Incidence and risk factors for trocar-site incisional hernia detected by clinical and ultrasound examination: a prospect
- PDF / 831,216 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 78 Downloads / 189 Views
Open Access
RESEARCH ARTICLE
Incidence and risk factors for trocar‑site incisional hernia detected by clinical and ultrasound examination: a prospective observational study Ana Ciscar1* , Josep M. Badia2,3 , Francesc Novell4, Santiago Bolívar5 and Esther Mans1,6
Abstract Background: Trocar site incisional hernia (TSIH) is the most frequent complication associated with laparoscopic surgery. Few studies currently describe its incidence or risk factors. The aim of this report is to determine the real incidence of TSIH and to identify risk factors. Methods: A cross-sectional prospective study was performed including consecutive patients who underwent a laparoscopic procedure during a 4 months period. All the patients were assessed both clinically (TSIHc) and by an ultrasonographic examination (TSIHu). The main variable studied was the incidence of TSIH. A multivariate analysis was performed to identify risk factors. Results: 76 patients were included. 27.6% of patients were clinically diagnosed as having TSIH (TSIHc) but only 23.7% of those cases were radiologically confirmed (TSIHu). In the logistic regression analysis, age > 70 years (OR 3.462 CI 1.14–10.515, p = 0.028) and body mass index (BMI) ≥ 30 kg/m2 (OR 3.313 CI 1.037–10.588, p = 0.043) were identified as risk factors for TSIH. The size of the trocar also showed statistically significant differences (p 70
22 (28.9)
Gender n (%) Male
32 (41.1)
Female
44 (57.9)
DM n (%) Yes
10 (13.2)
Not
66 (86.8)
COPD n (%) Yes
4 (5.4)
Not
70 (94.6)
Smokers n (%) Not BMI kg/m2 (SD)
19 (27.1) 51 (72.9) 27.54 (4.25)
≥ 30 n (%)
19 (27.5)
70
9 (50)
13 (22.4)
0.037§
13.39 (7.55)
Cranio caudal diameter mm (SD)
12.37 (8.52)
Follow up months (SD)
33.66 (4.36)
DM diabetes mellitus, COPD chronic obstructive pulmonary disease, BMI body mass index, TSIHc trocar site incision hernia clinically diagnosed, TSIHu trocar site incision hernia diagnosed radiologically
(5.5%) TSIH occurred in a 5-mm trocar site, whereas the other 17 hernias (94.45%) were located in 10-mm trocar sites. All hernias were located in the umbilical area (M3), except for one located in the left lumbar region (L4). Nine cases of TSIH (15%) suspected by clinical examination were not confirmed following ultrasonography. On the contrary, five cases (28%) diagnosed by ultrasonographic examination were not clinically found. Ultrasonography showed a significant better diagnostic capacity than clinical examination (p 70 years (OR 3.462; 95% CI 1.14–10.515; p = 0.028) and BMI ≥ 30 (OR 3.313; CI 1.037–10.588; p = 0.043) (Table 4). Other variables were discarded. Both, age > 70 years (OR 4.464; 95% CI 1.32–15.091; p = 0.016) and BMI ≥ 30 (OR
Ciscar et al. BMC Surg
(2020) 20:330
Page 5 of 7
Table 4 Results of univariate logistic regression analysis. Identification of risk factors Variable
OR
95%IC
p
Age (years) ≤ 70
Reference
> 70
3.462
1.14–10.515
0.028
1.037–10.588
0.043
BMI (kg/m2) 70
4.464 1.034–12.338
0.044
Age (years)
BMI (kg/m2)
Data Loading...
