Risk factors for incisional hernia after open abdominal aortic aneurysm repair: a systematic review and meta-analysis
- 26.09.2024
- Review
Erschienen in:
- Verfasst von
- Nandita N. Mahajan
- Carlos Andre Balthazar da Silveira
- Julia Adriana Kasmirski
- Diego Laurentino Lima
- Gabriele Eckerdt Lech
- Luiza Bertolli Lucchese Moraes
- Carolina Moronte Sturmer
- Leandro Totti Cavazzola
- Prashanth Sreeramoju
- Erschienen in
- Hernia | Ausgabe 6/2024
Abstract
Background
The incidence of incisional hernia (IH) after an open abdominal aortic aneurysm (AAA) repair can reach up to 35%, contributing to long-term morbidity. Individual studies have been limited in identifying modifiable risk factors for IH after an open AAA repair. This meta-analysis aims to review all the risk factors for IH after an open AAA repair.
Methods
We searched Cochrane Central, Embase, PubMed, MEDLINE, and Web of Science databases for original studies. Risk factors assessed were age, sex, comorbidities, surgical incision, blood loss, and surgical site infection (SSI). Data analysis was done using RStudio 4.1.2. We computed Relative Risk (RR) for dichotomous outcomes and Mean differences (MD) with 95% Confidence Interval (CI) for continuous outcomes. P-values less than 0.05 were considered statistically significant.
Results
Ten studies met the inclusion criteria among 1,795 screened articles. Among those ten studies, there were a total of 1,806 patients of which 341 patients developed IH. Older age (Mean 69.6–70.7 years, MD 1.39 years, CI [1.12–1.66], P < 0.01), midline vertical incision (RR 1.55, CI [1.06–2.25], P = 0.02) and increased intraoperative blood loss (MD 429.8 ml, CI [234.8- 624.8], P < 0.01) were associated with an increased incidence of IH. Surgical site infection (SSI) was noted as a risk factor for IH after open AAA repair (RR 2.36, CI [1.31–4.24], P = 0.004). No statistically significant association was found between the incidence of IH and sex (RR 1.0, CI [0.8–1.14], P = 0.98), smoking (RR 1.01, CI [0.93–1.09], P = 0.88), diabetes (RR 1.38, CI [0.85–2.25], P = 0.19), and chronic kidney disease (RR 1.55, CI [0.47–5.09], P = 0.46).
Conclusion
This meta-analysis shows that age, midline vertical incision, intraoperative blood loss, and SSI are risk factors for IH after open AAA repair.
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- Titel
- Risk factors for incisional hernia after open abdominal aortic aneurysm repair: a systematic review and meta-analysis
- Verfasst von
-
Nandita N. Mahajan
Carlos Andre Balthazar da Silveira
Julia Adriana Kasmirski
Diego Laurentino Lima
Gabriele Eckerdt Lech
Luiza Bertolli Lucchese Moraes
Carolina Moronte Sturmer
Leandro Totti Cavazzola
Prashanth Sreeramoju
- Publikationsdatum
- 26.09.2024
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 6/2024
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03182-x
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