Incisional hernia after cystectomy: incidence, risk factors and anthropometric predisposition

Area of Science:

• Urology
• Surgical Oncology
• Abdominal Surgery

Background:

• Postoperative incisional hernias (PIH) are a known complication following abdominal surgery.
• Rates and risk factors for PIH after radical cystectomy (RC) are not well-defined.
• Comparing open radical cystectomy (ORC) and robotic-assisted radical cystectomy (RARC) is crucial for understanding PIH incidence.

Purpose of the Study:

• To compare the rates of PIH after ORC and RARC.
• To identify risk factors associated with PIH in patients undergoing RC.
• To evaluate the incidence of postoperative hernia repair (PHR) in relation to surgical approach.

Main Methods:

• Retrospective review of 469 patients undergoing ORC or RARC between 2000-2015.
• Evaluation of pre- and postoperative cross-sectional imaging for radiographic PIH (RPIH).
• Assessment of patient demographics, urinary diversion type, and PHR.

Main Results:

• Overall incidence of RPIH was 14.3% and PHR was 9.0%.
• No significant difference in RPIH or PHR rates between ORC and RARC.
• Body mass index, ileal conduit diversion, and rectus diastasis width (RDW) were associated with RPIH and PHR risk.

Conclusions:

• Patients undergoing RC face significant risk of RPIH and PHR irrespective of surgical method.
• Anthropomorphic factors and urinary diversion type are linked to PIH risk.
• Further research is necessary to develop strategies for reducing PIH after cystectomy.