| Autor: |
Cano-Valderrama, Oscar, Sanz-López, Rodrigo, Domínguez-Serrano, Inmaculada, Dziakova, Jana, Catalán, Vanesa, Rojo, Mikel, García-Alonso, Mauricio, Mugüerza, José M., Torres, Antonio J. |
| Předmět: |
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| Zdroj: |
Surgical Endoscopy & Other Interventional Techniques; Sep2020, Vol. 34 Issue 9, p4048-4052, 5p, 1 Diagram, 2 Charts |
| Abstrakt: |
Background: Prophylactic mesh closure has only scarcely been studied to avoid extraction-site incisional hernia after laparoscopic colorectal surgery. The aim was to analyze extraction-site incisional hernia incidence after laparoscopic colorectal surgery to assess if prophylactic mesh closure should be studied.Methods: A retrospective analytic cohort study was conducted in patients who had undergone laparoscopic colorectal surgery with an extraction-site incision. Extraction-site incisional hernia was diagnosed during clinical examination or imaging. Risk factors for extraction-site incisional hernia were analyzed.Results: Two hundred and twenty-five patients were included. More than 80% of the patients had a malignant disease. Ninety-two patients (40.9%) underwent right colectomy. Midline extraction-site incision was used in 86 (38.2%) patients. After a mean follow-up of 2.4 years, 39 (17.3%) patients developed an extraction-site incisional hernia. Midline extraction-site incision was associated with incisional hernia when compared to transverse and Pfannenstiel incision (39.5% vs. 3.6%, OR 17.5, p < 0.001). Surgery to repair an extraction-site incisional hernia was also more frequent in the group of patients with a midline incision (10.5% vs. 1.4%, OR 8.0, p = 0.002). In the multivariate analysis, incisional hernia was associated with body mass index, high blood pressure, and midline incision.Conclusions: Extraction-site incisional hernia was mainly related to midline incisions; therefore, midline incision should be avoided whenever possible. Studying prophylactic mesh closure for Pfannesnstiel or transverse incisions is needless, as these incisions have a low incisional hernia risk. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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