دورية أكاديمية
Incidence of and Risk Factors for Incisional Hernia After Hepatectomy for Colorectal Liver Metastases.
العنوان: | Incidence of and Risk Factors for Incisional Hernia After Hepatectomy for Colorectal Liver Metastases. |
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المؤلفون: | Maki H; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Kim BJ; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Kawaguchi Y; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Fernandez-Placencia R; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Haddad A; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Panettieri E; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Newhook TE; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Baumann DP; Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Santos D; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Tran Cao HS; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Chun YS; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Tzeng CD; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA., Vauthey JN; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA. jvauthey@mdanderson.org., Vreeland TJ; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA. |
المصدر: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2023 Nov; Vol. 27 (11), pp. 2388-2395. Date of Electronic Publication: 2023 Aug 03. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 9706084 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4626 (Electronic) Linking ISSN: 1091255X NLM ISO Abbreviation: J Gastrointest Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2024-: [Amsterdam] : Elsevier B.V. Original Publication: St. Louis, MO : Quality Medical Pub., c1997- |
مواضيع طبية MeSH: | Incisional Hernia*/epidemiology , Incisional Hernia*/etiology , Incisional Hernia*/surgery , Liver Neoplasms*/complications , Colorectal Neoplasms*/surgery , Colorectal Neoplasms*/pathology, Humans ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Hepatectomy/adverse effects ; Retrospective Studies ; Incidence ; Risk Factors |
مستخلص: | Background: Incisional hernia (IH) is common after major abdominal surgery; however, the incidence after hepatectomy for cancer has not been described. We analyzed incidence of and risk factors for IH after hepatectomy for colorectal liver metastases (CLM). Methods: Patients who underwent open hepatectomy with midline or reverse-L incision for CLM at a single institution between 2010 and 2018 were retrospectively analyzed. Postoperative CT scans were reviewed to identify IH and the time from hepatectomy to hernia. Cumulative IH incidence was calculated using competing risk analysis. Risk factors were assessed using Cox proportional hazards model analysis. The relationship between IH incidence and preoperative body mass index (BMI) was estimated using a generalized additive model. Results: Among 470 patients (median follow-up: 16.9 months), IH rates at 12, 24, and 60 months were 41.5%, 51.0%, and 59.2%, respectively. Factors independently associated with IH were surgical site infection (HR: 1.54, 95% CI 1.16-2.06, P = 0.003) and BMI > 25 kg/m 2 (HR: 1.94, 95% CI 1.45-2.61, P < 0.001). IH incidence was similar in patients undergoing midline and reverse-L incisions and patients who received and did not receive a bevacizumab-containing regimen. The 1-year IH rate increased with increasing number of risk factors (zero: 22.2%; one: 46.8%; two: 60.3%; P < 0.001). Estimated IH incidence was 10% for BMI of 15 kg/m 2 and 80% for BMI of 40 kg/m 2 . Conclusion: IH is common after open hepatectomy for CLM, particularly in obese patients and patients with surgical site infection. Surgeons should consider risk-mitigation strategies, including alternative fascial closure techniques. (© 2023. The Society for Surgery of the Alimentary Tract.) |
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معلومات مُعتمدة: | CA016672 United States CA NCI NIH HHS; CA016672 United States CA NCI NIH HHS |
فهرسة مساهمة: | Keywords: Colorectal cancer; Incisional hernia; Liver metastases; Liver resection; Obesity |
تواريخ الأحداث: | Date Created: 20230803 Date Completed: 20231122 Latest Revision: 20240321 |
رمز التحديث: | 20240321 |
DOI: | 10.1007/s11605-023-05777-8 |
PMID: | 37537494 |
قاعدة البيانات: | MEDLINE |
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