Ellis Ryan C, Maskal Sara M, Bertke Alexander, de Figueiredo Sergio Mazzola Poli, Woo Kimberly P, Fafaj Aldo, Messer Nir, Remulla Daphne, Krpata David M, Miller Benjamin T, Beffa Lucas R A, Petro Clayton C, Prabhu Ajita S, Rosen Michael J
Department of Surgery, Cleveland Clinic Center for Abdominal Core Health Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Department of Surgery, Cleveland Clinic Foundation Akron General Hospital, Akron, OH, USA.
Hernia. 2024 Dec 27;29(1):56. doi: 10.1007/s10029-024-03251-1.
Forceful coughing is assumed to be an uncommon etiology for lateral abdominal wall hernias. The literature regarding this topic is very limited and there is a lack of consensus in management, both operative and non-operative. We aim to report our center's experience in repair of lateral abdominal wall hernias secondary to vigorous coughing.
All patients undergoing lateral abdominal wall hernia repairs secondary to coughing at our institution from August 2014 to December 2023 were identified in the Abdominal Core Health Quality Collaborative (ACHQC). Only patients with lateral abdominal wall hernias without prior lateral incisions, reporting a vigorous coughing event were included in the analysis. Recurrent repairs were also included. Patient and hernia characteristics, operative details, post-operative outcomes, and long-term patient reported outcomes were extracted from the ACHQC database and chart review.
Twelve patients with lateral abdominal wall hernias secondary to coughing underwent repair within the study period. The median hernia width was 18.5 cm. Transversus abdominus release was performed in all patients, 8 had heavyweight polypropylene mesh placed, and 9 received mesh fixation. Wound complications were noted in 2 patients, both resolved with superficial wound opening. At a mean follow up of 4.0 years, one patient reported a bulge, and no clinical or radiographic recurrences were identified.
Lateral abdominal wall hernias after forceful coughing have not been well defined. Here we present our series based on our repairs. Unfortunately, our ability to comment on recurrences is limited by a lack of follow up.
强力咳嗽被认为是侧腹壁疝的一种罕见病因。关于这一主题的文献非常有限，在手术和非手术治疗方面缺乏共识。我们旨在报告我们中心修复因剧烈咳嗽继发的侧腹壁疝的经验。
在腹部核心健康质量协作组（ACHQC）中确定了2014年8月至2023年12月在我们机构接受因咳嗽继发的侧腹壁疝修补术的所有患者。分析仅纳入无先前侧方切口、报告有剧烈咳嗽事件的侧腹壁疝患者。复发性修补术患者也包括在内。从ACHQC数据库和病历回顾中提取患者和疝的特征、手术细节、术后结果以及患者报告的长期结果。
在研究期间，12例因咳嗽继发的侧腹壁疝患者接受了修补术。疝的中位宽度为18.5厘米。所有患者均进行了腹横肌松解，8例放置了重磅聚丙烯补片，9例接受了补片固定。2例患者出现伤口并发症，均通过浅表伤口开放得以解决。平均随访4.0年时，1例患者报告有隆起，未发现临床或影像学复发。
强力咳嗽后发生的侧腹壁疝尚未得到明确界定。在此我们展示了基于我们修补术的系列病例。遗憾的是，由于缺乏随访，我们对复发情况发表评论的能力有限。
