Introduction & Objective:
Because the incisional hernia is one of the most frequent complications after abdominal surgery. We aimed to determine the incisional hernia incidence after cystectomy in our patients and its risk factors related.
Material & Methods:
We performed a clinical review of all patients who underwent a radical cystoprostatectomy or anterior pelvic exanteration between July 2014 and July 2017. The incidence of incisional hernia, has been determined.
Different variables have been taken into account to determine which can be a risk factor for the development of incisional hernia.
The differences between the means of the continuous variables were assessed using T-Student test, and the differences between the proportions of the categorical variables were assessed with the X2 test. To assess the association between variables we performed the Pearson correlation coefficient.
Results:
A total of 120 patients were included. The incidence of incisional hernia was 27.5% and the paraestomal hernia was 12.22%. The 90.83% (n=102) of the patients were men. We performed a medial laparotomy in 72.5% (n=87) of the patients. About the urination derivation, we performed: ileal conduit in 75% (n=90), orthotopic neobladder in 14.16% (n=17), cutaneous ureterostomy in 10% (n=12) and one percutaneous nephrostomy.
The mean follow-up was 21.6 months, the mean time of onset of incisional and paraestomal hernia was 5.84 months and 9.63 months, respectively. Forty-seven patients (39.16%) have died.
In the univariate analysis we found significant results in low levels of cholesterol (p=0.012), high levels of haemoglobin (p=0.019), localized disease (< or =T2) (p=0.043), wound infection (p=0.019), wound dehiscence (p=0.001) and the need of Vacuum Assisted Closure (p=0.007). In the multivariate analysis we found significant results in low levels of cholesterol (p=0.027).
Conclusions:
The low levels of cholesterol, suggestive of malnutrition, should be considered as a risk factor for the incisional hernia in these patients, which raises the question of improving nutritional status before surgery.
