Simultaneous incisional hernia repair and colorectal surgery: one or two-step procedure?
Purpose Patients requiring colorectal surgery in the context of an incisional hernia are common, but it is not clear whether the repair should be performed as a single or two-step surgery. Our aim was to evaluate complications after concomitant abdominal wall repair and colorectal surgery compared t...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2024-12, Vol.28 (6), p.2321-2332 |
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| container_title | Hernia : the journal of hernias and abdominal wall surgery |
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| creator | Verdaguer-Tremolosa, M. Rodrigues-Gonçalves, V. Martínez-López, M. P. Sánchez-García, J. L. López-Cano, M. |
| description | Purpose
Patients requiring colorectal surgery in the context of an incisional hernia are common, but it is not clear whether the repair should be performed as a single or two-step surgery. Our aim was to evaluate complications after concomitant abdominal wall repair and colorectal surgery compared to those after incisional hernia repair alone.
Methods
Adult patients who underwent elective incisional hernia surgery from 2012–2022 from the EVEREG registry were included. Patients who underwent midline incisional hernia repair as a single procedure and patients who underwent midline incisional hernia repair concomitant with colorectal surgery were included. The primary outcome was surgical site infection (SSI). The secondary outcomes were the Clavien–Dindo classification grade, in-hospital mortality and recurrence.
Results
A total of 7783 patients were included: 256(3.3%) who underwent concomitant surgery and 7527(96.7%) who underwent only midline incisional hernia repair. The first group included more comorbid patients and complex hernias. SSI was found in 55.4% of patients who underwent simultaneous surgery compared to 30.7% of patients who underwent hernia repair alone (
P
= 0.000). Multivariate analysis revealed that the risk factors for SSI were BMI (OR = 1.07, 95% CI 1.02–1.11;
P
= 0.004), smoking (OR = 1.89, 95% CI 1.12–3.19;
P
= 0.017), transverse diameter (OR = 1.06, 95% CI 1.01–1.11;
P
= 0.017), component separation (OR = 1.996, 95% CI 1.25–3.08;
P
= 0.037) and clean-contaminated and contaminated surgeries(OR = 3.86, 95% CI 1.36–10.66;
P
= 0.009). Higher grades of Clavien–Dindo (
P
= 0.001) and mortality rates (
P
|
| doi_str_mv | 10.1007/s10029-024-03164-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11530480</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3110401579</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-389595b306fe736dc49e7dc1df65e24f8150072c73d8f9c3bc0fb6e3d8c1a6693</originalsourceid><addsrcrecordid>eNp9UU1P3TAQtKqiQmn_QA-VpV64pKw_4sRcEEL0Q0LiQCv1Zvk5GzDKs4OdtIJfXz9CKXDgYns1s7PeGUI-MPjMAJr9XE6uK-CyAsGUrG5fkR3GZVtpDvL1o_c2eZvzFQC0UrVvyLbQgjdCww75de7X8zDZgHHO1Afns4_BDvQSU_CWJhytT9SGjro4xIRuKmCe0wWmmwMaA9KY6PQnVnnCkY4pOuzmhIfvyFZvh4zv7-9d8vPLyY_jb9Xp2dfvx0enlRO1mirR6lrXKwGqx0aozkmNTedY16sauexbVpdVuWtE1_baiZWDfqWwVI5ZpbTYJYeL7jiv1tg5DFOygxmTX9t0Y6L15ikS_KW5iL8NY7UA2UJR2LtXSPF6xjyZtc8Oh2ExxQjGQAKrm82wT8-oV3FOxa4NiwvWAFd1YfGF5VLMOWH_8BsGZpOcWZIzJTlzl5y5LU0fH-_x0PIvqkIQCyEXKBT7_89-QfYvfwyl9Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3123170265</pqid></control><display><type>article</type><title>Simultaneous incisional hernia repair and colorectal surgery: one or two-step procedure?</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Verdaguer-Tremolosa, M. ; Rodrigues-Gonçalves, V. ; Martínez-López, M. P. ; Sánchez-García, J. L. ; López-Cano, M.</creator><creatorcontrib>Verdaguer-Tremolosa, M. ; Rodrigues-Gonçalves, V. ; Martínez-López, M. P. ; Sánchez-García, J. L. ; López-Cano, M. ; in representation of EVEREG group</creatorcontrib><description>Purpose
Patients requiring colorectal surgery in the context of an incisional hernia are common, but it is not clear whether the repair should be performed as a single or two-step surgery. Our aim was to evaluate complications after concomitant abdominal wall repair and colorectal surgery compared to those after incisional hernia repair alone.
Methods
Adult patients who underwent elective incisional hernia surgery from 2012–2022 from the EVEREG registry were included. Patients who underwent midline incisional hernia repair as a single procedure and patients who underwent midline incisional hernia repair concomitant with colorectal surgery were included. The primary outcome was surgical site infection (SSI). The secondary outcomes were the Clavien–Dindo classification grade, in-hospital mortality and recurrence.
Results
A total of 7783 patients were included: 256(3.3%) who underwent concomitant surgery and 7527(96.7%) who underwent only midline incisional hernia repair. The first group included more comorbid patients and complex hernias. SSI was found in 55.4% of patients who underwent simultaneous surgery compared to 30.7% of patients who underwent hernia repair alone (
P
= 0.000). Multivariate analysis revealed that the risk factors for SSI were BMI (OR = 1.07, 95% CI 1.02–1.11;
P
= 0.004), smoking (OR = 1.89, 95% CI 1.12–3.19;
P
= 0.017), transverse diameter (OR = 1.06, 95% CI 1.01–1.11;
P
= 0.017), component separation (OR = 1.996, 95% CI 1.25–3.08;
P
= 0.037) and clean-contaminated and contaminated surgeries(OR = 3.86, 95% CI 1.36–10.66;
P
= 0.009). Higher grades of Clavien–Dindo (
P
= 0.001) and mortality rates (
P
< 0.001) were found in the colorectal surgery group, although specific risk factors were detected. No differences were observed in terms of recurrence (
P
= 0.104).
Conclusions
Concomitant surgery is related to greater risk of complications, especially in patients with comorbidities and complex hernias. In properly selected cases, simultaneous procedures can yield satisfactory results.</description><identifier>ISSN: 1248-9204</identifier><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-024-03164-z</identifier><identifier>PMID: 39327390</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdominal Surgery ; Abdominal wall ; Aged ; Colorectal surgery ; Colorectal Surgery - adverse effects ; Comorbidity ; Female ; Hernia ; Hernias ; Herniorrhaphy - adverse effects ; Herniorrhaphy - methods ; Hospital Mortality ; Humans ; Incisional Hernia - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Multivariate analysis ; Original ; Original Article ; Patients ; Recurrence ; Retrospective Studies ; Risk Factors ; Surgery ; Surgical site infections ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - etiology</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2024-12, Vol.28 (6), p.2321-2332</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-389595b306fe736dc49e7dc1df65e24f8150072c73d8f9c3bc0fb6e3d8c1a6693</cites><orcidid>0000-0002-5649-5263</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/s10029-024-03164-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-024-03164-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39327390$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Verdaguer-Tremolosa, M.</creatorcontrib><creatorcontrib>Rodrigues-Gonçalves, V.</creatorcontrib><creatorcontrib>Martínez-López, M. P.</creatorcontrib><creatorcontrib>Sánchez-García, J. L.</creatorcontrib><creatorcontrib>López-Cano, M.</creatorcontrib><creatorcontrib>in representation of EVEREG group</creatorcontrib><title>Simultaneous incisional hernia repair and colorectal surgery: one or two-step procedure?</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Purpose
Patients requiring colorectal surgery in the context of an incisional hernia are common, but it is not clear whether the repair should be performed as a single or two-step surgery. Our aim was to evaluate complications after concomitant abdominal wall repair and colorectal surgery compared to those after incisional hernia repair alone.
Methods
Adult patients who underwent elective incisional hernia surgery from 2012–2022 from the EVEREG registry were included. Patients who underwent midline incisional hernia repair as a single procedure and patients who underwent midline incisional hernia repair concomitant with colorectal surgery were included. The primary outcome was surgical site infection (SSI). The secondary outcomes were the Clavien–Dindo classification grade, in-hospital mortality and recurrence.
Results
A total of 7783 patients were included: 256(3.3%) who underwent concomitant surgery and 7527(96.7%) who underwent only midline incisional hernia repair. The first group included more comorbid patients and complex hernias. SSI was found in 55.4% of patients who underwent simultaneous surgery compared to 30.7% of patients who underwent hernia repair alone (
P
= 0.000). Multivariate analysis revealed that the risk factors for SSI were BMI (OR = 1.07, 95% CI 1.02–1.11;
P
= 0.004), smoking (OR = 1.89, 95% CI 1.12–3.19;
P
= 0.017), transverse diameter (OR = 1.06, 95% CI 1.01–1.11;
P
= 0.017), component separation (OR = 1.996, 95% CI 1.25–3.08;
P
= 0.037) and clean-contaminated and contaminated surgeries(OR = 3.86, 95% CI 1.36–10.66;
P
= 0.009). Higher grades of Clavien–Dindo (
P
= 0.001) and mortality rates (
P
< 0.001) were found in the colorectal surgery group, although specific risk factors were detected. No differences were observed in terms of recurrence (
P
= 0.104).
Conclusions
Concomitant surgery is related to greater risk of complications, especially in patients with comorbidities and complex hernias. In properly selected cases, simultaneous procedures can yield satisfactory results.</description><subject>Abdominal Surgery</subject><subject>Abdominal wall</subject><subject>Aged</subject><subject>Colorectal surgery</subject><subject>Colorectal Surgery - adverse effects</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Hernia</subject><subject>Hernias</subject><subject>Herniorrhaphy - adverse effects</subject><subject>Herniorrhaphy - methods</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Incisional Hernia - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - etiology</subject><issn>1248-9204</issn><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9UU1P3TAQtKqiQmn_QA-VpV64pKw_4sRcEEL0Q0LiQCv1Zvk5GzDKs4OdtIJfXz9CKXDgYns1s7PeGUI-MPjMAJr9XE6uK-CyAsGUrG5fkR3GZVtpDvL1o_c2eZvzFQC0UrVvyLbQgjdCww75de7X8zDZgHHO1Afns4_BDvQSU_CWJhytT9SGjro4xIRuKmCe0wWmmwMaA9KY6PQnVnnCkY4pOuzmhIfvyFZvh4zv7-9d8vPLyY_jb9Xp2dfvx0enlRO1mirR6lrXKwGqx0aozkmNTedY16sauexbVpdVuWtE1_baiZWDfqWwVI5ZpbTYJYeL7jiv1tg5DFOygxmTX9t0Y6L15ikS_KW5iL8NY7UA2UJR2LtXSPF6xjyZtc8Oh2ExxQjGQAKrm82wT8-oV3FOxa4NiwvWAFd1YfGF5VLMOWH_8BsGZpOcWZIzJTlzl5y5LU0fH-_x0PIvqkIQCyEXKBT7_89-QfYvfwyl9Q</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Verdaguer-Tremolosa, M.</creator><creator>Rodrigues-Gonçalves, V.</creator><creator>Martínez-López, M. P.</creator><creator>Sánchez-García, J. L.</creator><creator>López-Cano, M.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>C6C</scope><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>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5649-5263</orcidid></search><sort><creationdate>20241201</creationdate><title>Simultaneous incisional hernia repair and colorectal surgery: one or two-step procedure?</title><author>Verdaguer-Tremolosa, M. ; Rodrigues-Gonçalves, V. ; Martínez-López, M. P. ; Sánchez-García, J. L. ; López-Cano, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-389595b306fe736dc49e7dc1df65e24f8150072c73d8f9c3bc0fb6e3d8c1a6693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Abdominal wall</topic><topic>Aged</topic><topic>Colorectal surgery</topic><topic>Colorectal Surgery - adverse effects</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Hernia</topic><topic>Hernias</topic><topic>Herniorrhaphy - adverse effects</topic><topic>Herniorrhaphy - methods</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Incisional Hernia - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Verdaguer-Tremolosa, M.</creatorcontrib><creatorcontrib>Rodrigues-Gonçalves, V.</creatorcontrib><creatorcontrib>Martínez-López, M. P.</creatorcontrib><creatorcontrib>Sánchez-García, J. L.</creatorcontrib><creatorcontrib>López-Cano, M.</creatorcontrib><creatorcontrib>in representation of EVEREG group</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</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>Verdaguer-Tremolosa, M.</au><au>Rodrigues-Gonçalves, V.</au><au>Martínez-López, M. P.</au><au>Sánchez-García, J. L.</au><au>López-Cano, M.</au><aucorp>in representation of EVEREG group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Simultaneous incisional hernia repair and colorectal surgery: one or two-step procedure?</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>28</volume><issue>6</issue><spage>2321</spage><epage>2332</epage><pages>2321-2332</pages><issn>1248-9204</issn><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Purpose
Patients requiring colorectal surgery in the context of an incisional hernia are common, but it is not clear whether the repair should be performed as a single or two-step surgery. Our aim was to evaluate complications after concomitant abdominal wall repair and colorectal surgery compared to those after incisional hernia repair alone.
Methods
Adult patients who underwent elective incisional hernia surgery from 2012–2022 from the EVEREG registry were included. Patients who underwent midline incisional hernia repair as a single procedure and patients who underwent midline incisional hernia repair concomitant with colorectal surgery were included. The primary outcome was surgical site infection (SSI). The secondary outcomes were the Clavien–Dindo classification grade, in-hospital mortality and recurrence.
Results
A total of 7783 patients were included: 256(3.3%) who underwent concomitant surgery and 7527(96.7%) who underwent only midline incisional hernia repair. The first group included more comorbid patients and complex hernias. SSI was found in 55.4% of patients who underwent simultaneous surgery compared to 30.7% of patients who underwent hernia repair alone (
P
= 0.000). Multivariate analysis revealed that the risk factors for SSI were BMI (OR = 1.07, 95% CI 1.02–1.11;
P
= 0.004), smoking (OR = 1.89, 95% CI 1.12–3.19;
P
= 0.017), transverse diameter (OR = 1.06, 95% CI 1.01–1.11;
P
= 0.017), component separation (OR = 1.996, 95% CI 1.25–3.08;
P
= 0.037) and clean-contaminated and contaminated surgeries(OR = 3.86, 95% CI 1.36–10.66;
P
= 0.009). Higher grades of Clavien–Dindo (
P
= 0.001) and mortality rates (
P
< 0.001) were found in the colorectal surgery group, although specific risk factors were detected. No differences were observed in terms of recurrence (
P
= 0.104).
Conclusions
Concomitant surgery is related to greater risk of complications, especially in patients with comorbidities and complex hernias. In properly selected cases, simultaneous procedures can yield satisfactory results.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>39327390</pmid><doi>10.1007/s10029-024-03164-z</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-5649-5263</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1248-9204 |
| ispartof | Hernia : the journal of hernias and abdominal wall surgery, 2024-12, Vol.28 (6), p.2321-2332 |
| issn | 1248-9204 1265-4906 1248-9204 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Abdominal wall Aged Colorectal surgery Colorectal Surgery - adverse effects Comorbidity Female Hernia Hernias Herniorrhaphy - adverse effects Herniorrhaphy - methods Hospital Mortality Humans Incisional Hernia - surgery Male Medicine Medicine & Public Health Middle Aged Mortality Multivariate analysis Original Original Article Patients Recurrence Retrospective Studies Risk Factors Surgery Surgical site infections Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology |
| title | Simultaneous incisional hernia repair and colorectal surgery: one or two-step procedure? |
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