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Subxiphoid Incisional Hernia Development after Coronary Artery Bypass Grafting
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 161-165, 2012.
Article Dans Anglais | WPRIM | ID: wpr-79086
ABSTRACT

BACKGROUND:

Median sternotomy can weaken the upper abdominal wall and result in subxiphoid incisional hernia. We evaluated risk factors associated with the development of subxiphoid incisional hernias after coronary artery bypass grafting (CABG). MATERIALS AND

METHODS:

Of 1,656 isolated CABGs performed between January 2001 and July 2010, 1,599 patients who were completely followed up were analyzed. The mean follow-up duration was 49.5+/-34.3 months. Subxiphoid incisional hernia requiring surgical repair developed in 13 patients (0.8%). The hernia was diagnosed 16.3+/-10.3 months postoperatively, and hernia repair was performed 25.0+/-26.1 months after the initial operation. Risk factors associated with the development of subxiphoid incisional hernia were analyzed with the Cox proportional hazard model.

RESULTS:

Five-year freedom from the hernia was 99.0%. Univariate analysis revealed that female sex (p=0.019), height (p=0.019), body surface area (p=0.046), redo operation (p=0.012), off-pump CABG (p=0.049), a postoperative wound problem (p=0.041), postoperative bleeding (p=0.046), and low cardiac output syndrome (p<0.001) were risk factors for the development of the hernia. Multivariable analysis showed that female sex (p=0.01) and low cardiac output syndrome (p<0.001) were associated with subxiphoid hernia formation.

CONCLUSION:

Female sex and postoperative low cardiac output syndrome were risk factors of subxiphoid hernia. Therefore, special attention is needed for patients with high-risk factors.
Sujets)

Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Surface corporelle / Bas débit cardiaque / Pontage aortocoronarien / Facteurs de risque / Études de suivi / Vaisseaux coronaires / Paroi abdominale / Sternotomie / Herniorraphie / Liberté Type d'étude: Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains langue: Anglais Texte intégral: The Korean Journal of Thoracic and Cardiovascular Surgery Année: 2012 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Surface corporelle / Bas débit cardiaque / Pontage aortocoronarien / Facteurs de risque / Études de suivi / Vaisseaux coronaires / Paroi abdominale / Sternotomie / Herniorraphie / Liberté Type d'étude: Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains langue: Anglais Texte intégral: The Korean Journal of Thoracic and Cardiovascular Surgery Année: 2012 Type: Article