Abstract
Background
Laparoscopic colorectal surgery has been reported to have some advantages compared with open surgery. The purpose of this study was to evaluate the incidence of incisional hernias after elective open colorectal resection versus laparoscopic colorectal resection.
Methods
The study group consisted of 104 patients who underwent elective colorectal resection or reversal of a Hartmann’s procedure between November 2003 and March 2005. Baseline data were prospectively recorded on all patients. All were examined by an independent observer for evidence of incisional hernia after they had reached a minimum follow up of one year.
Results
At a median follow up of 22 (17–26) months, nine patients had died and 95 were reviewed. Of these, 32 underwent laparoscopic resection while 63 had open surgery. Patients were well matched for all baseline characteristics. The median length of the wound in the laparoscopic group was 9 cm (IQR: 8–11 cm) while in the open group it was 20.8 cm (IQR: 17–24 cm). There was no significant difference in incisional hernia rates between the groups (3 vs. 10, p = 0.52) or in those who had symptoms from their hernia (p = 0.773).
Conclusions
Laparoscopic colorectal resection does not appear to reduce incisional hernia rates when compared with open surgery. Large randomised trials are required to confirm these findings.
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References
Franklin ME, Kazantsev GB, Abrego D, Diaz-E JA, Balli J, Glass JL (2000) Laparoscopic surgery for stage III colon cancer: Long term follow up. Surg Endosc 14(7):612–616
Hahnloser D, Chanson Ch, Nassiopoulos K, Wahl P, Petropoulos P (2002) Laparoscopic surgery of colorectal cancer. Apropos of 103 interventions. Swiss Surg 8(5):203–208
Morino M, Parini U, Giraudo G, Salval M, Brachet Contul R, Garrone C (2003) Laparoscopic total mesorectal excision : a consecutive series of 100 patients. Ann Surg 237(3):335–342
Polliand C, Barrat C, Raselli R, Elizalde A, Champault G (2002) Colorectal cancer:74 patients treated by laparoscopic resection with a mean follow-up of 5 years. Annales de Chirurgie 127(9):690–696
Hoer J, Lawong G, Klinge U, Schumpelick V (2002) Factors influencing the development of incisional hernia. A retrospective study of 2,983 laparotomy patients over a period of 10 years. Chirurg 73(5):474–480
Adell-Carceller R, Segarra-Soria MA, Pellicer-Castell V, Marcote-Valdivieso E, Gamon-Giner R, Martin-Franco MA, Ibanez-Palacin F, Torner-Pardo A (2006) Incisional hernia in colorectal cancer surgery. Associated risk factors. Cir Esp 79(1):42–45
Regnard JF, Hay JM, Rea S, Finerhut A, Flamant Y, Maillard JN (1988) Ventral Incisional hernias: incidence, date of recurrence, localization and risk factors. Ital J Surg Sci 18(3):259–265
Grantcharov TP, Rosenberg J (2001) Vertical compared with transverse incisions in abdominal surgery. Eur J of Surg 167(4):260–267
Fassiadis N, Roidl M, Hennig M, South LM, Andrews SM (2005) Randomized clinical trial of vertical or transverse laparotomy for abdominal aortic aneurysm repair. Br J Surg 92(10):1208–1211
Van ‘t Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J (2002) Meta-analysis of techniques for closure of midline abdominal incisions. Br J Surg 89(110):13
Gecim IE, Kocak S, Ersoz S, Bumin C, Aribal D (1996) Recurrence after incisional hernia repair: results and risk factors. Surg Today 26:607–609
Lumley J, Stitz R, Stevenson A, Fielding G, Luck A (2002) Laparoscopic colorectal Surgery for cancer: intermediate to long-term outcomes. Dis Colon Rectum 45(7):867–872
Regadas FS, Rodrigues LV, Nicodemo AM, Siebra JA, Furtado DC, Regadas SM (1998) Complications in laparoscopic colorectal resection: main types and prevention. Surg Lap & Endos 8(3):189–192
Jacobus WAB, Roland WL, Wim CJH, Jens AH, Emiel GGV, Johannes J (2004) Long term follow-up of a randomized contolled trial of suture versus mesh repair of incisional hernia. Ann of Surg 240:578–585
Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jorgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch of Surg 140:119–123
Strzelczyk JM, Szymanski D, Nowicki ME, Wilczynski W, Gaszynski T, Czupryniak L (2006) Randomised clinical trial of postoperative hernia prophylaxis in open bariatric surgery. Br J Surg 93:1347–1350
Pans A, Desaive C (1995) Use of an absorbable polglactin mesh for the prevention of incisional hernias. Acta Chir Belg 95:265–268
Fassiadis N, Roidl M, Hennig M, South LM, Andrews SM (2005) Randomised clinical trial of vertical or transverse laparotomy for abdominal aortic aneurysm repair. Br J Surg 92:1208–1211
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Ihedioha, U., Mackay, G., Leung, E. et al. Laparoscopic colorectal resection does not reduce incisional hernia rates when compared with open colorectal resection. Surg Endosc 22, 689–692 (2008). https://doi.org/10.1007/s00464-007-9462-y
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DOI: https://doi.org/10.1007/s00464-007-9462-y