Incidence of Incisional Hernias After Liver Resections Performed Through Subcostal Laparotomies

Abstract

Introduction: Incisional hernias are common and important long-term complications in oncological surgery. This study aimed to provide accurate data on the incidence and risk factors for the occurrence of incisional hernial after liver resections performed through subcostal incisions. Method: This prospective observational study included 55 patients after liver resections performed for suspected malignancy in the Department of General, Transplant and Liver Surgery of the Medical University of Warsaw. Incidence of incisional hernias was the primary outcome measure. Follow up was based on clinical assessment and ultrasonographic examination of the scar at least 12 months postoperatively. Logistic regression was applied for risk factor analysis. Odds ratios (ORs) were presented with 95% confidence intervals (95% CI). Results: Incisional hernias occurred in 18 of 55 patients (32.7%). On univariable analyses, male sex (p=0.020), body mass index (p=0.010), and arterial hypertension (p=0.006) increased the risk of incisional hernias. Arterial hypertension was the independent risk factor (OR 2.53; 95% CI 1.31-4.89). Incisional hernias occurred in 9 of 41 (22.0%) patients without arterial hypertension as opposed to 9 of 14 (64.3%) patients with arterial hypertension (p=0.007). Conclusion: Incisional hernias commonly occur after liver resections performed though subcostal incisions. Individual susceptibility, as reflected by arterial hypertension, is a major determinant of their development.