Incidence and risk factors for incisional hernia after open abdominal aortic aneurysm repair / Incidencia y factores de riesgo de hernia incisional tras la cirugía abierta del aneurisma de aorta abdominal

Introduction: Incisional hernia (IH) is common after open abdominal aortic aneurysm (AAA) repair. Recent studies reported incidence rates higher than previously stated. The aim of this study was to quantify the IH incidence after open AAA surgery. The secondary outcome was to identify the risk factors associated with the development of an IH. Methods: Retrospective observational study of all consecutive patients who underwent an open repair of AAA, from January 2010 to June 2018, at our institution. Patients were free of abdominal wall hernias at the moment of inclusion in the study. Data were extracted from electronic records: baseline characteristics, surgical factors, and postoperative events. Computed tomography (CT) scans performed during follow-up were analyzed. Results: A total of 157 patients were analysed. The IH incidence after open repair of AAA was 46.5% (73 patients). The median time for IH development was 24.43 months (IQR: 10.40–45.27), while the median follow-up time was 37.20 months (IQR: 20.53–64.12). The risk factors linked to IH were: active (HR: 4.535; 95% CI: 1.369–15.022) or previous smoking habit (HR: 4.652; 95% CI: 1.430–15.131), chronic kidney disease (HR: 2.007; 95% CI: 1.162–3.467) and previous abdominal surgery (HR: 1.653; 95% CI: 1.014–2.695). Conclusion: The incisional hernia after open abdominal aortic aneurysm repair affected a high proportion of the intervened patients. Previous abdominal surgery, chronic kidney disease, and smoking habit were independent factors for the development of an incisional hernia. (AU)

Introducción: La hernia incisional (HI) tras la cirugía abierta del aneurisma de aorta abdominal (AAA) es común. Estudios recientes muestran incidencias superiores a las consideradas anteriormente. El objetivo es evaluar la incidencia de HI tras la cirugía abierta del AAA. El objetivo secundario fue evaluar los factores de riesgo de HI. Métodos: Estudio observacional retrospectivo de pacientes consecutivos sometidos a cirugía abierta del AAA de enero de 2010 a junio de 2018 en nuestro centro. Todos los pacientes estaban libres de hernias de pared abdominal en el momento de la cirugía. Se analizaron los datos de la historia clínica electrónica: características basales, factores quirúrgicos y eventos postoperatorios. Se analizaron también los estudios de tomografía computarizada durante el seguimiento. Resultados: Se analizaron 157 pacientes. La incidencia de HI tras la cirugía abierta del AAA fue del 46,5% (73 pacientes). La mediana de tiempo para el desarrollo de HI fue de 24,43 meses (RIC 10,40-45,27), con una mediana de seguimiento de 37,20 meses (RIC 20,53-64,12). Los factores de riesgo asociados fueron: tabaquismo activo (HR 4,535; IC 95% 1,369-15,022) o hábito tabáquico previo (HR 4,652; IC 95% 1,430-15,131), enfermedad renal crónica (HR 2,007; IC 95% 1,162-3,467) y cirugía abdominal previa (HR 1,653; IC 95% 1,014-2,695). Conclusiones: La HI tras la cirugía abierta del AAA afectó a un gran número de pacientes intervenidos. La cirugía abdominal previa, la enfermedad renal crónica y el hábito tabáquico fueron factores de riesgo independientes de HI. (AU)

Incidence and risk factors for incisional hernia after open abdominal aortic aneurysm repair.

INTRODUCTION: Incisional hernia (IH) is common after open abdominal aortic aneurysm (AAA) repair. Recent studies reported incidence rates higher than previously stated. The aim of this study was to quantify the IH incidence after open AAA surgery. The secondary outcome was to identify the risk factors associated with the development of an IH. METHODS: Retrospective observational study of all consecutive patients who underwent an open repair of AAA, from January 2010 to June 2018, at our institution. Patients were free of abdominal wall hernias at the moment of inclusion in the study. Data were extracted from electronic records: baseline characteristics, surgical factors, and postoperative events. Computed tomography (CT) scans performed during follow-up were analyzed. RESULTS: A total of 157 patients were analysed. The IH incidence after open repair of AAA was 46.5% (73 patients). The median time for IH development was 24.43 months (IQR: 10.40-45.27), while the median follow-up time was 37.20 months (IQR: 20.53-64.12). The risk factors linked to IH were: active (HR: 4.535; 95% CI: 1.369-15.022) or previous smoking habit (HR: 4.652; 95% CI: 1.430-15.131), chronic kidney disease (HR: 2.007; 95% CI: 1.162-3.467) and previous abdominal surgery (HR: 1.653; 95% CI: 1.014-2.695). CONCLUSION: The incisional hernia after open abdominal aortic aneurysm repair affected a high proportion of the intervened patients. Previous abdominal surgery, chronic kidney disease, and smoking habit were independent factors for the development of an incisional hernia.

Incidence and risk factors for incisional hernia after open abdominal aortic aneurysm repair.

INTRODUCTION: Incisional hernia (IH) is common after open abdominal aortic aneurysm (AAA) repair. Recent studies reported incidence rates higher than previously stated. The aim of this study was to quantify the IH incidence after open AAA surgery. The secondary outcome was to identify the risk factors associated with the development of an IH. METHODS: Retrospective observational study of all consecutive patients who underwent an open repair of AAA, from January 2010 to June 2018, at our institution. Patients were free of abdominal wall hernias at the moment of inclusion in the study. Data were extracted from electronic records: baseline characteristics, surgical factors, and postoperative events. Computed tomography (CT) scans performed during follow-up were analyzed. RESULTS: A total of 157 patients were analysed. The IH incidence after open repair of AAA was 46.5% (73 patients). The median time for IH development was 24.43 months (IQR: 10.40-45.27), while the median follow-up time was 37.20 months (IQR: 20.53-64.12). The risk factors linked to IH were: active (HR: 4.535; 95% CI: 1.369-15.022) or previous smoking habit (HR: 4.652; 95% CI: 1.430-15.131), chronic kidney disease (HR: 2.007; 95% CI: 1.162-3.467) and previous abdominal surgery (HR: 1.653; 95% CI: 1.014-2.695). CONCLUSION: The incisional hernia after open abdominal aortic aneurysm repair affected a high proportion of the intervened patients. Previous abdominal surgery, chronic kidney disease, and smoking habit were independent factors for the development of an incisional hernia.