Incidence of Incisional Hernia After Open and Laparoscopic Colorectal Cancer Resection

Abstract

ObjectivesTo determine the incidence of incisional hernia in patients subjected to colorectal cancer surgery. To analyse the individual risk factors and to determine which patients would benefit more from the use of prophylactic measures. Patients and methodsA retrospective study was performed on the demographic and surgical data, as well as the complications, risk factors and outcomes of all patients subjected to colorectal cancer surgery in the period between January 2006 and September 2008. The diagnosis of incisional hernia was made by means of physical examination or by a review of the follow up CT scan. ResultsA total of 338 patients were reviewed (249 laparotomy and 89 laparoscopy). After a median follow-up of 19.7 months, 87 patients (25.7%) were diagnosed with incisional hernia by a physical examination. The CT scan enabled 48 hernias (14.2%) not detected clinically. The incisional hernia rate was 39.9% (135 patients). There were no significant differences between patients subjected to laparotomy (40.9%) or laparoscopy (37.1%). The incisional hernia rate in overweight patients (BMI≥25kg/m2) was 51.3% compared to 31.1% in patients with normal weight (P=.02). Post-surgical complications (P=.007), surgical wound infections (P=.04), and further surgery during the post-operative period (P<.0001), were also associated with a higher incidence of incisional hernia. ConclusionThe prevalence of incisional hernia after colorectal cancer resection is higher than expected (41%). Patients with a BMI greater than 25kg/m2, and those who require further surgery are candidates to receive a prophylactic mesh.