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The influence of laparoscopy on incisional hernia rates: a retrospective analysis of 1057 colorectal cancer resections
Author(s) -
Mishra A.,
Keeler B. D.,
MaxwellArmstrong C.,
Simpson J. A.,
Acheson A. G.
Publication year - 2014
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12687
Subject(s) - medicine , incisional hernia , laparoscopic surgery , laparoscopy , hernia , colorectal cancer , surgery , stoma (medicine) , general surgery , incidence (geometry) , cancer , physics , optics
Aim The aim of this study was to evaluate the incidence of incisional hernia formation after laparoscopic and open surgery for colorectal cancer. Method A retrospective analysis was conducted of 1057 colorectal cancer resection cases (289 laparoscopic, 768 open) performed in a single national laparoscopic training centre between January 2006 and December 2011. Clinical notes and serial computed tomography scans were reviewed, with any incisional hernia including those at a surgical incision, port site, stoma and stoma closure site identified and the size of the defect measured. Results The overall incisional hernia rate was 14.8%. There was no significant difference between the open and laparoscopic groups (14.4% vs 15.9%, P = 0.566). Excluding stoma‐related hernia, 10.7% of the open group developed a surgical wound hernia, and 11.1% of the laparoscopic group developed a hernia at a port site, extraction site or surgical midline incision. There was no statistical difference between the two groups ( P = 0.853). The defects were smaller in the laparoscopic group ( P < 0.005). There were significantly more parastomal hernias in the laparoscopic group (40%) than in the open group (12.7%, P < 0.001). Conclusion The incidence of incisional hernia formation was similar after laparoscopic or open surgery for colorectal cancer. Parastomal hernia was more frequent after laparoscopic surgery.