Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Dec 3;10(1):21170.
doi: 10.1038/s41598-020-77976-1.

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Laurens D Eeftinck Schattenkerk  1   2 , Gijsbert D Musters  3 , David J Nijssen  3 , Wouter J de Jonge  4   5 , Ralph de Vries  6 , L W Ernest van Heurn  3   4 , Joep Pm Derikx  3   4
Affiliations
Meta-Analysis

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Laurens D Eeftinck Schattenkerk et al. Sci Rep. .

Abstract

Incisional hernia (IH) in children could result in life-threatening complications, including incarceration and bowel strangulation. The incidence and risk factors of IH in infants are scarcely reported. Since IH-correction may require extensive surgery and a long recovery program, identifying infants and birth defects at risk, may lead to a different approach during the primary surgery. Therefore, the aim of this review is to systematically review the available data on the incidence of IH following surgery for congenital anomalies in infants. All studies describing IH were considered eligible. PubMed and Embase were searched and risk of bias was assessed. Primary outcome was the incidence of IH, secondary outcomes were difference in IH occurrence between disease severity (complex vs simple) and closure method (SILO vs primary closure) in gastroschisis patients. A meta-analysis was performed to pool the reported incidences in total and per congenital anomaly separately. Subgroup analysis within gastroschisis articles was performed. The 50 included studies represent 3140 patients. The pooled proportion of IH was 0.03 (95% CI 0.02-0.05; I2 = 79%, p ≤ 0.01) all anomalies combined. Gastroschisis (GS) reported highest pooled proportion 0.10 (95% CI 0.06-0.17; n = 142/1273; I2 = 86%; p ≤ 0.01). SILO closure (OR 3.09) and simple gastroschisis, i.e. without additional anomalies, (OR 0.18) were of significant influence. This review reports the incidence of IH in infants with different congenital abdominal anomalies, of which gastroschisis reported the highest risk. In GS patients, complex GS and SILO closure are risk factors for IH development.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow diagram article selection.
Figure 2
Figure 2
Pooled proportion of IH.
Figure 3
Figure 3
Forest plot simple vs complex GS.
Figure 4
Figure 4
Forest plot SILO vs primary closure.
See this image and copyright information in PMC

References

    1. Dietz UA, Menzel S, Lock J, Wiegering A. The Treatment of Incisional Hernia. Deutsch. Arzteblatt Int. 2018;115:31–37. doi: 10.3238/arztebl.2018.0031. - DOI - PMC - PubMed
    1. Nacef K, et al. Trocar site post incisional hernia: about 19 cases. The Pan African medical journal. 2018;29:183. doi: 10.11604/pamj.2018.29.183.14467. - DOI - PMC - PubMed
    1. McCann ME, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial. Lancet (Lond., Engl.) 2019;393:664–677. doi: 10.1016/s0140-6736(18)32485-1. - DOI - PMC - PubMed
    1. Sun L. Early childhood general anaesthesia exposure and neurocognitive development. Br J Anaesth. 2010;105(Suppl 1):i61–i68. doi: 10.1093/bja/aeq302. - DOI - PMC - PubMed
    1. Itatsu K, et al. Incidence of and risk factors for incisional hernia after abdominal surgery. Br. J. Surg. 2014;101:1439–1447. doi: 10.1002/bjs.9600. - DOI - PubMed