Abstract
Aim:
Incisional
hernias are one of the most common problems seen after abdominal operations.
About 2 – 11% of abdominal incisions result in incisional hernia. The
recurrence rate is about 30-50% after primary repair. Recently with the use of
prostethic materials recurrence rate decreased to 0-15%. The aim of this study
to determine the risk factors that may have a role in incisional hernia
recurrence.
Material and method: We retrospectively analyses the
files of 60 cases that had incisional hernia and repaired with a prosthetic
material. Cases were evaluated for the risk factors for hernia recurrence.
Statistical analysis was performed by SPSS sotware. The mean follow up of the
study was 33.8 months.
Findings: Thirty two cases underwent onlay reapir and 28 cases
underwent sublay repair. The overall
recurrence rate was 20%. Risk factors for recurrence were found to be; chronic
constipation, history of malignancy, wound site infection and seroma formation.
Conclusion: Postoperative close follow of co-morbidities and a
good wound care can be affective in prevention of recurrence after incisional
hernia repair.
Keywords
References
- Larson GM, Vantertoll DJ: Approaches to repair of ventral hernia and full-thickness losses of the abdominal wall. Surg Clin North Am 1984; 64: 335–349.
- Bucknall TE, Cox PJ, Ellis H: Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies. Br med J 1982; 284: 931-933.
- Lamont PM, Ellis H: Incisional hernia in re-opened abdominal incisions: An overlooked risk factor. Br J Surg. 1988; 75: 374-376.
- Read RC. Development of inguinal herniorraphy. Surg Clin North Am 1984,64: 185-196
- Topuzlu C. Fıtıklar. Çev. Ed, Andican A. in Mamgot Abdominal Operasyonlar, cilt l, Nobcl Kitabevi, İstanbul, 1989, 247
- Schoetz DJ, Çöller JA, Veidenheimer MC: Closure of abdominal wounds with polydioxanone: A prospective study. Arch Surg 1988; 123: 72-74
- Ricardo M.Young, Rohert Gustafson, Robert C. Dinsmore. Sepramesh vs. Dualmesh for abdominal wall hernia repairs in a rabbit model. Current Surgery 2004 Jan,77-79.
- Cox PT, Ausobosky JR, Ellis H, Pollack AV: No wounds no incisional hernias: lateral versus midline incisions. J. R. Soc. Med. 1986; 79:711-712.
- Read RC, Yoger G: Recent trends in the management of incisional herniation. Arch. Surg. 1989; 124:485-488.
- Antony T, Bergen PC, Kim LT, et al: Factors affecting recurrens following incisional herniorraphy. World J. Surg. 2000; 24:95-101.
- Jacobus WA, Roland W: Long term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann. Surg. 2004; 240:578-583.
- Vidovic D, Jurisic D, Franjic B.D et al: Factors affecting recurrence after incisional hernia repair. Hernia 2006; 10: 322-325.
- Sauerland S, Korenkov M, Kleinen T: obesity is a risk factors for recurrence after incisional hernia repair. Hernia 2004; 8:42-46.
- Grose WE, Read RC: Basic future of abdominal wall herniation and its repair. Shackelford ‘s surgery of alimantary tracts. WB Saunders Company, Philedelphia: 87-96, 1991.
- Bucknall TE, Cox PJ, Ellis H: Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies. Br med J 1982; 284: 931-933
- Polk, H. C., Trachtenberg, L., and Finn, M. P. Antibiotic activity in surgical incisions. JAMA 1980; 244: 1353.
- Geçim IE, Koçak S, Ersöz S, Bumin C, Arıbal D: Recurrence after incisional hernia repair results and risk factors. Surg. Today. 1996; 26: 607-609
- Heselling et al. Risk factors of incisional hernia recurrens surgery. Gynecology obstetrics-merck 1993; 176: 228-233.
- Shukla, V. K., Grupta, A., Singh, H., et al. Cardiff repair of incisional hernia: A university hospital experience. Eur. J. Surg. 1998; 164: 271.
- Rios A, Rodriques J.M, Munitiz V et al: Factors that affect recurrence after incisional herniorraphy with prosthetic material. Eur J Surg. 2001; 167:855-859.
- Lois D, Stoppa R, Henry X, Verhaegh P: Postoperative eventrations. A propos of 247 surgically treated cases. J Chir (Paris) 1985; 122(10): 523-527.
- Stoppa R: Long-term complications of prosthetic incisional hernioplasty. Arch Surg. 1998; 133: 1254-1255.
- Sevinç B, Okuş A, Ay S, Aksoy N, Karahan Ö. Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia. Turk J Surg. 2018; 34: 17-20
- Shaikh NA, Shaikh NM. Comperative study of repair of incisional hernia. J Park Med Assoc 1994; 44: 38-39.
Abstract
Giriş
ve amaç:
Karın ön duvarı hernileri (ventral herniler)
arasında yer alan insizyonel
herniler, karında uygulanan cerrahi girişimlerden sonra sık karşılaşılan
sorunlardan biridir. Kapatılan abdominal insizyonların % 2 ile % 11 ‘i
insizyonel herni ile sonuçlanmaktadır. İnsizyonel hernilerin primer tamirinden
sonra % 30-50 oranında nüks bildirilmektedir; herni onarımı mesh uygulaması ile
yapıldığında bu oran % 0-15 oranına düşmektedir. Bu çalışmadaki amacımız insizyonel
herni onarımında kullanılan tekniklerin ve predispozan faktörlerin insizyonel
herni nüksü üzerine etkisini araştırmaktı.
Materyal ve metod: İzmir Atatürk Eğitim ve Araştırma
Hastanesi 2. Genel Cerrahi kliniğinde Mart 2003 - Mayıs 2007 yılları arasında
protezli tamir uyguladığımız ardışık 60 insizyonel hernili olgu çalışmamıza
dahil edildi. Olgularımız insizyonel herni nüksüne etki eden parametreler
açısından incelendi. Verilerimizin istatiksel değerlendirilmesi ki-kare testi
ve çok değişkenli ikili lojistik regresyon testi ile yapıldı. Takip sürelerimiz
ortalama 33,8
aydır (12-63 ay).
Bulgular: Prostetik materyalle tamir uyguladığımız hastalarımızın
32 ‘sine onlay yöntemle, 28 ‘ine sublay yöntem ile yama yerleştirilmiş idi.
Olgularımızın toplam % 20 ‘sinde nüks izlendi. Nükse etki eden faktörler
arasında; kronik kabızlık öyküsü, malignite varlığı, yara yeri enfeksiyonu ve
seroma oluşumu istatiksel olarak anlamlı bulundu.
Sonuç: Kronik kabızlık, malignite öyküsü, postoperatif
yarayerinde enfeksiyon ve seroma oluşumu insizyonel herni operasyonu sonrasında
nükse sebep olabilecek faktörler arasındadır. Preoperatif dönemde ek
hastalıkların kontrol altına alınması ve postoperatif dönemde yara bakımının
iyi yapılması ile nükslerin engellenebileceğini düşünmekteyiz.
Keywords
References
- Larson GM, Vantertoll DJ: Approaches to repair of ventral hernia and full-thickness losses of the abdominal wall. Surg Clin North Am 1984; 64: 335–349.
- Bucknall TE, Cox PJ, Ellis H: Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies. Br med J 1982; 284: 931-933.
- Lamont PM, Ellis H: Incisional hernia in re-opened abdominal incisions: An overlooked risk factor. Br J Surg. 1988; 75: 374-376.
- Read RC. Development of inguinal herniorraphy. Surg Clin North Am 1984,64: 185-196
- Topuzlu C. Fıtıklar. Çev. Ed, Andican A. in Mamgot Abdominal Operasyonlar, cilt l, Nobcl Kitabevi, İstanbul, 1989, 247
- Schoetz DJ, Çöller JA, Veidenheimer MC: Closure of abdominal wounds with polydioxanone: A prospective study. Arch Surg 1988; 123: 72-74
- Ricardo M.Young, Rohert Gustafson, Robert C. Dinsmore. Sepramesh vs. Dualmesh for abdominal wall hernia repairs in a rabbit model. Current Surgery 2004 Jan,77-79.
- Cox PT, Ausobosky JR, Ellis H, Pollack AV: No wounds no incisional hernias: lateral versus midline incisions. J. R. Soc. Med. 1986; 79:711-712.
- Read RC, Yoger G: Recent trends in the management of incisional herniation. Arch. Surg. 1989; 124:485-488.
- Antony T, Bergen PC, Kim LT, et al: Factors affecting recurrens following incisional herniorraphy. World J. Surg. 2000; 24:95-101.
- Jacobus WA, Roland W: Long term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann. Surg. 2004; 240:578-583.
- Vidovic D, Jurisic D, Franjic B.D et al: Factors affecting recurrence after incisional hernia repair. Hernia 2006; 10: 322-325.
- Sauerland S, Korenkov M, Kleinen T: obesity is a risk factors for recurrence after incisional hernia repair. Hernia 2004; 8:42-46.
- Grose WE, Read RC: Basic future of abdominal wall herniation and its repair. Shackelford ‘s surgery of alimantary tracts. WB Saunders Company, Philedelphia: 87-96, 1991.
- Bucknall TE, Cox PJ, Ellis H: Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies. Br med J 1982; 284: 931-933
- Polk, H. C., Trachtenberg, L., and Finn, M. P. Antibiotic activity in surgical incisions. JAMA 1980; 244: 1353.
- Geçim IE, Koçak S, Ersöz S, Bumin C, Arıbal D: Recurrence after incisional hernia repair results and risk factors. Surg. Today. 1996; 26: 607-609
- Heselling et al. Risk factors of incisional hernia recurrens surgery. Gynecology obstetrics-merck 1993; 176: 228-233.
- Shukla, V. K., Grupta, A., Singh, H., et al. Cardiff repair of incisional hernia: A university hospital experience. Eur. J. Surg. 1998; 164: 271.
- Rios A, Rodriques J.M, Munitiz V et al: Factors that affect recurrence after incisional herniorraphy with prosthetic material. Eur J Surg. 2001; 167:855-859.
- Lois D, Stoppa R, Henry X, Verhaegh P: Postoperative eventrations. A propos of 247 surgically treated cases. J Chir (Paris) 1985; 122(10): 523-527.
- Stoppa R: Long-term complications of prosthetic incisional hernioplasty. Arch Surg. 1998; 133: 1254-1255.
- Sevinç B, Okuş A, Ay S, Aksoy N, Karahan Ö. Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia. Turk J Surg. 2018; 34: 17-20
- Shaikh NA, Shaikh NM. Comperative study of repair of incisional hernia. J Park Med Assoc 1994; 44: 38-39.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Surgery |
| Journal Section | Original Investigation |
| Authors | |
| Publication Date | December 14, 2018 |
| Acceptance Date | October 11, 2018 |
| Published in Issue | Year 2018 Volume: 1 Issue: 3 |
