Prevention of Incisional Hernia after Open Hepato-Pancreato-Biliary Surgery: A Systematic Review.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Digestive Surgery Pub Date : 2022-01-01 Epub Date: 2021-12-07 DOI:10.1159/000521169

Robert Memba, Olga Morató, Laia Estalella, Mihai C Pavel, Erik Llàcer-Millán, Mar Achalandabaso, Elisabet Julià, Erlinda Padilla, Carles Olona, Donal O'Connor, Rosa Jorba

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引用次数: 4

Abstract

Introduction: Most hepato-pancreato-biliary (HPB) procedures are still performed through open approach. Incisional hernia (IH) is one of the most common complications after open surgery. To date, published data on IH after HPB surgery are scarce; therefore, the aim of this study was to assess the current evidence regarding incidence, risk factors, and prevention.

Methods: Medline/PubMed (1946-2020), EMBASE (1947-2020), and the Cochrane library (1995-2020) were searched for studies on IH in open HPB surgery. Animal studies, editorials, letters, reviews, comments, short case series and liver transplant, laparoscopic, or robotic procedures were excluded. The protocol was registered with PROSPERO (CRD42020163296).

Results: A total of 5,079 articles were retrieved. Eight studies were finally included for the analysis. The incidence of IH after HPB surgery ranges from 7.7% to 38.8%. The identified risk factors were body mass index, surgical site infection, ascites, Mercedes or reversed T incisions, and previous IH. Prophylactic mesh might be safe and effective.

Conclusions: IH after open HPB surgery is still an important matter. Some of the risk factors are specific for the HPB operations and the incision type should be carefully considered. Randomized controlled trials are required to confirm the role of prophylactic mesh after HPB operations.

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肝胰胆开放性手术后切口疝的预防:一项系统综述。

大多数肝胰胆(HPB)手术仍然通过开放的方式进行。切口疝(IH)是开放手术后最常见的并发症之一。迄今为止，关于HPB手术后IH的公开数据很少;因此，本研究的目的是评估目前关于发病率、危险因素和预防的证据。方法:检索Medline/PubMed (1946-2020)， EMBASE(1947-2020)和Cochrane图书馆(1995-2020)，检索开放HPB手术中IH的研究。动物研究、社论、信件、评论、评论、短病例系列和肝移植、腹腔镜或机器人手术被排除在外。该协议已在PROSPERO注册(CRD42020163296)。结果:共检索到5079篇文献。8项研究最终被纳入分析。HPB术后IH的发生率为7.7% ~ 38.8%。确定的危险因素为体重指数、手术部位感染、腹水、梅赛德斯或逆转T形切口以及既往IH。预防性网状物可能是安全有效的。结论:开放HPB手术后的IH仍然是一个重要的问题。一些危险因素是HPB手术所特有的，应仔细考虑切口类型。需要随机对照试验来证实预防性补片在HPB手术后的作用。

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

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.