Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2024; 16(3): 710-716
Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.710
Clinical observation of extraction-site incisional hernia after laparoscopic colorectal surgery
Bao-Hang Fan, Ke-Li Zhong, Li-Jin Zhu, Zhao Chen, Fang Li, Wen-Fei Wu
Bao-Hang Fan, Zhao Chen, Wen-Fei Wu, Second Clinical Medical College of Jinan University, Jinan University, Shenzhen 518020, Guangdong Province, China
Ke-Li Zhong, Fang Li, Department of Gastrointestinal Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
Li-Jin Zhu, Department of Radiation Oncology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
Author contributions: Fan BH was responsible for investigation, writing of the original draft, formal analysis, data curation, and manuscript writing, review, and editing; Zhong KL was responsible for conceptualization, funding acquisition, methodology, project administration, and manuscript writing, review, and editing; Chen Z performed validation, formal analysis, and supervision; Zhu LJ performed supervision, formal analysis, validation, and data curation; Li F provided software, resources, and visualization; Wu WF provided software, resources, and formal analysis.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Shenzhen People's Hospital.
Informed consent statement: Patients were apprised of their rights to informed consent and provided with a signed document during postoperative follow-up.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke-Li Zhong, PhD, Chief Doctor, Surgeon, Department of Gastrointestinal Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), No. 1017 Dongmen North Road, Luohu District, Shenzhen 518020, Guangdong Province, China. zhongkeli@126.com
Received: October 9, 2023
Peer-review started: October 9, 2023
First decision: December 12, 2023
Revised: December 17, 2023
Accepted: February 23, 2024
Article in press: February 23, 2024
Published online: March 27, 2024
Processing time: 165 Days and 3.2 Hours
Abstract
BACKGROUND

Laparoscopic colorectal cancer surgery increases the risk of incisional hernia (IH) at the tumor extraction site.

AIM

To investigate the incidence of IH at extraction sites following laparoscopic colorectal cancer surgery and identify the risk factors for IH incidence.

METHODS

This study retrospectively analyzed the data of 1614 patients who underwent laparoscopic radical colorectal cancer surgery with tumor extraction through the abdominal wall at our center between January 2017 and December 2022. Differences in the incidence of postoperative IH at different extraction sites and the risk factors for IH incidence were investigated.

RESULTS

Among the 1614 patients who underwent laparoscopic radical colorectal cancer surgery, 303 (18.8%), 923 (57.2%), 171 (10.6%), and 217 (13.4%) tumors were extracted through supraumbilical midline, infraumbilical midline, umbilical, and off-midline incisions. Of these, 52 patients developed IH in the abdominal wall, with an incidence of 3.2%. The incidence of postoperative IH was significantly higher in the off-midline incision group (8.8%) than in the middle incision groups [the supraumbilical midline (2.6%), infraumbilical midline (2.2%), and umbilical incision (2.9%) groups] (χ2 = 24.985; P < 0.05). Univariate analysis showed that IH occurrence was associated with age, obesity, sex, chronic cough, incision infection, and combined diabetes, anemia, and hypoproteinemia (P < 0.05). Similarly, multivariate analysis showed that off-midline incision, age, sex (female), obesity, incision infection, combined chronic cough, and hypoproteinemia were independent risk factors for IH at the site of laparoscopic colorectal cancer surgery (P < 0.05).

CONCLUSION

The incidence of postoperative IH differs between extraction sites for laparoscopic colorectal cancer surgery. The infraumbilical midline incision is associated with a lower hernia rate and is thus a suitable tumor extraction site.

Keywords: Incisional hernia; Laparoscopy; Colorectal cancer; Incision infection

Core Tip: There is a risk of incisional hernia (IH) at the tumor extraction site following laparoscopic colorectal cancer surgery. Here, we included 1614 patients who underwent laparoscopic colorectal cancer surgery to analyze the differences in the incidence of IH at different tumor extraction sites and evaluate the risk factors for IHs.