Are perioperative outcomes in cancer-related ventral incisional hernia repair worse than in the general population? An Abdominal Core Health Quality Collaborative (ACHQC) database study
Tóm tắt
Patients with a history of cancer-related abdominal surgery undergoing incisional hernia repair (IHR) are highly heterogenous and increasingly prevalent. We explored whether cancer surgery should be considered an independent risk factor for worse IHR perioperative outcomes. Patients undergoing IHR between 2018 and 2020 were identified within the Abdominal Core Health Quality Collaborative (ACHQC). Regression models were used to assess associations between cancer operation history and 30 d surgical site occurrences—exclusive of infection (SSO-EIs), surgical site infections (SSIs), reoperations, time to recurrence, and quality of life (QoL) scores. Cancer cohort subgroup analysis was performed for operative approach and mesh location. 8019 patients who underwent IHR were identified in the ACHQC, 1321 of which had a history of cancer operation. Cancer cohort patients were more likely to be older, males with a higher ASA status and lower BMI, and have longer and wider hernias (p < 0.001). After adjusting for confounding, the cancer cohort was less likely to experience SSO-EIs (OR 0.74, 95% CI 0.59–0.94 p = 0.0092) and showed lower odds of SSIs, reoperations, and recurrence (SSI OR 0.7, 95% CI 0.47–1.05, p = 0.0542; reoperation OR 0.66, 95% CI 0.37–1.17, p = 0.1002; recurrence OR 0.8, 95% CI 0.63–1.02, p = 0.08). There was no difference in postoperative QoL scores between cohorts. There were also no differences in perioperative or QoL outcomes within the cancer cohort based on operative approach or mesh location. These data show no evidence that history of cancer operation predisposes patients to worse incisional hernia repair perioperative or quality of life outcomes.
Tài liệu tham khảo
Bosanquet DC et al (2015) Systematic review and meta-regression of factors affecting midline incisional hernia rates: analysis of 14,618 patients. PLoS ONE 10(9):e0138745
Fink C et al (2014) Incisional hernia rate 3 years after midline laparotomy. Br J Surg 101(2):51–54
Harris HW et al (2018) Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias. Surgery 164(2):319–326
Al Chalabi H et al (2015) A systematic review of laparoscopic versus open abdominal incisional hernia repair, with meta-analysis of randomized controlled trials. Int J Surg 20:65–74
Lam MB et al (2020) Changes in racial disparities in mortality after cancer surgery in the US, 2007–2016. JAMA Netw Open 3(12):e2027415
Khorgami Z et al (2019) Predictors of mortality after elective ventral hernia repair: an analysis of national inpatient sample. Hernia 23(5):979–985
Barnes LA et al (2018) Determining the impact of sarcopenia on postoperative complications after ventral hernia repair. J Plast Reconstr Aesthet Surg 71(9):1260–1268
Jensen KK et al (2020) Long-term impact of incisional hernia on quality of life after colonic cancer resection. Hernia 24(2):265–272
Feng MP et al (2019) Early repair of ventral incisional hernia may improve quality of life after surgery for abdominal malignancy: a prospective observational cohort study. Hernia 23(1):81–90
Poulose BK et al (2016) Design and implementation of the Americas Hernia Society Quality Collaborative (AHSQC): improving value in hernia care. Hernia 20(2):177–189
Kanters AE et al (2012) Modified hernia grading scale to stratify surgical site occurrence after open ventral hernia repairs. J Am Coll Surg 215(6):787–793
Rothrock NE, Amtmann D, Cook KF (2020) Development and validation of an interpretive guide for PROMIS scores. J Patient Rep Outcomes 4(1):16
Fafaj A et al (2021) Is there an advantage to laparoscopy over open repair of primary umbilical hernias in obese patients? An analysis of the Americas Hernia Society Quality Collaborative (AHSQC). Hernia 25(3):579–585
Fafaj A et al (2021) Management of ventral hernia defect during enterocutaneous fistula takedown: practice patterns and short-term outcomes from the Abdominal Core Health Quality Collaborative. Hernia 25(4):1013–1020
Thomas JD et al (2021) Non-coated versus coated mesh for retrorectus ventral hernia repair: a propensity score-matched analysis of the Americas Hernia Society Quality Collaborative (AHSQC). Hernia 25(3):665–672
Jensen KK et al (2016) Incisional hernias after open versus laparoscopic surgery for colonic cancer: a nationwide cohort study. Surg Endosc 30(10):4469–4479
Mericli AF, Baumann DP, Butler CE (2018) Reconstruction of the abdominal wall after oncologic resection: defect classification and management strategies. Plast Reconstr Surg 142(3 Suppl):187S-196S
Poulose B et al (2012) Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 16(2):179–183
Yabroff KR et al (2019) Minimizing the burden of cancer in the United States: Goals for a high-performing health care system. CA Cancer J Clin 69(3):166–183
Karalashvili L et al (2018) Current condition and challenges in treatment of non-healing wound after radiation therapy (Review). Georgian Med News 280–281:23–28
Dormand EL, Banwell PE, Goodacre TE (2005) Radiotherapy and wound healing. Int Wound J 2(2):112–127
Eker HH et al (2013) Laparoscopic vs. open incisional hernia repair: a randomized clinical trial. JAMA Surg 148(3):259–263
Soliani G et al (2017) Laparoscopic versus open incisional hernia repair: a retrospective cohort study with costs analysis on 269 patients. Hernia 21(4):609–618
Liang MK et al (2017) Ventral hernia management: expert consensus guided by systematic review. Ann Surg 265(1):80–89