Song In Ho, Ha Heon-Kyun, Choi Sang-Gi, Jeon Byeong Geon, Kim Min Jung, Park Kyu Joo
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Korean Soc Coloproctol. 2012 Dec;28(6):299-303. doi: 10.3393/jksc.2012.28.6.299. Epub 2012 Dec 31.
The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery.
The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed.
The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias.
Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.
本研究旨在评估结直肠手术后切口疝和造口旁疝发生的总体发生率及危险因素。
研究队列包括2005年至2007年间由同一位外科医生进行开放性结直肠手术的795例连续患者。对前瞻性收集的数据进行回顾性分析。
切口疝的总体发生率为2%（14/690）。本研究显示，切口疝的累积发生率在12个月时为1%，36个月后为3%。所有切口疝的86%在结肠切除术后3年内发生。有造口患者的造口旁疝总体发生率为6.7%（7/105）。结肠造口组造口旁疝的发生率显著高于回肠造口组（11.9%对0%；P = 0.007）。肥胖、腹主动脉瘤、美国麻醉医师协会评分、血清白蛋白水平、急诊手术和术后肠梗阻均不影响切口疝或造口旁疝的发生率。然而，多变量分析显示，女性性别和伤口感染是切口疝发生的显著危险因素（女性：P = 0.009，伤口感染：P = 0.041）。与造口旁疝发生相关的无显著因素。
我们的结果表明，大多数切口疝在结肠切除术后3年内发生。女性性别和伤口感染是结直肠手术后切口疝发生的危险因素。相比之下，未发现与造口旁疝发生相关的显著因素。
