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The choice of extraction site modulates the incidence of incisional hernia in colorectal surgery: a cohort analysis.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: The choice of extraction site modulates the incidence of incisional hernia in colorectal surgery: a cohort analysis.
Συγγραφείς: Burgard M; Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland. Marie.Burgard@web.de., Liot E; Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.; Medical School, University of Geneva, Geneva, Switzerland., Meurette G; Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.; Medical School, University of Geneva, Geneva, Switzerland., Poletti PA; Division of Radiology, University Hospitals of Geneva, Geneva, Switzerland., Toso C; Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.; Medical School, University of Geneva, Geneva, Switzerland., Ris F; Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.; Medical School, University of Geneva, Geneva, Switzerland., Meyer J; Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.; Medical School, University of Geneva, Geneva, Switzerland.
Πηγή: Updates in surgery [Updates Surg] 2026 Aug; Vol. 78 (4), pp. 1581-1587. Date of Electronic Publication: 2025 Jun 27.
Τύπος έκδοσης: Journal Article; Observational Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 101539818 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2038-3312 (Electronic) Linking ISSN: 2038131X NLM ISO Abbreviation: Updates Surg Subsets: MEDLINE
Imprint Name(s): Original Publication: Milano : Springer-Verlag Italia
Ιατρικοί όροι (MeSH): Incisional Hernia*/epidemiology , Incisional Hernia*/etiology , Incisional Hernia*/prevention & control , Colorectal Neoplasms*/surgery , Colectomy*/methods , Minimally Invasive Surgical Procedures*/methods , Minimally Invasive Surgical Procedures*/adverse effects, Humans ; Incidence ; Retrospective Studies ; Female ; Male ; Aged ; Middle Aged ; Colorectal Surgical Procedures ; Cohort Studies
Περίληψη: Although minimally invasive surgery has significantly reduced the incidence of incisional hernia (IH) in colorectal procedures, the choice of specimen extraction site continues to pose a risk. This study explores how the location of extraction site influences the occurrence of IH in patients undergoing minimally invasive colorectal resections. We conducted a retrospective observational cohort study involving consecutive patients who underwent minimally invasive colorectal resection for colorectal cancer from 2013 to 2021. Patients with open surgery, previous hernia repair, reoperations during the study period or without imaging follow-up were excluded. The primary outcome measured was the CT-proven incidence of IH at the extraction site. A total of 191 patients were analyzed. Among them, 113 patients (59.2%) had a midline extraction site, while and 78 patients (40.8%) had an off-midline extraction. Midline extraction was preferably used during right and transverse colectomy (98% and 100% respectively), whereas off-midline were preferred in left hemicolectomy, sigmoidectomy, and anterior resection (55%, 88%, 95% respectively). Remarkably, the overall incidence of IH at the extraction site was 30.9% for midline extractions compared to 0% for off-midline extractions (p value < 0.001). The mean follow-up duration was of 3.3 ± 2.1 years. Multivariate logistic regression analysis revealed midline extraction as a significant risk factor for IH with a relative risk of 29.1 (95% CI 3.8-220.5, p value < 0.001). The findings highlight a substantial increase in the risk of IH associated with midline extraction sites. As such, it is crucial to advocate for fully minimally invasive colorectal resection using off-midline incision to enhance patient outcomes and reduce the risk of incisional hernias.
(© 2025. The Author(s).)
Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Research involving human participants and/or animals: The study was performed in Compliance with local Ethical Standards and was approved by the local ethics committee (ID 2023-0016). Informed consent: For this type of study, formal consent is not required.
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Contributed Indexing: Keywords: Colectomy; Extraction site; Incisional hernia; Minimally invasive surgical procedures
Entry Date(s): Date Created: 20250627 Date Completed: 20260729 Latest Revision: 20260801
Update Code: 20260801
PubMed Central ID: PMC13421187
DOI: 10.1007/s13304-025-02272-4
PMID: 40579630
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:2038-3312
DOI:10.1007/s13304-025-02272-4