Jenny M Shao, MD1, Chris Devulapalli, MD1, Anne Fabrizio, MD1, Hepzibha Alexander, BSN2, Sameer Desale3, Mohammed Bayasi, MD1, Lynt B Johnson, MD, MBA1, Parag Bhanot, MD1. 1Medstar Georgetown University Hospital, 2Georgetown University School of Medicine, 3Medstar Health Research Institute
INTRODUCTION: Patients undergoing major abdominal surgery have increased risk of developing incisional hernias, which can be associated with significant morbidity. This is a multi-institutional study looking at patients undergoing major abdominal operations, defined as colectomy, hepatectomy, pancreatectomy, and gastrectomy, and the incidence and duration to symptomatic hernia occurrence requiring repair within each cohort.
METHODS AND PROCEDURES: An IRB- approved retrospective study within the MedStar Hospital database was conducted, incorporating all isolated colectomy, hepatectomy, pancreatectomy, and gastrectomy procedures performed across 11 hospitals between the years of 2002 to 2016. All patients were identified using ICD-9 and ICD-10 codes for relevant procedures. Exclusion criteria comprised of patients who had concomitant organ resection, or those undergoing organ transplant. Data validation was performed to verify the accuracy of the data set. The rate of symptomatic incisional hernia rates (IHRs) were determined for each cohort based on subsequent hernia procedural codes identified and repairs performed. Descriptive statistics and chi squared test were used to report IHRs in each group.
RESULTS: During this 15-year span, a total of 7,583 major abdominal operations were performed at all 11 institutions, comprising of 4,970 colectomies, 1,122 hepatectomies, 1,165 pancreatectomies, and 326 gastrectomies. Total incidence of symptomatic incisional hernia occurrence requiring repair was 375 (4.9%). Incisional hernia rate was 297 (5.98%) in colectomies, 28 (2.5%) in hepatectomies, 41 (3.52%) in pancreatectomies, and 9 (2.76%) in gastrectomies (p < 0.001). The mean duration to hernia surgery was 804 days for colectomy, 564 days for hepatectomy, 484 days for pancreatectomy, and 840 days for gastrectomy (p = 0.076).
CONCLUSION: Symptomatic incisional hernia rates following colectomy was significantly higher than other major abdominal surgeries. However, mean duration to hernia development was not significantly different among all patients undergoing major abdominal surgery and ranged from 484 to 840 days.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88320
Program Number: P009
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster