Chen Peng, Jiao Jingyi, Xue Huimin, Zhu Xiaojun, Wang Xiaojuan, Wang Peng
Nantong University Medical School, Nantong, 226001, China.
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Nantong University, No.20 Xisi Road, Nantong, Jiangsu, 226001, China.
BMC Surg. 2025 May 22;25(1):224. doi: 10.1186/s12893-025-02958-x.
The rising popularity of Single Incision Laparoscopic Surgery (SILS) brings concerns regarding a higher incidence of postoperative incisional hernias due to the enlarged umbilical incision compared to conventional laparoscopy. This study aims to explore the occurrence of incisional hernias following single-port laparoscopic surgery and identify associated risk factors.
The patient cohort included individuals who underwent cholecystectomy and inguinal hernia repair procedures using the SILS technique. Follow-up assessments were conducted via written correspondence, telephone interviews, and clinical examinations. Univariate and multivariate analyses were employed to investigate the impact of demographic variables and surgical parameters, including age, gender, BMI, ASA score, operative duration, pre-existing umbilical hernia, and the occurrence of postoperative incisional hernia.
A total of 753 patients completed follow-up, with a mean duration of 60.2 months and variance: 51.26. Among them, 342 (45.4%) underwent cholecystectomy, while 411 (54.6%) underwent inguinal hernia repair. The study cohort comprised 405 women (53.8%) and 348 men (46.2%), with a mean age of 40 years (range 10-83 years) at the time of surgery. Only one patient (0.13%) required conversion to conventional laparoscopy for surgical access. Intraoperative complications occurred in 0.1% of cases, while postoperative complications occurred in 1.6%. Incisional hernias developed in 10 patients (1.3%), with a notably higher incidence of 5.9% among obese patients than normoweight patients. Additionally, 23.1% of patients with pre-existing umbilical hernias experienced incisional hernia during the follow-up period. Multivariate analyses revealed that obesity(OR: 18.56, Cl:5.76-86.42, p value:0.003), pre-existing umbilical hernia(OR:16.32,Cl:4.26-61.68, p value:0,002), diabetes(OR:2.42, Cl:1.86-20.42, p value:0.496), and hypertension(OR:1.96, Cl:0.72-12.64,p value:0.924) were significantly associated with incisional hernia incidence. However, gender, age, type of surgery (inguinal hernia repair vs. cholecystectomy), presence of acute inflammation, and duration of surgery did not show statistically significant associations with incisional hernia occurrence.
Detecting incisional hernias necessitates an extended follow-up period. In the univariate analysis, obesity and pre-existing umbilical hernias were linked to an elevated risk of this complication. Following meticulous patient selection, Single Incision Laparoscopic Surgery (SILS) presents a secure method for performing cholecystectomy and inguinal hernia repair.
单孔腹腔镜手术（SILS）日益普及，与传统腹腔镜手术相比，脐部切口扩大引发了人们对术后切口疝发生率更高的担忧。本研究旨在探讨单孔腹腔镜手术后切口疝的发生情况，并确定相关危险因素。
患者队列包括采用SILS技术进行胆囊切除术和腹股沟疝修补术的个体。通过书面通信、电话访谈和临床检查进行随访评估。采用单因素和多因素分析来研究人口统计学变量和手术参数的影响，包括年龄、性别、体重指数（BMI）、美国麻醉医师协会（ASA）评分、手术持续时间、既往脐疝情况以及术后切口疝的发生情况。
共有753例患者完成随访，平均随访时间为60.2个月，方差为51.26。其中，342例（45.4%）接受了胆囊切除术，411例（54.6%）接受了腹股沟疝修补术。研究队列包括405名女性（53.8%）和348名男性（46.2%），手术时的平均年龄为40岁（范围10 - 83岁）。只有1例患者（0.13%）因手术入路需要转为传统腹腔镜手术。术中并发症发生率为0.1%，术后并发症发生率为1.6%。10例患者（1.3%）发生了切口疝，但肥胖患者的发生率（5.9%）显著高于正常体重患者。此外，既往有脐疝的患者中有23.1%在随访期间发生了切口疝。多因素分析显示，肥胖（比值比[OR]：18.56，可信区间[CI]：5.76 - 86.42，p值：0.003）、既往脐疝（OR：16.32，CI：4.26 - 61.68，p值：0.002）、糖尿病（OR：2.42，CI：1.86 - 20.42，p值：0.496）和高血压（OR：1.96，CI：0.72 - 12.64，p值：
