Retrospective study of an incisional hernia after laparoscopic colectomy

Purpose: This study aimed to examine the incidence of incisional hernia (IH) in elective laparoscopic colorectal surgery (LC) using regulated computed tomography (CT) images intervals every 6 months. Methods: : We retrospectively examined the diagnosis of IH in patients who underwent LC for colorectal cancer at Kansai Medical University Hospital from January 2014 to August 2018. The diagnosis of IH was defined as loss of continuity of the fascia in the axial CT images. Results: : 470 patients were included in the analysis. IH was diagnosed in 47 cases at 1 year after LC. The IH size was 7.8 cm 2 [1.3–55.6] . In total, 38 patients with IH underwent CT examination 6 months after LC, and 37 were already diagnosed with IH. The IH size was 4.1 cm 2 [0–58.9]. The IH size increased in 17 cases between 6 months and 1 year postoperatively, and in 1 case, a new IH occurred. 47%(18/38) of them continued to grow until 1 year after LC. A multivariate analysis was performed on the risk of IH occurrence. SSI was most significantly associated with IH occurrence (OR:5.28 [2.14–13.05], p=0.0003). Conclusion: In previous reports, IH was evaluated mainly by clinical symptoms, but in this study, CT was used to investigate the occurrence of IH. Therefore, we clarified that we were able to find IH while it is still small by CT taken regularly.