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. 2018 Oct;33(10):1411-1417.
doi: 10.1007/s00384-018-3124-5. Epub 2018 Jul 17.

Incisional hernia after surgery for colorectal cancer: a population-based register study

Harald Söderbäck  1   2 , Ulf Gunnarsson  3 , Per Hellman  4 , Gabriel Sandblom  5   6
Affiliations

Incisional hernia after surgery for colorectal cancer: a population-based register study

Harald Söderbäck et al. Int J Colorectal Dis. 2018 Oct.

Abstract

Background: Our knowledge on the incidence of incisional hernia and risk factors for developing incisional hernia following surgery for colorectal cancer is far from complete.

Methods: All procedures registered in the Swedish Colorectal Cancer Register (SCRCR) 2007-2013 were identified. Patients with comorbid disease diagnoses, registered at admissions and visits prior to the procedure and relevant to this study, were obtained from the National Patient Register (NPR). These diagnoses included cardiovascular disease, connective tissue disorders, liver cirrhosis, renal failure, diabetes, chronic obstructive lung disease and chronic inflammatory conditions. Data on occurrence of incisional hernias were obtained by combining data from the SCRCR and the NPR (International Classification of Diseases code).

Results: During 2007-2013, 39,984 procedures were registered in the SCRCR. After excluding laparoscopic procedures, procedures repeated on the same patient, procedures with concomitant liver resection and procedures without laparotomy, 28,913 cases remained for analysis. Five years after surgery, the cumulative incidence of incisional hernia was 5.3%. In multivariate proportional hazard analysis, significantly increased risk for incisional hernia was found for the male gender (hazard ratio [HR] 1.40, 95% confidence interval [CI] 1.21-1.62), operation time exceeding 180 min (HR 1.25, CI 1.08-1.45), body mass index (BMI) > 30 (HR 1.78, CI 1.51-2.09), age < 70 years (HR 1.34, CI 1.16-1.56) and postoperative wound complication (HR 2.09, CI 1.70-2.58).

Discussion: Men, patients younger than 70 years and patients with BMI > 30 face a higher risk for incisional hernia. The risk is also increased in cases where the procedure takes longer than 3 h or where postoperative wound complications occur. These patients will benefit from measures aimed at preventing the development of incisional hernia.

Keywords: Colorectal cancer; Incisional hernia; Risk factors.

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Conflict of interest statement

This study is approved by the regional ethics review board in Stockholm (ref. 2014/1351-31/5).

Figures

Fig. 1
Fig. 1
Flow chart of cohort assembly
Fig. 2
Fig. 2
Gender vs cumulative incidence of incisional hernia
Fig. 3
Fig. 3
Age vs cumulative incidence of incisional hernia
Fig. 4
Fig. 4
Operation time vs cumulative incidence of incisional hernia
Fig. 5
Fig. 5
BMI vs cumulative incidence of incisional hernia
Fig. 6
Fig. 6
Wound complication vs cumulative incidence of incisional hernia
See this image and copyright information in PMC

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