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Tytuł:
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Prevention of Incisional Hernia after Open Hepato-Pancreato-Biliary Surgery: A Systematic Review.
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Autorzy:
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Memba R; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.; School of Medicine, Rovira i Virgili University, Reus, Spain.
Morató O; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.
Estalella L; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.; School of Medicine, Rovira i Virgili University, Reus, Spain.
Pavel MC; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.; School of Medicine, Rovira i Virgili University, Reus, Spain.
Llàcer-Millán E; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.; School of Medicine, Rovira i Virgili University, Reus, Spain.
Achalandabaso M; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.; School of Medicine, Rovira i Virgili University, Reus, Spain.
Julià E; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.
Padilla E; Abdominal Wall Surgery Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.
Olona C; School of Medicine, Rovira i Virgili University, Reus, Spain.; Abdominal Wall Surgery Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.
O'Connor D; Department of Surgery, School of Medicine, Trinity College Dublin, College Green, Dublin, Ireland.
Jorba R; Hepato-Pancreato-Biliary Unit, General Surgery Department, University Hospital of Tarragona Joan XXIII, Tarragona, Spain.; School of Medicine, Rovira i Virgili University, Reus, Spain.
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Źródło:
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Digestive surgery [Dig Surg] 2022; Vol. 39 (1), pp. 6-16. Date of Electronic Publication: 2021 Dec 07.
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Typ publikacji:
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Systematic Review
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Język:
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English
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Imprint Name(s):
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Original Publication: Basel ; New York : S. Karger, [c1984-
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MeSH Terms:
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Biliary Tract Surgical Procedures*/adverse effects
Incisional Hernia*/etiology
Incisional Hernia*/prevention & control
Laparoscopy*/methods
Liver Transplantation*/adverse effects
Humans ; Surgical Wound Infection/etiology
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Contributed Indexing:
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Keywords: Hepato-pancreato-biliary surgery; Incisional hernia; Mesh reinforcement; Prophylactic mesh; Subcostal incision
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Entry Date(s):
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Date Created: 20211207 Date Completed: 20220317 Latest Revision: 20220317
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Update Code:
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20240105
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DOI:
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10.1159/000521169
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PMID:
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34875657
Introduction: Most hepato-pancreato-biliary (HPB) procedures are still performed through open approach. Incisional hernia (IH) is one of the most common complications after open surgery. To date, published data on IH after HPB surgery are scarce; therefore, the aim of this study was to assess the current evidence regarding incidence, risk factors, and prevention.
Methods: Medline/PubMed (1946-2020), EMBASE (1947-2020), and the Cochrane library (1995-2020) were searched for studies on IH in open HPB surgery. Animal studies, editorials, letters, reviews, comments, short case series and liver transplant, laparoscopic, or robotic procedures were excluded. The protocol was registered with PROSPERO (CRD42020163296).
Results: A total of 5,079 articles were retrieved. Eight studies were finally included for the analysis. The incidence of IH after HPB surgery ranges from 7.7% to 38.8%. The identified risk factors were body mass index, surgical site infection, ascites, Mercedes or reversed T incisions, and previous IH. Prophylactic mesh might be safe and effective.
Conclusions: IH after open HPB surgery is still an important matter. Some of the risk factors are specific for the HPB operations and the incision type should be carefully considered. Randomized controlled trials are required to confirm the role of prophylactic mesh after HPB operations.
(© 2021 S. Karger AG, Basel.)
