abstract
OBJECTIVE::
To
evaluate a cohort of gynecologic oncology patients to discover risk
factors for early- and late-occurring incisional hernia after midline
incision for ovarian cancer.
METHODS::
We
collected retrospective data from patients undergoing primary
laparotomy for ovarian cancer at the University of Wisconsin Hospitals
and Clinics from 2001 to 2007. Patient characteristics and potential
risk factors for hernia formation were noted. Physical examination,
abdominal computerized assisted tomography scans, or both were used to
detect hernias 1 year after surgery (early hernia) and 2 years after
surgery (late hernia).
RESULTS::
There
were 265 patients available for the 1-year analysis and 189 patients
for the 2-year analysis. Early and late hernia formation occurred in
9.8% (95% confidence interval [CI] 6.2-12%) and an additional 7.9% (95%
CI 4.1-12%) of patients, respectively. Using multiple logistic
regression, poor nutritional status (albumin less than 3 g/dL) and
suboptimal cytoreductive surgery (1 cm or greater residual tumor) were
significantly associated with the formation of early incisional hernia
after midline incision (P<.001 for both). Late hernia formation was
associated only with age 65 years or older (P=.01).
CONCLUSION::
The
formation of early incisional hernias after midline incision is
associated with poor nutritional status and suboptimal cytoreductive
surgery, whereas late hernia formation is associated with advanced age.
LEVEL OF EVIDENCE:: II.
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