Jenny M Shao, MD1, Chris Devulapalli, MD1, Anne Fabrizio, MD1, Hepzibha Alexander, BSN2, Sameer Desale, MS3, 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: Incisional hernias following abdominal surgery can be associated with significant morbidity leading to decreased quality of life, increase in health care spending and need for repeat operations. Patients undergoing gastrointestinal and hepatobiliary surgery for malignant disease may be at higher risk for developing incisional hernias. Identifying these risk factors for incisional hernia development can help decrease occurrence. This will be the largest multi-institutional study looking at incidence of symptomatic hernia rates for major abdominal operations including colectomy, hepatectomy, pancreatectomy, and gastrectomy.
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 and then subdivided into either having benign or malignant disease. 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. Malignancy was the indication for surgery in 2,178 (43.8%) colectomies, 747 (66.6%) hepatectomies, 763 (65.5%) pancreatectomies, and 207 (63.5%) gastrectomies. IHR in each cohort for benign vs malignant etiologies, respectively, are as follows: 193 (6.9%) vs 104 (4.8%) in colectomy (p = 0.002), 12 (3.2%) vs 16 (2.1%) in hepatectomy (p = 0.385), 17 (4.2%) vs 24 (3.1%) in pancreatectomy (p = 0.431), and 4 (3.4%) vs 5 (2.4%) in gastrectomy (p = 0.88) patients.
CONCLUSION: Symptomatic incisional hernia rates following major gastrointestinal and hepatobiliary surgery ranges from 2.1-6.9%. There was no significant increase in hernia rates in patients undergoing surgery for malignancy. Patients undergoing colectomy for benign disease had a high incidence of symptomatic IHRs.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86660
Program Number: P017
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster