Mahamid Ahmad, Abu-Zaydeh Omar, Sawaied Muneer, Goldberg Natalia, Haddad Riad
Department of Surgery, Carmel Medical Center, Haifa 3436212, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3525433, Israel.
J Pers Med. 2022 Mar 18;12(3):492. doi: 10.3390/jpm12030492.
(1) Background: Hand-assisted laparoscopic surgery for liver resection is a globally established technique. In this study, we report on the incidence and risk factors for postoperative incisional hernia (IH) after hand-assisted laparoscopic surgery for colorectal liver metastasis. (2) Methods: This was retrospective analysis of 89 consecutive hand-assisted laparoscopic surgery for colorectal liver metastasis. (3) Results: Participants were 39 females and 50 males. Median age was 65 years, and in 63%, the BMI was ≥25. Postoperative complications were encountered in 18% of the patients. Seven patients (7.8%) had postoperative incisional hernia in the hand port site. There was significantly higher incidence of incisional hernia in overweight patients (BMI ≥ 25) ( = 0.04), and in cases with simultaneous liver and colon resection ( = 0.02). In univariant and multivariant analyses, simultaneous liver and colon resection ( = 0.004 and 0.03, respectively), and platelet-to-lymphocyte ratio ≤ 200 ( = 0.03, 0.04, respectively) were both independent risk factors for developing postoperative incisional hernia. (4) Conclusions: Both simultaneous liver and colon resection, and platelet-to-lymphocyte ratio ≤ 200 are independent risk factors for postoperative incisional hernia after hand-assisted laparoscopic surgery for colorectal liver metastasis.
(1) 背景：手辅助腹腔镜肝切除术是一项在全球范围内已确立的技术。在本研究中，我们报告了手辅助腹腔镜手术治疗结直肠癌肝转移术后切口疝（IH）的发生率及危险因素。(2) 方法：对连续89例手辅助腹腔镜手术治疗结直肠癌肝转移的病例进行回顾性分析。(3) 结果：参与者中女性39例，男性50例。中位年龄为65岁，63%的患者BMI≥25。18%的患者出现术后并发症。7例患者（7.8%）在手辅助端口部位发生术后切口疝。超重患者（BMI≥25）的切口疝发生率显著更高（P = 0.04），同时进行肝脏和结肠切除的病例也是如此（P = 0.02）。在单因素和多因素分析中，同时进行肝脏和结肠切除（分别为P = 0.004和0.03）以及血小板与淋巴细胞比值≤200（分别为P = 0.03、0.04）均是发生术后切口疝的独立危险因素。(4) 结论：同时进行肝脏和结肠切除以及血小板与淋巴细胞比值≤200均是手辅助腹腔镜手术治疗结直肠癌肝转移术后切口疝的独立危险因素。
