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. 2009 Dec;20(4):246-50.
doi: 10.3802/jgo.2009.20.4.246. Epub 2009 Dec 28.

Chemotherapy and patient co-morbidity in ventral site hernia development

Mark A Rettenmaier  1 , Lisa N Abaid, John V Brown, John P Micha, Bram H Goldstein
Affiliations

Chemotherapy and patient co-morbidity in ventral site hernia development

Mark A Rettenmaier et al. J Gynecol Oncol. 2009 Dec.

Abstract

Objective: The risk factors associated with early ventral site hernia development following cancer surgery are ill defined and associated with an undetermined incidence.

Methods: We analyzed 1,391 gynecologic cancer patient charts to identify the number of post-operative ventral site hernias over a nearly 6 year period. The following study variables were noted for evaluation: patient demographics, disease co-morbidity (hypertension, cardiovascular disease, diabetes), body mass index (BMI), treatment (e.g., chemotherapy regimen), intra-operative (e.g., bleeding) and postoperative (e.g., infection) complications, time to hernia development and length of hospital stay.

Results: Twenty-six gynecologic cancer patients who developed a post-operative ventral hernia and subsequently underwent herniorrhaphy by our gynecologic oncology service were identified. The patient group's overall time to initial hernia development was 11.23 months. Following a multiple regression analysis, we found that treatment (e.g., bevacizumab, liposomal doxorubicin or radiotherapy associated with compromised wound healing [p=0.0186] and disease co-morbidity [0.0432]) were significant prognostic indicators for an accelerated time to hernia development. Moreover, five patients underwent treatment associated with compromised wound healing and also had disease co-morbidity. In this sub-group, post-operative hernia development occurred more rapidly (3.8 months) than the overall group of patients. BMI and age did not impact time to hernia development (p>0.05).

Conclusion: In the present gynecologic cancer patient series, a tendency for early post-operative hernia development appeared to coincide with treatment associated with compromised wound healing and disease co-morbidity. Gynecologic cancer surgeons should anticipate this potential complication and consider employing prophylactic intra-operative mesh to potentially prevent this condition.

Keywords: Gynecologic cancer surgery; Herniorrhaphy; Treatment; Ventral site hernia.

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