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Incisional hernia after open resections for colorectal liver metastases - Incidence and risk factors

NILSSON, JAN LU ; Strandberg Holka, Peter LU and Sturesson, Christian LU (2016) In HPB 18(5). p.436-441
Abstract

Background: Incisional hernia is one of the most common complications after laparotomy. The aim of this retrospective study was to investigate incidence, location and risk factors for incisional hernia after open resection for colorectal liver metastases including the use of perioperative chemotherapy and targeted therapy evaluated by computed tomography. Methods: Patients operated for colorectal liver metastases between 2010 and 2013 were included. Incisional hernia was defined as a discontinuity in the abdominal fascia observed on computed tomography. Results: A total of 256 patients were analyzed in regard to incisional hernia. Seventy-eight patients (30.5%) developed incisional hernia. Hernia locations were midline alone in 66... (More)

Background: Incisional hernia is one of the most common complications after laparotomy. The aim of this retrospective study was to investigate incidence, location and risk factors for incisional hernia after open resection for colorectal liver metastases including the use of perioperative chemotherapy and targeted therapy evaluated by computed tomography. Methods: Patients operated for colorectal liver metastases between 2010 and 2013 were included. Incisional hernia was defined as a discontinuity in the abdominal fascia observed on computed tomography. Results: A total of 256 patients were analyzed in regard to incisional hernia. Seventy-eight patients (30.5%) developed incisional hernia. Hernia locations were midline alone in 66 patients (84.6%) and involving the midline in another 8 patients (10.3%). In multivariate analysis, preoperative chemotherapy >6 cycles (hazard ratio 2.12, 95% confidence interval 1.14-3.94), preoperative bevacizumab (hazard ratio 3.63, 95% confidence interval 1.86-7.08) and incisional hernia from previous surgery (hazard ratio 3.50, 95% confidence interval 1.98-6.18) were found to be independent risk factors. Conclusions: Prolonged preoperative chemotherapy and also preoperative bevacizumab were strong predictors for developing an incisional hernia. After an extended right subcostal incision, the hernia location was almost exclusively in the midline.

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publication status
published
subject
in
HPB
volume
18
issue
5
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:84965070455
  • pmid:27154807
  • wos:000377821000006
ISSN
1365-182X
DOI
10.1016/j.hpb.2016.02.001
language
English
LU publication?
yes
id
79e39bf8-b75e-4642-978d-02a19cd69b4a
date added to LUP
2016-06-01 13:12:39
date last changed
2024-06-14 09:06:39
@article{79e39bf8-b75e-4642-978d-02a19cd69b4a,
  abstract     = {{<p>Background: Incisional hernia is one of the most common complications after laparotomy. The aim of this retrospective study was to investigate incidence, location and risk factors for incisional hernia after open resection for colorectal liver metastases including the use of perioperative chemotherapy and targeted therapy evaluated by computed tomography. Methods: Patients operated for colorectal liver metastases between 2010 and 2013 were included. Incisional hernia was defined as a discontinuity in the abdominal fascia observed on computed tomography. Results: A total of 256 patients were analyzed in regard to incisional hernia. Seventy-eight patients (30.5%) developed incisional hernia. Hernia locations were midline alone in 66 patients (84.6%) and involving the midline in another 8 patients (10.3%). In multivariate analysis, preoperative chemotherapy &gt;6 cycles (hazard ratio 2.12, 95% confidence interval 1.14-3.94), preoperative bevacizumab (hazard ratio 3.63, 95% confidence interval 1.86-7.08) and incisional hernia from previous surgery (hazard ratio 3.50, 95% confidence interval 1.98-6.18) were found to be independent risk factors. Conclusions: Prolonged preoperative chemotherapy and also preoperative bevacizumab were strong predictors for developing an incisional hernia. After an extended right subcostal incision, the hernia location was almost exclusively in the midline.</p>}},
  author       = {{NILSSON, JAN and Strandberg Holka, Peter and Sturesson, Christian}},
  issn         = {{1365-182X}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{436--441}},
  publisher    = {{Elsevier}},
  series       = {{HPB}},
  title        = {{Incisional hernia after open resections for colorectal liver metastases - Incidence and risk factors}},
  url          = {{http://dx.doi.org/10.1016/j.hpb.2016.02.001}},
  doi          = {{10.1016/j.hpb.2016.02.001}},
  volume       = {{18}},
  year         = {{2016}},
}