Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, People's Republic of China.
Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Lujiang Road, Hefei, People's Republic of China.
ANZ J Surg. 2024 May;94(5):804-810. doi: 10.1111/ans.18873. Epub 2024 Jan 23.
Obesity is known to increase the likelihood of developing abdominal wall hernias, body mass index (BMI) alone does not provide detailed information about the amount and location of body fat. The aim of this study was to investigate the link between various adipose tissue parameters and the incidence of incisional hernias (IHs), as well as the outcomes of hernia repair.
We conducted a comprehensive review of the existing literature to examine the relationship between various body fat parameters and the occurrence of IHs after abdominal surgeries, as well as the outcomes of hernia repair.
Thirteen studies were included for analysis. Eight trials evaluated the IH development after abdominal surgeries via specific fat parameters, and five studies evaluated the postoperative outcomes after IH repair. The findings of this study suggest that an increase in visceral fat volume (VFA or VFV) and subcutaneous fat (SFA or SFV) are linked to a higher incidence of IHs after abdominal surgeries. Higher levels of VFV or VFA were associated with more challenging fascia closure and greater postoperative recurrence rates following repair. Whereas BMI did not demonstrate a significant association.
Measuring visceral and subcutaneous fat composition preoperatively can be a useful tool for assessing the risk of IH, and is more reliable than BMI. Elevated levels of these fat parameters have been linked to increased recurrence of IH following hernia repair, as well as the use of complex surgical techniques during repair.
肥胖已知会增加腹壁疝发生的可能性，而体重指数 (BMI) 本身并不能提供有关体脂量和分布的详细信息。本研究旨在探讨各种脂肪组织参数与切口疝 (IH) 的发生以及疝修补术的结果之间的关系。
我们对现有文献进行了全面综述，以检查各种体脂参数与腹部手术后 IH 的发生以及疝修补术的结果之间的关系。
共纳入 13 项研究进行分析。八项试验通过特定的脂肪参数评估腹部手术后 IH 的发展，五项研究评估 IH 修复后的术后结果。本研究的结果表明，内脏脂肪量 (VFA 或 VFV) 和皮下脂肪 (SFA 或 SFV) 的增加与腹部手术后 IH 的发生率增加有关。较高的 VFV 或 VFA 水平与筋膜闭合更具挑战性以及修复后的更高术后复发率相关。而 BMI 则没有显示出显著的相关性。
术前测量内脏和皮下脂肪成分可以作为评估 IH 风险的有用工具，比 BMI 更可靠。这些脂肪参数的升高与疝修复后 IH 的复发增加以及修复过程中使用复杂的手术技术有关。
