The burden of incisional hernia in necrotizing pancreatitis: how can we improve?
| Autor: | Keith D. Lillemoe, Attila Nakeeb, Hayder H. Al-Azzawi, Angela M. Bermes, Thomas J. Howard, Nicholas J. Zyromski, Don J. Selzer, Sarah N. Bishop, Heidi Kuhlenschmidt |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Pancreatic disease Incisional hernia medicine.medical_treatment Physical examination Risk Factors Laparotomy medicine Humans Hernia Risk factor Retrospective Studies medicine.diagnostic_test Pancreatitis Acute Necrotizing business.industry Incidence General surgery Retrospective cohort study General Medicine Middle Aged medicine.disease Hernia Ventral Surgery Pancreatitis Female business |
| Zdroj: | The American Journal of Surgery. 199:310-314 |
| ISSN: | 0002-9610 |
| Popis: | Necrotizing pancreatitis (NP) patients frequently require pancreatic debridement, and have risk factors for incisional hernia (IH). However, no published data exist regarding the incidence of IH in NP. The aim of the current study was to define the incidence of and identify risk factors for developing IH after pancreatic debridement.Hernia presence was determined by clinical examination and patient interview. Technical and clinical considerations were noted: type of incision, closure, suture material, age, body mass index (BMI), diabetes mellitus (DM), preoperative albumin, and number of operations.Sixty-three (42%) of 149 debrided patients with NP developed IH. IH patients were older (P.05). No differences in surgical technique or clinical risk factors were seen between groups.The incidence of IH in NP patients requiring operative debridement is substantially higher than that in patients undergoing routine laparotomy. Innovative fascial closure techniques such as primary fascial buttress with nonsynthetic mesh should be considered. |
| Databáze: | OpenAIRE |
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