Risk factors for incisional hernia after open abdominal aortic aneurysm repair: a systematic review and meta-analysis.

IF 2.6 2区医学 Q1 SURGERY Hernia Pub Date : 2024-09-26 DOI:10.1007/s10029-024-03182-x

Nandita N Mahajan, Carlos Andre Balthazar da Silveira, Julia Adriana Kasmirski, Diego Laurentino Lima, Gabriele Eckerdt Lech, Luiza Bertolli Lucchese Moraes, Carolina Moronte Sturmer, Leandro Totti Cavazzola, Prashanth Sreeramoju

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Abstract

Background: The incidence of incisional hernia (IH) after an open abdominal aortic aneurysm (AAA) repair can reach up to 35%, contributing to long-term morbidity. Individual studies have been limited in identifying modifiable risk factors for IH after an open AAA repair. This meta-analysis aims to review all the risk factors for IH after an open AAA repair.

Methods: We searched Cochrane Central, Embase, PubMed, MEDLINE, and Web of Science databases for original studies. Risk factors assessed were age, sex, comorbidities, surgical incision, blood loss, and surgical site infection (SSI). Data analysis was done using RStudio 4.1.2. We computed Relative Risk (RR) for dichotomous outcomes and Mean differences (MD) with 95% Confidence Interval (CI) for continuous outcomes. P-values less than 0.05 were considered statistically significant.

Results: Ten studies met the inclusion criteria among 1,795 screened articles. Among those ten studies, there were a total of 1,806 patients of which 341 patients developed IH. Older age (Mean 69.6-70.7 years, MD 1.39 years, CI [1.12-1.66], P < 0.01), midline vertical incision (RR 1.55, CI [1.06-2.25], P = 0.02) and increased intraoperative blood loss (MD 429.8 ml, CI [234.8- 624.8], P < 0.01) were associated with an increased incidence of IH. Surgical site infection (SSI) was noted as a risk factor for IH after open AAA repair (RR 2.36, CI [1.31-4.24], P = 0.004). No statistically significant association was found between the incidence of IH and sex (RR 1.0, CI [0.8-1.14], P = 0.98), smoking (RR 1.01, CI [0.93-1.09], P = 0.88), diabetes (RR 1.38, CI [0.85-2.25], P = 0.19), and chronic kidney disease (RR 1.55, CI [0.47-5.09], P = 0.46).

Conclusion: This meta-analysis shows that age, midline vertical incision, intraoperative blood loss, and SSI are risk factors for IH after open AAA repair.

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开腹主动脉瘤修补术后切口疝的风险因素：系统回顾和荟萃分析。

背景：开放性腹主动脉瘤（AAA）修补术后切口疝（IH）的发生率可高达 35%，导致长期发病。单项研究在确定开放式 AAA 修复术后切口疝的可调节风险因素方面存在局限性。本荟萃分析旨在回顾开放式 AAA 修复术后 IH 的所有风险因素：我们检索了 Cochrane Central、Embase、PubMed、MEDLINE 和 Web of Science 数据库中的原始研究。评估的风险因素包括年龄、性别、合并症、手术切口、失血量和手术部位感染（SSI）。数据分析使用 RStudio 4.1.2 进行。对于二分结果，我们计算了相对风险（RR）；对于连续结果，我们计算了平均差（MD）和 95% 置信区间（CI）。P值小于0.05被认为具有统计学意义：在筛选出的 1,795 篇文章中，有 10 项研究符合纳入标准。在这十项研究中，共有 1,806 名患者，其中 341 名患者患上了 IH。年龄较大（平均 69.6-70.7 岁，MD 1.39 岁，CI [1.12-1.66]，P 结论：年龄越大，IH 的发病率越高：这项荟萃分析表明，年龄、中线垂直切口、术中失血和 SSI 是开放式 AAA 修复术后发生 IH 的风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.