Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow-up study.

Autor:	Comajuncosas J; 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., Hermoso J; 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., Gris P; 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., Jimeno J; 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., Orbeal R; 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., Vallverdú H; 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., López Negre JL; 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., Urgellés J; 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., Estalella L; 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., Parés D; 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.
Jazyk:	angličtina
Zdroj:	American journal of surgery [Am J Surg] 2014 Jan; Vol. 207 (1), pp. 1-6. Date of Electronic Publication: 2013 Oct 07.
DOI:	10.1016/j.amjsurg.2013.05.010
Abstrakt:	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. (Copyright © 2014 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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