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Computed Tomography Verified Prevalence of Incisional Hernia 1 Year Postoperatively after Colorectal Cancer Resection

Karlsson, Niklas ; Zackrisson, Sophia LU and Buchwald, Pamela LU (2021) In Scandinavian Journal of Surgery 110(3). p.373-379
Abstract

BACKGROUND AND OBJECTIVE: Incisional hernia is a frequent negative outcome after open and minimal invasive surgery of colorectal cancer. This study aimed to determine computed tomography-verified incisional hernia prevalence 1-year post colorectal cancer surgical resection in patients sutured with standardized small stich 4:1 technique, identify risk factors for incisional hernia and assess to what extent incisional hernia required surgical correction.

METHODS: All patients subjected to resectional colorectal cancer surgery during 2012-2016 at Skåne University Hospital were identified in the Swedish Colorectal Cancer Registry. The 1-year follow-up computed tomography was re-evaluated to establish the presence of incisional hernia.... (More)

BACKGROUND AND OBJECTIVE: Incisional hernia is a frequent negative outcome after open and minimal invasive surgery of colorectal cancer. This study aimed to determine computed tomography-verified incisional hernia prevalence 1-year post colorectal cancer surgical resection in patients sutured with standardized small stich 4:1 technique, identify risk factors for incisional hernia and assess to what extent incisional hernia required surgical correction.

METHODS: All patients subjected to resectional colorectal cancer surgery during 2012-2016 at Skåne University Hospital were identified in the Swedish Colorectal Cancer Registry. The 1-year follow-up computed tomography was re-evaluated to establish the presence of incisional hernia. Clinical data were collected from Swedish Colorectal Cancer Registry and the patients' medical charts were reviewed. Non-parametric tests and binary logistic regression analysis were used for statistical analysis.

RESULTS: In total, 1744 tumors were identified resulting in 1231 patients meeting the inclusion criteria. In total, 25.9% (n = 319) had incisional hernia at the 1-year follow-up computed tomography and 13.2% (n = 162) of the colorectal cancer resections were minimal invasive surgery, and there was non-significant incisional hernia prevalence difference between open and minimal invasive surgery. However, for converted and non-converted minimal invasive surgery, the incisional hernia frequencies were 43.9% (n = 18) and 24.1% (n = 39), respectively (p = 0.012). Significant risk factors for incisional hernia were body mass index, wound rupture, and procedure time. During the follow-up time, 14.1% (n = 45) needed incisional hernia corrective surgery.

CONCLUSIONS: Incisional hernia after colorectal cancer surgery is common despite standardized small stich 4:1 closure, but few incisional hernias are surgically corrected. Incisional hernia is equally frequent after open surgery and minimal invasive surgery. However, the risk of incisional hernia is considerably higher after minimal invasive surgery conversion.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Colorectal Neoplasms/diagnostic imaging, Hernia, Ventral/diagnostic imaging, Humans, Incisional Hernia/diagnostic imaging, Laparoscopy, Prevalence, Risk Factors, Tomography, X-Ray Computed
in
Scandinavian Journal of Surgery
volume
110
issue
3
pages
7 pages
publisher
Finnish Surgical Society
external identifiers
  • pmid:33326354
  • scopus:85097611508
ISSN
1799-7267
DOI
10.1177/1457496920976053
language
English
LU publication?
yes
id
0cbd102d-fdaa-4dfd-9498-3b477a1e93f2
date added to LUP
2021-12-29 12:19:59
date last changed
2024-06-15 23:33:21
@article{0cbd102d-fdaa-4dfd-9498-3b477a1e93f2,
  abstract     = {{<p>BACKGROUND AND OBJECTIVE: Incisional hernia is a frequent negative outcome after open and minimal invasive surgery of colorectal cancer. This study aimed to determine computed tomography-verified incisional hernia prevalence 1-year post colorectal cancer surgical resection in patients sutured with standardized small stich 4:1 technique, identify risk factors for incisional hernia and assess to what extent incisional hernia required surgical correction.</p><p>METHODS: All patients subjected to resectional colorectal cancer surgery during 2012-2016 at Skåne University Hospital were identified in the Swedish Colorectal Cancer Registry. The 1-year follow-up computed tomography was re-evaluated to establish the presence of incisional hernia. Clinical data were collected from Swedish Colorectal Cancer Registry and the patients' medical charts were reviewed. Non-parametric tests and binary logistic regression analysis were used for statistical analysis.</p><p>RESULTS: In total, 1744 tumors were identified resulting in 1231 patients meeting the inclusion criteria. In total, 25.9% (n = 319) had incisional hernia at the 1-year follow-up computed tomography and 13.2% (n = 162) of the colorectal cancer resections were minimal invasive surgery, and there was non-significant incisional hernia prevalence difference between open and minimal invasive surgery. However, for converted and non-converted minimal invasive surgery, the incisional hernia frequencies were 43.9% (n = 18) and 24.1% (n = 39), respectively (p = 0.012). Significant risk factors for incisional hernia were body mass index, wound rupture, and procedure time. During the follow-up time, 14.1% (n = 45) needed incisional hernia corrective surgery.</p><p>CONCLUSIONS: Incisional hernia after colorectal cancer surgery is common despite standardized small stich 4:1 closure, but few incisional hernias are surgically corrected. Incisional hernia is equally frequent after open surgery and minimal invasive surgery. However, the risk of incisional hernia is considerably higher after minimal invasive surgery conversion.</p>}},
  author       = {{Karlsson, Niklas and Zackrisson, Sophia and Buchwald, Pamela}},
  issn         = {{1799-7267}},
  keywords     = {{Colorectal Neoplasms/diagnostic imaging; Hernia, Ventral/diagnostic imaging; Humans; Incisional Hernia/diagnostic imaging; Laparoscopy; Prevalence; Risk Factors; Tomography, X-Ray Computed}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{373--379}},
  publisher    = {{Finnish Surgical Society}},
  series       = {{Scandinavian Journal of Surgery}},
  title        = {{Computed Tomography Verified Prevalence of Incisional Hernia 1 Year Postoperatively after Colorectal Cancer Resection}},
  url          = {{http://dx.doi.org/10.1177/1457496920976053}},
  doi          = {{10.1177/1457496920976053}},
  volume       = {{110}},
  year         = {{2021}},
}