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Ventral hernia following abdominal aortic reconstruction
C A Stevick1, J B Long, B Jamasbi
1Department of Surgery, Palo Alto VA Medical Center, CA 94304.
Insights
Aortic reconstruction surgery shows a high rate of ventral incisional hernias, particularly in aneurysm patients. This finding highlights potential differences between aortic aneurysm and occlusive disease patient populations.
Area of Science:
- Vascular Surgery
- Abdominal Aortic Surgery
- Hernia Research
Background:
- Ventral incisional hernias are a known complication after abdominal surgery.
- The frequency of hernias following aortic reconstruction requires further investigation.
Purpose of the Study:
- To determine the incidence of ventral incisional hernias in patients undergoing aortic reconstruction.
- To compare hernia rates between patients with aortic aneurysms and those with occlusive disease.
Main Methods:
- Retrospective review of 76 patients undergoing aortic reconstruction over a three-year period.
- Evaluation of 66 patients with at least one year of follow-up post-procedure.
- Statistical analysis to compare hernia incidence between aneurysm and occlusive disease groups.
Main Results:
- A 21.2% incidence of ventral incisional hernias was observed in 66 evaluable patients.
- Ten of 14 hernias (37%) occurred in patients with aortic aneurysms (n=27).
- Four of 14 hernias (10%) occurred in patients with occlusive disease (n=39), consistent with literature.
Conclusions:
- Ventral incisional hernias are a significant complication following aortic reconstruction.
- Aneurysm patients exhibit a statistically higher incidence of hernias compared to occlusive disease patients.
- These findings may reflect underlying biological differences between aortic aneurysm and occlusive atherosclerotic disease.
Abstract:
An unexpectedly high frequency of ventral incisional hernia in our aortic reconstruction patients prompted us to review a recent three year period. Of 76 aortic reconstruction patients, 66 were evaluable for at least one year following their aortic procedure. In these 66 patients, ventral incisional hernias occurred in 14 (21.2%). Of statistical significance (P less than .01) was that ten of the 14 hernias occurred in the 27 aneurysm patients (37%) and four occurred in the 39 occlusive disease patients (10%). Though a comparison group of aneurysm patients is not available in the literature, the incidence of hernia in our occlusive disease population is consistent with the literature experience when careful long-term follow-up is employed. These observations may represent another manifestation of previously reported differences between aortic aneurysm and occlusive atherosclerotic populations.