76 Incidence of Incisional Hernia Post-Colorectal Liver Metastasis Resection - a Longitudinal Radiological Cohort Study
K Mallalieu, A Lynch, S Adams, R Jones, C Walsh- Surgery
Abstract
Aim
The aim of this study is to determine the incidence and time to development of incisional hernia (IH) in post partial hepatectomy (PH) for colorectal liver metastases (CRLM) patients to enable surgeons to prepare and accurately consent patients for the operations.
Method
The radiological images and reports of all patients undergoing hepatectomy for CRLM at a tertiary hepatobiliary surgical unit between December 2010 and August 2015 were retrospectively followed up for 5 years post-procedure. The primary outcome was the radiological incidence of an incisional hernia post-hepatectomy within 5 years of the procedure. Secondary outcomes included risk factors for the development of IH and time to hernia development and incidence of incisional hernia repair.
Results
249 patients, 164 men (66%), 85 women (34%); median age 65, IQR 59-73 underwent open hepatectomy. Incidence of incisional hernia 19.1% (n = 40) at a median of 8.5 months, IQR 4.75-12 months. High BMI was a risk factor associated with IH (P<.0001), 95% CI 1.084 to 1.232. (10% (n = 4) of those with IH had radiological evidence of incisional hernia repair.
Conclusions
IH represents a significant risk for patients undergoing open hepatectomy for CRLM. IH has the potential to have large impact on patient’s quality of life and increases the risk to return to theatre, either for emergency operation in the event of incarcerated hernias or for planned elective hernia repairs. It is important to know accurate figures of incidence of IH to enable surgeons to adequately prepare and consent patients for open PH.