Clinical importance of incisional hernia in patients resected for colorectal liver metastases: quality of life and abdominal wall symptoms.

Abstract

Purpose: Incisional hernia (IH) after open liver surgery is a well-recognized complication. The clinical importance of IH detected on computed tomography in terms of objective abdominal wall discomfort and impairment of quality of life (QoL) is less well known.

Methods: Patients who underwent curative surgery for colorectal liver metastases between 2010 and 2015 at a single center and were alive in February 2017 were asked to complete a ventral hernia pain questionnaire and the EORTC QLQ-C30 QoL questionnaire.

Results: A total of 105 patients (80%) completed the questionnaires. Forty-three patients (42%) developed IH. The majority (77%) of IHs were < 2.5 cm. Patients who had an IH before liver surgery developed a new IH to a greater extent (P = 0.001). There were no significant differences regarding abdominal wall symptoms and QoL between patients with and without IH. However, about half (48%) of all patients had abdominal wall symptoms after a median follow-up of 34 months.

Conclusion: Radiologically detected IH after open liver surgery has low clinical importance. About half of all patients who underwent liver surgery experienced abdominal wall symptoms a long after surgery, but these symptoms were not related to IH.