Incisional Hernia After Laparoscopic Colorectal Surgery. Is there an Y Factor Associated?

J Kerman Cabo, MD, E Sadava, MD, F Carballo, MD, E Grzona, MD, A Canelas, MD, M Laporte, MD, M Bun, MD, C Peczan, MD, N Rotholtz, MD

Colorectal Surgery Division – Hospital Aleman de Buenos Aires. Argentina.

It has been described that laparoscopic approach has reduced the incidence of incisional hernia. However, there is scarce data concerning laparoscopic colorectal surgery. We aimed to evaluate related factors and incidence of incisional hernia following this approach.

A retrospective analysis of consecutive patients underwent colorectal surgery with laparoscopic approach in a single center was performed. Patients with a minimum follow up of 6 months, and also with converted to open surgery were included. Uni- and multi-variate analysis was made using the following variables: age, gender, type of surgery (left, right, total or segmental colectomy), associated diseases (diabetes and chronic pulmonary obstructive disease), previous surgery, operative time and body mass index (BMI). Right (medial incision) vs. left (left lower quadrant incision) colectomy was also compared.

In a period of 12 years, 1051 colorectal surgeries were performed. The incidence of incisional hernia was 6 % (n = 63). Univariate analysis showed that BMI > 30 kg/m2 (p: 0.004, OR: 2.5 [1.3-4.7]), operative time > 180 minutes (p < 0.005, OR: 2.1 [1.2-3.6]) and conversion to open surgery (p: 0.01, OR: 2.4 [1.1-5.0]) had related to incisional hernias. Only BMI had a statistically significant relation with the incidence of ventral hernia in multivariate analysis (p: 0.008). No statistical difference between right and left colectomy was observed (5.7 % vs. 5.0 %, respectively).

The incidence of incisional hernia after laparoscopic colorectal surgery seems to be acceptable. Having a BMI over 30 Kg/m2 is strongly associated to this complication.

Session: Poster Presentation

Program Number: P108

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