Evaluating postoperative hernia incidence and risk factors following pelvic exenteration

Milanko, NA; Kelly, ME; Turner, G; Kong, J; Behrenbruch, C; Mohan, H; Guerra, G; Warrier, S; McCormick, J; Heriot, A

Author(s): Milanko, NA; Kelly, ME; Turner, G; Kong, J; Behrenbruch, C; Mohan, H; Guerra, G; Warrier, S; McCormick, J; Heriot, A;
Details: Publication Year 2024-05-08,Volume 39,Issue #1,Page 70
Journal Title: International Journal of Colorectal Disease
Publication Type: Research article
Abstract: Pelvic exenteration (PE) is a technically challenging surgical procedure. More recently, quality of life and survivorship following PEs are being increasingly acknowledged as important patient outcomes. This includes evaluating major long-term complications such as hernias, defined as the protrusion of internal organs through a facial defect (The PelvEx Collaborative in Br J Surg 109:1251-1263, 2022), for which there is currently limited literature. The aim of this paper is to ascertain the incidence and risk factors for postoperative hernia formation among our PE cohort managed at a quaternary centre. METHOD: A retrospective cohort study examining hernia formation following PE for locally advanced rectal carcinoma and locally recurrent rectal carcinoma between June 2010 and August 2022 at a quaternary cancer centre was performed. Baseline data evaluating patient characteristics, surgical techniques and outcomes was collated among a PE cohort of 243 patients. Postoperative hernia incidence was evaluated via independent radiological screening and clinical examination. RESULTS: A total of 79 patients (32.5%) were identified as having developed a hernia. Expectantly, those undergoing flap reconstruction had a lower incidence of postoperative hernias. Of the 79 patients who developed postoperative hernias, 16.5% reported symptoms with the most common symptom reported being pain. Reintervention was required in 18 patients (23%), all of which were operative. CONCLUSION: This study found over one-third of PE patients developed a hernia postoperatively. This paper highlights the importance of careful perioperative planning and optimization of patients to minimize morbidity.
Publisher: Springer Nature
Keywords: Humans; Incidence; Female; Risk Factors; *Pelvic Exenteration/adverse effects; Male; Middle Aged; *Postoperative Complications/etiology/epidemiology; Aged; Hernia/etiology/epidemiology; Adult; Retrospective Studies; Advanced rectal cancer; Hernia; Pelvic exenteration; Postoperative complications; Surgical outcomes
Department(s): Surgical Oncology
Publisher's Version: https://doi.org/10.1007/s00384-024-04638-3
Open Access at Publisher's Site: https://doi.org/10.1007/s00384-024-04638-3
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-07-17 03:02:34

Last Modified: 2024-07-17 03:11:20