[Incisional hernia in colorectal cancer surgery. Associated risk factors]. / Hernia incisional en cirugía de cáncer colorrectal. Factores de riesgo relacionados.

BACKGROUND: Incisional hernia is one of the most common complications in abdominal surgery. The aim of this retrospective study was to examine the true incidence of incisional hernia and its risk factors in patients undergoing surgery for colorectal cancer. PATIENTS AND METHOD: Two hundred ninety-five patients who underwent colorectal cancer surgery between 1993 and 2003 were included. The mean follow-up was 37.5 +/- 22 months. RESULTS: Forty-three patients developed incisional hernia, representing 14.5% of the total. The cumulative percentage of patients developing incisional hernia was 7% at 6 months, 16% at 1 year, 21% at 2 years and 33% at 5 and 10 years. The only significant independent risk factors were chronic obstructive pulmonary disease (COPD) (2-year cumulative incidence of incisional hernia of 53%, p = 0.04) and abdominal wound infection (2-year cumulative incidence of incisional hernia of 28%; p = 0.02). CONCLUSION: COPD and abdominal wound infection predispose to incisional hernia in colorectal surgery. Abdominal wound infection is the only factor over which the surgeon can act preventively by using antibiotic prophylaxis and an aseptic technique.

Hernia incisional en cirugía de cáncer colorrectal. Factores de riesgo relacionados / Incisional hernia in colorectal cancer surgery. Associated risk factors

Introducción. Las hernias incisionales o eventraciones representan una de las complicaciones más frecuentes dentro de la cirugía abdominal. Presentamos un estudio retrospectivo sobre la incidencia de hernia incisional en los pacientes operados de cáncer colorrectal y los factores de riesgo implicados. Pacientes y método. Se incluyó en el estudio a 295 pacientes intervenidos por cáncer colorrectal entre los años 1993 y 2003. El tiempo medio de seguimiento fue de 37,5 ± 22 meses. Resultados. Presentaron eventración o hernia incisional un total de 43 pacientes, el 14,5% del total. La probabilidad de desarrollar eventración fue del 7% a los 6 meses, del 16% al año, del 21% a los 2 años y del 33% a los 5 y 10 años. Las únicas variables que demostraron significación de forma independiente como factores de riesgo fueron la enfermedad pulmonar obstructiva crónica (incidencia acumulada de eventración a los 2 años del 53%; p = 0,04) y la infección de la herida quirúrgica (incidencia acumulada de eventración a los 2 años del 28%; p = 0,02). Conclusión. El antecedente de EPOC y la infección de la herida se asocian a una mayor incidencia de eventración. La infección es el factor sobre el que puede ejercer mayor control el cirujano, por lo que se recomienda una profilaxis antibiótica y la utilización de una técnica lo más aséptica posible (AU)

Background. Incisional hernia is one of the most common complications in abdominal surgery. The aim of this retrospective study was to examine the true incidence of incisional hernia and its risk factors in patients undergoing surgery for colorectal cancer. Patients and method. Two hundred ninety-five patients who underwent colorectal cancer surgery between 1993 and 2003 were included. The mean follow-up was 37.5 ± 22 months. Results. Forty-three patients developed incisional hernia, representing 14.5% of the total. The cumulative percentage of patients developing incisional hernia was 7% at 6 months, 16% at 1 year, 21% at 2 years and 33% at 5 and 10 years. The only significant independent risk factors were chronic obstructive pulmonary disease (COPD) (2-year cumulative incidence of incisional hernia of 53%, p = 0.04) and abdominal wound infection (2-year cumulative incidence of incisional hernia of 28%; p = 0.02). Conclusion. COPD and abdominal wound infection predispose to incisional hernia in colorectal surgery. Abdominal wound infection is the only factor over which the surgeon can act preventively by using antibiotic prophylaxis and an aseptic technique (AU)