Diastasis recti is associated with incisional hernia after midline abdominal surgery
- 22.09.2022
- Original Article
Erschienen in:
- Verfasst von
- A. T. Booth
- K. J. Gillen
- I. Visintin
- W. F. Ford
- M. D. Kovacs
- C. A. Edgerton
- V. V. George
- T. Curran
- Erschienen in
- Hernia | Ausgabe 2/2023
Abstract
Purpose
Incisional hernia occurs in up to 20% of patients after abdominal surgery and is most common after vertical midline incisions. Diastasis recti may contribute to incisional hernia but has not been explored as a risk factor or included in hernia risk models. We examined the association between diastasis recti and incisional hernia after midline incisions.
Methods
In this single-center study, all patients undergoing elective gastrointestinal surgery with a midline open incision or extraction site in a prospective surgical quality collaborative database between 2016 and 2020 were included. Eligible patients had axial imaging within 6 months prior to surgery and no less than 6 months after surgery to determine the presence of diastasis recti and incisional hernia, respectively. Radiographic hernia-free survival was assessed with log-rank tests and multivariable Cox regression, comparing patients with and without diastasis width > 25 mm.
Results
Of 156 patients, forty-four (28.2%) developed radiographic hernia > 1 cm. 36 of 85 patients (42.4%) with DR width > 25 mm developed IH, compared to 9 of 71 (12.7%) without DR (p < 0.001). Hernia-free survival differed by DR width on bivariate and multivariable Cox regression, adjusted hazard ratio: 3.87, 95% confidence interval: 1.84–8.14.
Conclusion
Diastasis recti is a significant risk factor for incisional hernia after midline abdominal surgery. When present, surgeons can include these data when discussing surgical risks and should consider a lower risk, off-midline approach when feasible. Incorporating diastasis into larger studies may improve comprehensive models of incisional hernia risk.
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- Titel
- Diastasis recti is associated with incisional hernia after midline abdominal surgery
- Verfasst von
-
A. T. Booth
K. J. Gillen
I. Visintin
W. F. Ford
M. D. Kovacs
C. A. Edgerton
V. V. George
T. Curran
- Publikationsdatum
- 22.09.2022
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 2/2023
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-022-02676-w
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