December 2016. Data were classified into 2groups, transverse (TI) and midline incision (MI), and the latter was divided into 2subgroups (mesh [MIM] and suture [MIS]). Patients were classified using the HERNIAscore. Hernias were diagnosed by clinical and/or CT examination. RESULTS: A total of 182 out of 210 surgical patients were included. After a median follow-up of 13.0 months, 39 IH (21.9%) were detected, 23 of which (13.4%) were in the EI; their frequency was lower in the TI group (3.4%) and in the MIM group (5.9%) than in the MIS group (29.5%; p=0.007). The probability of developing IH in the MIS group showed an OR=11.7 (95%CI: 3.3-42.0) compared to the TI group and 4.3 (IC 95%: 1.1-16.3) versus the MIM group. CONCLUSIONS: The location of the incision is relevant to avoid incisional hernias. Transverse incisions should be used as the first option. When a midline incision is needed, a prophylactic mesh could be considered in high risk patients because it is safe and associated with low morbidity.
Authors: A Bravo-Salva; A M González-Castillo; F F Vela-Polanco; E Membrilla-Fernández; J Vila-Domenech; M Pera-Román; J J Sancho-Insenser; J A Pereira-Rodríguez Journal: World J Surg Date: 2020-03 Impact factor: 3.352
Authors: J A Pereira-Rodríguez; S Amador-Gil; A Bravo-Salva; B Montcusí-Ventura; J Sancho-Insenser; M Pera-Román; M López-Cano Journal: Hernia Date: 2021-11-01 Impact factor: 2.920
Authors: Michele Manigrasso; Mario Musella; Ugo Elmore; Marco Ettore Allaix; Paolo Pietro Bianchi; Alberto Biondi; Luigi Boni; Umberto Bracale; Elisa Cassinotti; Graziano Ceccarelli; Francesco Corcione; Diego Cuccurullo; Maurizio Degiuli; Nicolò De Manzini; Domenico D'Ugo; Giampaolo Formisano; Mario Morino; Silvia Palmisano; Roberto Persiani; Rossella Reddavid; Fabio Rondelli; Nunzio Velotti; Riccardo Rosati; Giovanni Domenico De Palma; Marco Milone Journal: Updates Surg Date: 2022-05-31