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Risk factors and management of incisional hernia after cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal surface malignancies.
Risk factors and management of incisional hernia after cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal surface malignancies.
- Source :
-
Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2020 Apr; Vol. 24 (2), pp. 257-263. Date of Electronic Publication: 2019 May 08. - Publication Year :
- 2020
-
Abstract
- Background: The incidence of incisional hernia in patients with peritoneal surface malignancies treated by cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) remains unclear, and the criteria commonly used to indicate their repair cannot be applied in these patients. The objective of this work was to analyze the incidence of incisional hernias in these patients, identify the risk factors associated with their appearance, and propose an algorithm for their management.<br />Methods: We analyzed a series of patients with malignant pathologies of the peritoneal surface treated by cytoreduction with peritonectomy and HIPEC procedures between January 2008 and June 2017. Only patients with a minimum postoperative follow-up period of 12 months were included.<br />Results: Our series included 282 patients, 28 (10%) of whom developed an incisional hernia during the follow-up period. Fifty-one patients, all with ovarian cancer with peritoneal dissemination, did not receive HIPEC after cytoreduction as they were part of the control arm of the CARCINOHIPEC clinical trial (NCT02328716) or because they did not provide specific informed consent. In the multivariate analysis, treatment with HIPEC (OR 2.56, 95% CI [1.57, 4.31], p = 0.032) and the administration of preoperative systemic chemotherapy (OR = 1.59, 95% CI [1.26, 3.58], p = 0.041) were found to be independent factors related to the appearance of an incisional hernia.<br />Conclusions: The incidence of incisional hernia after cytoreduction and HIPEC is within the ranges described in the literature for other abdominal surgery procedures. The use of systemic chemotherapy and treatment with HIPEC, in particular, were identified as factors related to their occurrence.
- Subjects :
- Adolescent
Adult
Aged
Algorithms
Antineoplastic Agents administration & dosage
Female
Herniorrhaphy
Humans
Incidence
Incisional Hernia etiology
Incisional Hernia surgery
Middle Aged
Ovarian Neoplasms drug therapy
Ovarian Neoplasms pathology
Ovarian Neoplasms surgery
Peritoneal Neoplasms drug therapy
Peritoneal Neoplasms secondary
Peritoneum pathology
Peritoneum surgery
Retrospective Studies
Risk Factors
Spain epidemiology
Young Adult
Antineoplastic Agents adverse effects
Cytoreduction Surgical Procedures adverse effects
Hyperthermic Intraperitoneal Chemotherapy adverse effects
Incisional Hernia epidemiology
Peritoneal Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1248-9204
- Volume :
- 24
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Hernia : the journal of hernias and abdominal wall surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31069579
- Full Text :
- https://doi.org/10.1007/s10029-019-01962-4