Incisional hernia after sugery for diverticular disease
Background Incisional hernia after open surgery is a well-known complication. A retrospective study was conducted to determine the incidence and predisposing factors of incisional hernia after colonic surgery for diverticular disease. Methods A retrospective cohort of 105 consecutive patients undergoing either laparoscopic or open surgery for complicated diverticulosis between January 2000 and December 2010 was identified. The influence of demographic data, surgical approach and timing for incisional hernia development were analysed. Statistical evaluation was performed using the chisquare test according to Pearson and Mann-Whitney test. Results In a group of 31 men and 74 women, with an average age of 67 years, incisional hernia developed in 27 patients (26%) at a mean follow-up of 5.5 years. Incisional hernia was found in two of 23 patients (9%) in the laparoscopic surgery group compared with 25 of 82 patients (30%) in the open surgery group (P = 0.03). We did not prove a higher risk for incisional hernia after acute surgery (P = 0.6). Significant demographic factor influencing incisional hernia incidence was female gender (P = 0.003), but not age (P = 0.43). Mean time to hernia occurrence was 1.5 years. Conclusion Laparoscopic surgery leads to a significantly lower incidence of incisional hernia compared to open surgical technique. Female gender represents a higher risk for incisional hernia than acute surgery or age. Because laparoscopy is more feasible as elective surgery, when speaking of incisional hernia, we should recommend sigmoid resections early, especially to women.
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