Incisional hernias following open gynecological surgery: a population-based study

Area of Science:

• Gynecological Surgery
• Surgical Complications
• Hernia Research

Background:

• Incisional hernia is a frequent and expensive complication post-abdominal surgery.
• The incidence of incisional hernias after gynecological procedures is less understood compared to general surgery.

Purpose of the Study:

• To investigate the incidence and risk factors for incisional hernias following gynecological surgery.
• To identify patient and surgical characteristics associated with incisional hernia development.

Main Methods:

• Utilized data from the Swedish National Quality Register for Gynecological Surgery (GynOp) and the National Patient Register (NPR) from 2006-2014.
• Employed univariate and multivariate Cox proportional hazard analyses to assess risk factors.
• Included 39,312 women undergoing open gynecological surgery with a mean follow-up of 2.8 years.

Main Results:

• The cumulative incidence of incisional hernias was 2.0% at five years post-surgery.
• Obesity (BMI > 30), age over 60, midline incisions, smoking, and pre-existing kidney, liver, or pulmonary disease were significant predictors of increased risk.
• All identified risk factors were statistically significant (p < 0.05).

Conclusions:

• Preoperative smoking cessation and weight loss can potentially reduce incisional hernia risk.
• The Pfannenstiel incision is associated with a lower incidence of incisional hernias and should be considered when feasible.