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Risk factors for incisional hernia according to different wound sites after open hepatectomy using combinations of vertical and horizontal incisions: A multicenter cohort study.

IIDA Hiroya 30733901 0000-0001-6245-4583 TANI Masaji 60236677 0000-0003-1270-6003 HIROKAWA Fumitoshi UENO Masaki NODA Takehiro TAKEMURA Shigekazu NOMI Takeo NAKAI Takuya KAIBORI Masaki 0000-0002-0577-3921 KUBO Shoji 滋賀医科大学

2021.05.11

概要

Background:
Although several risk factors for incisional hernia after hepatectomy have been reported, their relationship to different wound sites has not been investigated. Therefore, this study aimed to examine the risk factors for incisional hernia according to various wound sites after hepatectomy.
Methods:
Patients from the Osaka Liver Surgery Study Group who underwent open hepatectomy using combinations of vertical and horizontal incisions (J-shaped incision, reversed L-shaped incision, reversed T-shaped incision, Mercedes incision) between January 2012 and December 2015 were included. Incisional hernia was defined as a hernia occurring within 3 y after surgery. Abdominal incisional hernia was classified into midline incisional hernia and transverse incisional hernia. The risk factors for each posthepatectomy incisional hernia type were identified.
Results:
A total of 1057 patients met the inclusion criteria. The overall posthepatectomy incisional hernia incidence rate was 5.9% (62 patients). In the multivariate analysis, the presence of diabetes mellitus and albumin levels <3.5 g/dL were identified as independent risk factors. Moreover, incidence rates of midline and transverse incisional hernias were 2.4% (25 patients), and 2.3% (24 patients), respectively. In multivariate analysis, the independent risk factor for transverse incisional hernia was the occurrence of superficial or deep incisional surgical site infection, and interrupted suturing for midline incisional hernia.
Conclusions:
Risk factors for incisional hernia after hepatectomy depend on the wound site. To prevent incisional hernia, running suture use might be better for midline wound closure. The prevention of postoperative wound infection is important for transverse wounds, under the presumption of preoperative nutrition and normoglycemia.

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How to cite this article: Iida H, Tani M, Hirokawa F, et al. Risk

factors for incisional hernia according to different wound

sites after open hepatectomy using combinations of vertical

and horizontal incisions: A multicenter cohort study. Ann

Gastroenterol Surg. 2021;00:1–­10. https://doi.org/10.1002/

ags3.12467

...

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