Risk factors of incisional hernia enlargement after colorectal cancer surgery: a retrospective, single-center study.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-09-14 DOI:10.1007/s00595-025-03131-w

Koki Tamai, Mitsuyoshi Tei, Naoto Tsujimura, Kentaro Nishida, Soichiro Mori, Yukihiro Yoshikawa, Masatoshi Nomura, Nobuyoshi Ohara, Takuya Hamakawa, Daisuke Takiuchi, Masanori Tsujie, Yusuke Akamaru

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引用次数: 0

Abstract

Purpose: Incisional hernia (IH) often develops during surveillance after colorectal cancer surgery, with repair sometimes delayed due to the risk of recurrence. This study aimed to identify the risk factors for IH enlargement by objectively measuring the changes in defect size.

Methods: We retrospectively analyzed 83 patients who developed IH after curative laparoscopic colorectal surgery at the Osaka Rosai Hospital between 2017 and 2021. Computed tomography was used to measure the IH defect sizes at diagnosis and at the end of the surveillance. Univariate and multivariate analyses were performed to determine the risk factors for enlargement.

Results: The median IH defect size increased from 23.7 to 32.7 mm over a median follow-up of 1003 days. The highest quartile of defect size change was 12.1 mm and was used to classify patients into stable and enlarged IH groups. A multivariate analysis revealed that a high body mass index (≥ 25 kg/m²; odds ratio [OR] 3.527, p = 0.037), early IH discovery (< 225 days after surgery; OR 4.753, p = 0.012), and high neutrophil-to-lymphocyte ratio (> 2.45; OR 3.604, p = 0.031) were independent risk factors for IH enlargement.

Conclusions: Obesity, early IH development, and systemic inflammation are associated with IH progression. Careful monitoring of patients with these risk factors is warranted.

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结直肠癌手术后切口疝扩大的危险因素：一项回顾性单中心研究。

目的：切口疝（IH）经常在结直肠癌手术后的监测期间发生，有时由于复发的风险而延迟修复。本研究旨在通过客观测量缺损大小的变化来确定IH扩大的危险因素。方法：回顾性分析2017年至2021年在大阪罗赛医院进行的83例根治性腹腔镜结直肠手术后发生IH的患者。计算机断层扫描用于测量诊断时和监测结束时的IH缺陷大小。进行单因素和多因素分析以确定扩大的危险因素。结果：在1003天的随访中，中位IH缺损尺寸从23.7 mm增加到32.7 mm。缺损大小变化的最高四分位数为12.1 mm，用于将患者分为稳定组和扩大组。多因素分析显示，高体重指数（≥25 kg/m2，比值比[OR] 3.527, p = 0.037）、早期发现IH（比值比[OR] 2.45， OR为3.604,p = 0.031）是IH扩大的独立危险因素。结论：肥胖、早期IH发展和全身性炎症与IH进展相关。有必要对具有这些危险因素的患者进行仔细监测。

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

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.