Rectus diastasis is a risk factor for incisional hernia after robot assisted laparoscopic radical prostatectomy for prostate cancer.

IF 2.4 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-07-16 DOI:10.1007/s10029-025-03419-3

Shusaku Honma, Kana Ishikawa, Takashi Kumode, Takahisa Suzuki, Teppei Murakami, Shinichi Hosokawa, Takatsugu Kan, Sanae Nakajima

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引用次数: 0

Abstract

Purpose: This study aimed to investigate the association between rectus diastasis (RD) and incisional hernia (IH) following robot-assisted laparoscopic radical prostatectomy (RARP).

Methods: We retrospectively reviewed all patients who underwent RARP for prostate cancer at our hospital between January 2017 and December 2023. All participants were required to undergo computed tomography imaging prior to RARP and at least once no less than five months after RARP to assess RD and IH, respectively. RD was defined as a widening of the linea alba exceeding 2 cm. A backward stepwise regression modeling was used to construct a multivariate logistic model. The cumulative incidence of IH was calculated and compared between patients with and without RD using the Kaplan-Meier method.

Results: Among 145 eligible patients, 45 (31.0%) developed IH. Multivariable logistic regression analysis identified RD (Odds ratio 4.03, 95% confidence interval 1.92-8.48) as an independent risk factor associated with IH after adjusting for pre-existing primary umbilical hernia, body mass index, specimen weight, and surgical site complication. The cumulative incidence of IH was significantly higher in patients with RD than those without.

Conclusion: RD is a significant risk factor for IH after RARP. Vertical midline incisions at the specimen extraction site should be avoided in patients with RD whenever possible.

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机器人辅助腹腔镜前列腺根治术治疗前列腺癌后，直肠肌转移是切口疝的危险因素。

目的：本研究旨在探讨机器人辅助腹腔镜根治性前列腺切除术（RARP）后直肠转移（RD）与切口疝（IH）的关系。方法：回顾性分析2017年1月至2023年12月在我院接受前列腺癌RARP治疗的所有患者。所有参与者在RARP前和RARP后至少5个月接受一次计算机断层成像，分别评估RD和IH。RD定义为白线增宽超过2厘米。采用后向逐步回归模型构建多元logistic模型。使用Kaplan-Meier方法计算并比较有和无RD患者间IH的累积发病率。结果：145例符合条件的患者中，45例（31.0%）发生IH。多变量logistic回归分析发现，在对已存在的原发性脐疝、体重指数、标本重量和手术部位并发症进行校正后，RD（优势比4.03,95%可信区间1.92-8.48）是与IH相关的独立危险因素。RD患者IH的累积发生率明显高于非RD患者。结论：RD是RARP术后IH发生的重要危险因素。RD患者应尽可能避免标本提取部位的垂直中线切口。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.