A RETROSPECTIVE STUDY OF INCISIONAL HERNIA
Abstract
Objectives: The aim of the study is to analyse the age/sex incidence, the duration following previous surgery and the type of incision resulting in incisional hernia. It is also done to study the predisposing factors and postoperative complications of the incisional hernia surgery.
Materials and methods: This is a retrospective study done in Department of general surgery in Government Dharmapuri Medical college and Hospital, Dharmapuri. The period of study is from July 2017 to July 2018. All patient records who underwent surgery for incisional hernia from July 2017 to July 2018 were collected from medical records department and registers maintained in General surgery department and taken for the study. Patients under exclusion criteria were not taken for the study. As a result 120 patients were selected for the study.
Results: Incisional hernia was more common in the fifth decade with 80.9% occurring in female population. Around 75% of incisional hernias occurred within five years of previous surgery with maximum number of cases occurring in the vertical incision. The incidence of incisional hernia after Obstetrics & Gynecological procedures were seen in 72% cases. Wound infection and diabetes mellitus are the dominant predisposing factors.
Conclusion: Incisional hernia occurs in up to 20% of patients after laparotomy. It is the common complication after abdominal surgery. There is increase in the incidence of the recurrence rates of incisional hernia. To reduce the recurrence, prevention of incisional hernias by using non-absorbable suture materials for closure of the abdomen, proper suture techniques( mass closure,tension free), good post operative care and avoiding the wound infection are warranted.
Keywords
Full Text:
PDFReferences
Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet 2003; 362:1561.
Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed) 1982; 284:931.
Sanders DL, Kingsnorth AN. The modern management of incisional hernias. BMJ 2012; 344:e2843.
Fassiadis N, Roidl M, Hennig M, et al. Randomized clinical trial of vertical or transverse laparotomy for abdominal aortic aneurysm repair. Br J Surg 2005; 92:1208.
Inaba T, Okinaga K, Fukushima R, et al. Prospective randomized study of two laparotomy incisions for gastrectomy: midline incision versus transverse incision. Gastric Cancer 2004; 7:167.
Levrant SG, Bieber E, Barnes R. Risk of Anterior Abdominal Wall Adhesions Increases with Number and Type of Previous Laparotomy. J Am Assoc Gynecol Laparosc 1994; 1:S19.
Bickenbach KA, Karanicolas PJ, Ammori JB, et al. Up and down or side to side? A systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery. Am J Surg 2013; 206:400.
Brown SR, Goodfellow PB. Transverse verses midline incisions for abdominal surgery. Cochrane Database Syst Rev 2005;CD005199.
George CD, Ellis H. The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl 1986; 68:185.
Seiler CM, Deckert A, Diener MK, et al. Midline versus transverse incision in major abdominal surgery: a randomized, double-blind equivalence trial (POVATI: ISRCTN60734227). Ann Surg 2009; 249:913.
den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical procedures for incisional hernias. Cochrane Database Syst Rev 2008; :CD006438.
Lowe JB, Garza JR, Bowman JL, et al. Endoscopically assisted "components separation" for closure of abdominal wall defects. Plast Reconstr Surg 2000; 105:720.
Sailes FC, Walls J, Guelig D, et al. Ventral hernia repairs: 10-year single-institution review at Thomas Jefferson University Hospital. J Am Coll Surg 2011; 212:119.
van Ramshorst GH, Nieuwenhuizen J, Hop WC, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg 2010; 34:20.
Courtney CA, Lee AC, Wilson C, O'Dwyer PJ. Ventral hernia repair: a study of current practice. Hernia 2003; 7:44.
Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 2006; 295:285.
Bellows CF, Alder A, Helton WS. Abdominal wall reconstruction using biological tissue grafts: present status and future opportunities. Expert Rev Med Devices 2006; 3:657.
Bringman S, Conze J, Cuccurullo D, et al. Hernia repair: the search for ideal meshes. Hernia 2010; 14:81.
DeMaria EJ, Moss JM, Sugerman HJ. Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Prospective comparison to open prefascial polypropylene mesh repair. Surg Endosc 2000; 14:326.
de Vries Reilingh TS, van Goor H, Charbon JA, et al. Repair of giant midline abdominal wall hernias: "components separation technique" versus prosthetic repair : interim analysis of a randomized controlled trial. World J Surg 2007; 31:756.
Gray SH, Hawn MT, Itani KM. Surgical progress in inguinal and ventral incisional hernia repair. Surg Clin North Am 2008; 88:17.21.Candage R, Jones K, Luchette FA, et al. Use of human acellular dermal matrix for hernia repair: friend or foe? Surgery 2008; 144:703.
Chavarriaga LF, Lin E, Losken A, et al. Management of complex abdominal wall defects using acellular porcine dermal collagen.
Am Surg 2010; 76:96.
Timmermans L, de Goede B, van Dijk SM, et al. Meta-analysis of sublay versus onlay mesh repair in incisional hernia surgery. Am J Surg 2014; 207:980.
Wéber G, Baracs J, Horváth OP. ["Onlay" mesh provides significantly better results than "sublay" reconstruction. Prospective randomized multicenter study of abdominal wall reconstruction with sutures only, or with surgical mesh--results of a five-years follow-up]. Magy Seb 2010; 63:302.
Ramirez OM, Ruas E, Dellon AL. "Components separation" method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg 1990; 86:519.
de Vries Reilingh TS, van Goor H, Rosman C, et al. "Components separation technique" for the repair of large abdominal wall hernias. J Am Coll Surg 2003; 196:32.
Rosen MJ, Williams C, Jin J, et al. Laparoscopic versus opencomponent separation: a comparative analysis in a porcine model. Am J Surg 2007; 194:385.
Luijendijk RW, Hop WC, van den Tol MP, et al. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 2000; 343:392.
DiBello JN Jr, Moore JH Jr. Sliding myofascial flap of the rectus abdominus muscles for the closure of recurrent ventral hernias.
Plast Reconstr Surg 1996; 98:464.
Shell DH 4th, de la Torre J, Andrades P, Vasconez LO. Open repair of ventral incisional hernias. Surg Clin North Am 2008; 88:61.
Sailes FC, Walls J, Guelig D, et al. Synthetic and biological mesh in component separation: a 10-year single institution review. Ann Plast Surg 2010; 64:696.
Wéber G, Horváth OP. [Results of ventral hernia repair: comparison of suture repair with mesh implantation (onlay vs sublay) using open and laparoscopic approach--prospective, randomized, multicenter study]. Magy Seb 2002; 55:285.
Conze J, Kingsnorth AN, Flament JB, et al. Randomized clinical trial comparing lightweight composite mesh with polyester or polypropylene mesh for incisional hernia repair. Br J Surg 2005; 92:1488.
Korenkov M, Sauerland S, Arndt M, et al. Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia. Br J Surg 2002; 89:50.
Afifi RY. A prospective study between two different techniques for the repair of a large recurrent ventral hernia: a double mesh intraperitoneal repair versus onlay mesh repair. Hernia 2005; 9:310.
Nguyen MT, Berger RL, Hicks SC, et al. Comparison of outcomes of synthetic mesh vs suture repair of elective primary ventral herniorrhaphy: a systematic review and meta-analysis. JAMA Surg 2014; 149:415.
Burger JW, Luijendijk RW, Hop WC, et al. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 2004; 240:578.
Mathes SJ, Steinwald PM, Foster RD, et al. Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg 2000; 232:586.
Schmidbauer S, Ladurner R, Hallfeldt KK, Mussack T. Heavyweight versus low-weight polypropylene meshes for open sublay mesh repair of incisional hernia. Eur J Med Res 2005; 10:247.
Matthews BD, Pratt BL, Pollinger HS, et al. Assessment of adhesion formation to intra-abdominal polypropylene mesh and polytetrafluoroethylene mesh. J Surg Res 2003; 114:126.
Zhang Y, Zhou H, Chai Y, et al. Laparoscopic versus open
incisional and ventral hernia repair: a systematic review and metaanalysis. World J Surg 2014; 38:2233.Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg 2002; 89:534.
Bingener J, Buck L, Richards M, et al. Long-term outcomes in laparoscopic vs open ventral hernia repair. Arch Surg 2007; 142:562.
Tsuruta A, Hirai T, Nakamura M. Retrospective comparison of open versus laparoscopic ventral and incisional hernia repair.
Asian J Endosc Surg 2014; 7:246.
Rogmark P, Petersson U, Bringman S, et al. Short-term outcomes for open and laparoscopic midline incisional hernia repair: a randomized multicenter controlled trial: the ProLOVE (prospective randomized trial on open versus laparoscopic operation of ventral eventrations) trial. Ann Surg 2013; 258:37.
Carbajo MA, Martín del Olmo JC, Blanco JI, et al. Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 1999; 13:250.
Pring CM, Tran V, O'Rourke N, Martin IJ. Laparoscopic versus open ventral hernia repair: a randomized controlled trial. ANZ J Surg 2008; 78:903.
Olmi S, Scaini A, Cesana GC, et al. Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc 2007; 21:555.
Eker HH, Hansson BM, Buunen M, et al. Laparoscopic vs. open incisional hernia repair: a randomized clinical trial. JAMA Surg 2013; 148:259.
Asencio F, Aguiló J, Peiró S, et al. Open randomized clinical trial of laparoscopic versus open incisional hernia repair. Surg Endosc 2009; 23:1441.
Itani KM, Hur K, Kim LT, et al. Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg 2010; 145:322.
Moreno-Egea A, Carrasco L, Girela E, et al. Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. Arch Surg 2002; 137:1266.
Navarra G, Musolino C, De Marco ML, et al. Retromuscular sutured incisional hernia repair: a randomized controlled trial to compare open and laparoscopic approach. Surg Laparosc Endosc Percutan Tech 2007; 17:86.
Misra MC, Bansal VK, Kulkarni MP, Pawar DK. Comparison of laparoscopic and open repair of incisional and primary ventral hernia: results of a prospective randomized study. Surg Endosc 2006; 20:1839.
Othman IH, Metwally YH, Bakr IS, et al. Comparative study between laparoscopic and open repair of paraumbilical hernia. J Egypt Soc Parasitol 2012; 42:175.
Novitsky YW, Cobb WS, Kercher KW, et al. Laparoscopic ventral hernia repair in obese patients: a new standard of care. Arch Surg 2006; 141:57.
Itani KM, Neumayer L, Reda D, et al. Repair of ventral incisional hernia: the design of a randomized trial to compare open and laparoscopic surgical techniques. Am J Surg 2004; 188:22S.
Gurusamy KS, Allen VB. Wound drains after incisional hernia repair. Cochrane Database Syst Rev 2013; :CD005570.
Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic repair of ventral hernias: nine years' experience with 850 consecutive hernias. Ann Surg 2003; 238:391.
Ujiki MB, Weinberger J, Varghese TK, et al. One hundred consecutive laparoscopic ventral hernia repairs. Am J Surg 2004; 188:593.
Harth KC, Rosen MJ. Endoscopic versus open component separation in complex abdominal wall reconstruction. Am J Surg 2010; 199:342.
Holihan JL, Alawadi Z, Martindale RG, et al. Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complications. J Am Coll Surg 2015; 221:478.
Refbacks
- There are currently no refbacks.