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Incisional hernias: incidence following abdominal aortic aneurysm repair
Abstract:
It is thought there is an increased incidence of incisional herniation after the repair of an abdominal aortic aneurysm. We sought to assess this premise by reviewing 281 patients who had undergone abdominal aortic aneurysm repair over the preceding eight years at Concord Hospital. Incisional hernias were found in fourteen patients. This made up 5% of the total group having surgery (281 patients) or 6% of those surviving 12 months or more after operation (231 patients). Of these 231 patients, seven had transverse incision hernias (6.7% of all those with transverse incisions), and seven had vertical incision hernias (5.4% of all those with vertical incisions). Six of the fourteen patients with a hernia had needed an urgent repair of an abdominal aortic aneurysm. We conclude from this study, that there is no evidence of an increased incidence of incisional hernias associated with aneurysmal disease itself. Rather, the factors causing such hernias are common to all laparotomies for major disease in sick, elderly patients, in the absence of intra-abdominal sepsis.
Insights
Incisional hernia repair after abdominal aortic aneurysm surgery is not more common than previously thought. Hernia risk factors are linked to patient health and surgery type, not the aneurysm itself.
Area of Science:
- Vascular Surgery
- Surgical Outcomes
- Abdominal Aortic Aneurysm
Background:
- Incisional hernias are a known complication following abdominal surgery.
- There is a prevailing belief that abdominal aortic aneurysm repair increases the incidence of incisional hernias.
Purpose of the Study:
- To investigate the actual incidence of incisional hernias after abdominal aortic aneurysm repair.
- To determine if abdominal aortic aneurysm disease itself is a risk factor for incisional hernias.
Main Methods:
- Retrospective review of 281 patients who underwent abdominal aortic aneurysm repair over eight years.
- Analysis of hernia incidence based on incision type (transverse vs. vertical) and patient survival.
- Correlation of hernia development with factors such as urgent repair and intra-abdominal sepsis.
Main Results:
- Fourteen patients (5% of total, 6% of 12-month survivors) developed incisional hernias.
- Incidence rates were similar for transverse (6.7%) and vertical (5.4%) incisions among 12-month survivors.
- Six of fourteen hernia patients required urgent abdominal aortic aneurysm repair.
Conclusions:
- The study found no evidence that abdominal aortic aneurysm disease increases incisional hernia incidence.
- Factors common to major abdominal surgeries in elderly, comorbid patients, excluding sepsis, appear to be the primary drivers of incisional hernias.