Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy : A prospective 3-year follow-up study
Comajuncosas, Jordi (Universitat de Barcelona)
Hermoso Bosch, Judit (Universitat de Barcelona)
Gris, Pere (Universitat de Barcelona)
Jimeno, Jaime (Universitat de Barcelona)
Orbeal, Rolando (Universitat de Barcelona)
Vallverdú, Helena (Universitat de Barcelona)
López Negre, Jose Luis (Universitat de Barcelona)
Gómez i Urgellés, Joan 1959- (Universitat de Barcelona)
Estalella Mercadé, Laia (Universitat de Barcelona)
Parés, David (Universitat de Barcelona)

Date:	2014
Abstract:	Background Trocar site incisional hernia (TSIH) is a common complication after laparoscopic cholecystectomy. The aim of this study was to evaluate the prevalence of TSIH and analyze the influence of several risk factors for this complication in a prospective series. Methods From 2007 to 2008, a prospective observational study with 3 years of follow-up was performed including all consecutive patients with cholelithiasis who underwent elective laparoscopic cholecystectomy. A multivariate analysis was performed to identify risk factors for TSIH. Results Overall, 241 patients were included. During a median follow-up period of 46. 8 months, 57 patients (25. 9%) were diagnosed with umbilical TSIH by physical exam or ultrasound. The multivariate analysis revealed that incision enlargement (odds ratio [OR], 14. 17; 95% confidence interval [CI], 3. 61 to 55. 51; P <. 001), wound infection (OR, 5. 62; 95% CI, 2. 35 to 13. 42; P <. 001), diabetes mellitus (OR, 2. 79; 95% CI, 1. 05 to 7. 37; P =. 0038), and obesity (OR, 2. 71; 95% CI, 1. 28 to 5. 75; P =. 009) contributed to the risk for developing a TSIH. Conclusions Umbilical TSIH is highly prevalent. This study identified several factors that could be useful to introduce preventive measures in high-risk patients.
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Language:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Published in:	American Journal of Surgery, Vol. 207, Num. 1 (January 2014) , p. 1-6, ISSN 1879-1883

DOI: 10.1016/j.amjsurg.2013.05.010

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