Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review
Purpose Incisional hernia is the most common complication of midline laparotomy. Although obesity is a known risk factor, the incidence of hernia formation in obese patients is not well defined. We sought to define the rate of incisional hernia formation in obese patients undergoing primary midline...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2023-06, Vol.27 (3), p.557-563 |
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| creator | Wehrle, C. J. Shukla, P. Miller, B. T. Blake, K. E. Prabhu, A. S. Petro, C. C. Krpata, D. M. Beffa, L. R. Tu, C. Rosen, M. J. |
| description | Purpose
Incisional hernia is the most common complication of midline laparotomy. Although obesity is a known risk factor, the incidence of hernia formation in obese patients is not well defined. We sought to define the rate of incisional hernia formation in obese patients undergoing primary midline laparotomy in a large academic medical center.
Methods
Obese patients (BMI ≥ 30 kg/m
2
) who underwent an elective or urgent primary midline laparotomy from 2017 to 2021 at our institution were retrospectively identified. A blinded hernia surgeon reviewed imaging to assess for incisional hernia formation, defined as a midline fascial defect with intra-abdominal contents herniated outside of the peritoneal cavity.
Results
A total of 2241 patients met inclusion criteria. Cross-sectional imaging was available for 914 (41%) of these patients. The median BMI for all patients was 34.3 kg/m
2
(range 30.0–59.1). Median time to follow-up imaging was 316 days (181–957, IQR = 185) for all patients and 316 days (201–903, IQR = 184) for patients with incisional hernia. In total, 474 (51.9%) had radiographic evidence of an incisional hernia. Colorectal and General Surgery demonstrated the highest rate of incisional hernia (
p
|
| doi_str_mv | 10.1007/s10029-022-02688-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2731057431</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2731057431</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-7b1533fa954c7ab3d213c93558a8d9af38d67ac4e5bd1028628cb61e4eee295c3</originalsourceid><addsrcrecordid>eNp9kUtPxCAUhYnR-Bj9Ay4MiRs3VR6lpe6M8ZWYuNE1ofR2BtNCBUbjvxcdX3HhAriE7xzgHoT2KTmmhNQnMc-sKQhjeVRSFtUa2qaslEXDSLn-q95COzE-EkJkWclNtMUrTiWXzTbSN87YaL3TA15AcFbjoBNE3Pth8C_WzfFou8E6wIOedPDJj6_YOpwWgH0LEfCkkwWXTnGWQgo-TmCSfYa8e7bwsos2ej1E2PtcZ-jh8uL-_Lq4vbu6OT-7LQyvRSrqlgrOe92I0tS65R2j3DRcCKll1-iey66qtSlBtB0lTFZMmraiUAIAa4ThM3S08p2Cf1pCTGq00cAwaAd-GRWrOSWiLjnN6OEf9NEvQ25BpiTNLyAit2eG2Ioy-U8xQK-mYEcdXhUl6j0AtQpA5QDURwCqyqKDT-tlO0L3LfnqeAb4Coj5yM0h_Nz9j-0bc2mReA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2819540518</pqid></control><display><type>article</type><title>Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wehrle, C. J. ; Shukla, P. ; Miller, B. T. ; Blake, K. E. ; Prabhu, A. S. ; Petro, C. C. ; Krpata, D. M. ; Beffa, L. R. ; Tu, C. ; Rosen, M. J.</creator><creatorcontrib>Wehrle, C. J. ; Shukla, P. ; Miller, B. T. ; Blake, K. E. ; Prabhu, A. S. ; Petro, C. C. ; Krpata, D. M. ; Beffa, L. R. ; Tu, C. ; Rosen, M. J.</creatorcontrib><description>Purpose
Incisional hernia is the most common complication of midline laparotomy. Although obesity is a known risk factor, the incidence of hernia formation in obese patients is not well defined. We sought to define the rate of incisional hernia formation in obese patients undergoing primary midline laparotomy in a large academic medical center.
Methods
Obese patients (BMI ≥ 30 kg/m
2
) who underwent an elective or urgent primary midline laparotomy from 2017 to 2021 at our institution were retrospectively identified. A blinded hernia surgeon reviewed imaging to assess for incisional hernia formation, defined as a midline fascial defect with intra-abdominal contents herniated outside of the peritoneal cavity.
Results
A total of 2241 patients met inclusion criteria. Cross-sectional imaging was available for 914 (41%) of these patients. The median BMI for all patients was 34.3 kg/m
2
(range 30.0–59.1). Median time to follow-up imaging was 316 days (181–957, IQR = 185) for all patients and 316 days (201–903, IQR = 184) for patients with incisional hernia. In total, 474 (51.9%) had radiographic evidence of an incisional hernia. Colorectal and General Surgery demonstrated the highest rate of incisional hernia (
p
< 0.001). During the study period, 138 patients (15.1%) underwent surgical repair of their hernia at our institution, with the highest percentage being Colorectal Surgery patients.
Conclusion
There is a high rate of hernia formation and subsequent hernia repair in obese patients undergoing midline laparotomy. Most importantly, these findings demonstrate an immediate and pressing need to identify the patient risk factors and technical issues related to this rate of hernia formation.</description><identifier>ISSN: 1248-9204</identifier><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-022-02688-6</identifier><identifier>PMID: 36318389</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdominal Surgery ; Hernia ; Hernias ; Herniorrhaphy - adverse effects ; Humans ; Incisional Hernia - epidemiology ; Incisional Hernia - etiology ; Laparotomy ; Laparotomy - adverse effects ; Medicine ; Medicine & Public Health ; Obesity ; Obesity - complications ; Original Article ; Patients ; Retrospective Studies ; Risk factors ; Surgery</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2023-06, Vol.27 (3), p.557-563</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-7b1533fa954c7ab3d213c93558a8d9af38d67ac4e5bd1028628cb61e4eee295c3</citedby><cites>FETCH-LOGICAL-c375t-7b1533fa954c7ab3d213c93558a8d9af38d67ac4e5bd1028628cb61e4eee295c3</cites><orcidid>0000-0002-9275-4744</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-022-02688-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-022-02688-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36318389$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wehrle, C. J.</creatorcontrib><creatorcontrib>Shukla, P.</creatorcontrib><creatorcontrib>Miller, B. T.</creatorcontrib><creatorcontrib>Blake, K. E.</creatorcontrib><creatorcontrib>Prabhu, A. S.</creatorcontrib><creatorcontrib>Petro, C. C.</creatorcontrib><creatorcontrib>Krpata, D. M.</creatorcontrib><creatorcontrib>Beffa, L. R.</creatorcontrib><creatorcontrib>Tu, C.</creatorcontrib><creatorcontrib>Rosen, M. J.</creatorcontrib><title>Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Purpose
Incisional hernia is the most common complication of midline laparotomy. Although obesity is a known risk factor, the incidence of hernia formation in obese patients is not well defined. We sought to define the rate of incisional hernia formation in obese patients undergoing primary midline laparotomy in a large academic medical center.
Methods
Obese patients (BMI ≥ 30 kg/m
2
) who underwent an elective or urgent primary midline laparotomy from 2017 to 2021 at our institution were retrospectively identified. A blinded hernia surgeon reviewed imaging to assess for incisional hernia formation, defined as a midline fascial defect with intra-abdominal contents herniated outside of the peritoneal cavity.
Results
A total of 2241 patients met inclusion criteria. Cross-sectional imaging was available for 914 (41%) of these patients. The median BMI for all patients was 34.3 kg/m
2
(range 30.0–59.1). Median time to follow-up imaging was 316 days (181–957, IQR = 185) for all patients and 316 days (201–903, IQR = 184) for patients with incisional hernia. In total, 474 (51.9%) had radiographic evidence of an incisional hernia. Colorectal and General Surgery demonstrated the highest rate of incisional hernia (
p
< 0.001). During the study period, 138 patients (15.1%) underwent surgical repair of their hernia at our institution, with the highest percentage being Colorectal Surgery patients.
Conclusion
There is a high rate of hernia formation and subsequent hernia repair in obese patients undergoing midline laparotomy. Most importantly, these findings demonstrate an immediate and pressing need to identify the patient risk factors and technical issues related to this rate of hernia formation.</description><subject>Abdominal Surgery</subject><subject>Hernia</subject><subject>Hernias</subject><subject>Herniorrhaphy - adverse effects</subject><subject>Humans</subject><subject>Incisional Hernia - epidemiology</subject><subject>Incisional Hernia - etiology</subject><subject>Laparotomy</subject><subject>Laparotomy - adverse effects</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Original Article</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Surgery</subject><issn>1248-9204</issn><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtPxCAUhYnR-Bj9Ay4MiRs3VR6lpe6M8ZWYuNE1ofR2BtNCBUbjvxcdX3HhAriE7xzgHoT2KTmmhNQnMc-sKQhjeVRSFtUa2qaslEXDSLn-q95COzE-EkJkWclNtMUrTiWXzTbSN87YaL3TA15AcFbjoBNE3Pth8C_WzfFou8E6wIOedPDJj6_YOpwWgH0LEfCkkwWXTnGWQgo-TmCSfYa8e7bwsos2ej1E2PtcZ-jh8uL-_Lq4vbu6OT-7LQyvRSrqlgrOe92I0tS65R2j3DRcCKll1-iey66qtSlBtB0lTFZMmraiUAIAa4ThM3S08p2Cf1pCTGq00cAwaAd-GRWrOSWiLjnN6OEf9NEvQ25BpiTNLyAit2eG2Ioy-U8xQK-mYEcdXhUl6j0AtQpA5QDURwCqyqKDT-tlO0L3LfnqeAb4Coj5yM0h_Nz9j-0bc2mReA</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Wehrle, C. J.</creator><creator>Shukla, P.</creator><creator>Miller, B. T.</creator><creator>Blake, K. E.</creator><creator>Prabhu, A. S.</creator><creator>Petro, C. C.</creator><creator>Krpata, D. M.</creator><creator>Beffa, L. R.</creator><creator>Tu, C.</creator><creator>Rosen, M. J.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9275-4744</orcidid></search><sort><creationdate>20230601</creationdate><title>Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review</title><author>Wehrle, C. J. ; Shukla, P. ; Miller, B. T. ; Blake, K. E. ; Prabhu, A. S. ; Petro, C. C. ; Krpata, D. M. ; Beffa, L. R. ; Tu, C. ; Rosen, M. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-7b1533fa954c7ab3d213c93558a8d9af38d67ac4e5bd1028628cb61e4eee295c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abdominal Surgery</topic><topic>Hernia</topic><topic>Hernias</topic><topic>Herniorrhaphy - adverse effects</topic><topic>Humans</topic><topic>Incisional Hernia - epidemiology</topic><topic>Incisional Hernia - etiology</topic><topic>Laparotomy</topic><topic>Laparotomy - adverse effects</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Original Article</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wehrle, C. J.</creatorcontrib><creatorcontrib>Shukla, P.</creatorcontrib><creatorcontrib>Miller, B. T.</creatorcontrib><creatorcontrib>Blake, K. E.</creatorcontrib><creatorcontrib>Prabhu, A. S.</creatorcontrib><creatorcontrib>Petro, C. C.</creatorcontrib><creatorcontrib>Krpata, D. M.</creatorcontrib><creatorcontrib>Beffa, L. R.</creatorcontrib><creatorcontrib>Tu, C.</creatorcontrib><creatorcontrib>Rosen, M. J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wehrle, C. J.</au><au>Shukla, P.</au><au>Miller, B. T.</au><au>Blake, K. E.</au><au>Prabhu, A. S.</au><au>Petro, C. C.</au><au>Krpata, D. M.</au><au>Beffa, L. R.</au><au>Tu, C.</au><au>Rosen, M. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>27</volume><issue>3</issue><spage>557</spage><epage>563</epage><pages>557-563</pages><issn>1248-9204</issn><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Purpose
Incisional hernia is the most common complication of midline laparotomy. Although obesity is a known risk factor, the incidence of hernia formation in obese patients is not well defined. We sought to define the rate of incisional hernia formation in obese patients undergoing primary midline laparotomy in a large academic medical center.
Methods
Obese patients (BMI ≥ 30 kg/m
2
) who underwent an elective or urgent primary midline laparotomy from 2017 to 2021 at our institution were retrospectively identified. A blinded hernia surgeon reviewed imaging to assess for incisional hernia formation, defined as a midline fascial defect with intra-abdominal contents herniated outside of the peritoneal cavity.
Results
A total of 2241 patients met inclusion criteria. Cross-sectional imaging was available for 914 (41%) of these patients. The median BMI for all patients was 34.3 kg/m
2
(range 30.0–59.1). Median time to follow-up imaging was 316 days (181–957, IQR = 185) for all patients and 316 days (201–903, IQR = 184) for patients with incisional hernia. In total, 474 (51.9%) had radiographic evidence of an incisional hernia. Colorectal and General Surgery demonstrated the highest rate of incisional hernia (
p
< 0.001). During the study period, 138 patients (15.1%) underwent surgical repair of their hernia at our institution, with the highest percentage being Colorectal Surgery patients.
Conclusion
There is a high rate of hernia formation and subsequent hernia repair in obese patients undergoing midline laparotomy. Most importantly, these findings demonstrate an immediate and pressing need to identify the patient risk factors and technical issues related to this rate of hernia formation.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>36318389</pmid><doi>10.1007/s10029-022-02688-6</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9275-4744</orcidid></addata></record> |
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| subjects | Abdominal Surgery Hernia Hernias Herniorrhaphy - adverse effects Humans Incisional Hernia - epidemiology Incisional Hernia - etiology Laparotomy Laparotomy - adverse effects Medicine Medicine & Public Health Obesity Obesity - complications Original Article Patients Retrospective Studies Risk factors Surgery |
| title | Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review |
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