TY - JOUR
T1 - Incisional hernia after abdominal surgery in infants: A retrospective analysis of incidence and risk factors
AU - Eeftinck Schattenkerk, Laurens D.
AU - Musters, Gijsbert D.
AU - Coultre, S. E. Le
AU - de Jonge, Wouter J.
AU - van Heurn, L. W. Ernest
AU - Derikx, Joep P. M.
N1 - Funding Information: We would like to thank Raymond Bus for proofreading and language assistance. Not applicable, II Publisher Copyright: © 2021 The Authors
PY - 2021/11
Y1 - 2021/11
N2 - Purpose: Incisional hernia (IH) is a complication following abdominal surgery extensively studied in adults but less so in infants. This study aimed to identify the incidence, high risk diseases and risk factors of IH following abdominal surgery in infants. Methods: Infants undergoing abdominal surgery before the age of three years in our tertiary centre between 1998 and 2018 were included. Patient demographics, peri‑operative details and the course during follow up were retrospectively extracted from patient records. Multivariate logistic regression was performed to identify risk factors. Results: The incidence of incisional hernia was 5.2% (107/2055). Necrotizing enterocolitis (12%), gastroschisis (19%), and omphalocele (17%) had the highest incidences of IH. Wound infection (OR: 5.3, 95%-CI:2.9–9.5), preterm birth (OR: 4.2, 95%-CI:2.6–6.7) and history of stoma (OR 1.7, 95%-CI:1.1–2.8) were significant risk factors for IH. Whilst age at surgery, surgical approach and total number of operations did not significantly influence IH development. The IH resolved in 15% (16/107) without surgery. Conclusion: One in twenty infants experiences IH following abdominal surgery, which is higher than previously described. Understanding the incidence of IH and associated risk factors will allow physicians to identify infants that may be at increased risk for IH and to possibly act pre-emptively.
AB - Purpose: Incisional hernia (IH) is a complication following abdominal surgery extensively studied in adults but less so in infants. This study aimed to identify the incidence, high risk diseases and risk factors of IH following abdominal surgery in infants. Methods: Infants undergoing abdominal surgery before the age of three years in our tertiary centre between 1998 and 2018 were included. Patient demographics, peri‑operative details and the course during follow up were retrospectively extracted from patient records. Multivariate logistic regression was performed to identify risk factors. Results: The incidence of incisional hernia was 5.2% (107/2055). Necrotizing enterocolitis (12%), gastroschisis (19%), and omphalocele (17%) had the highest incidences of IH. Wound infection (OR: 5.3, 95%-CI:2.9–9.5), preterm birth (OR: 4.2, 95%-CI:2.6–6.7) and history of stoma (OR 1.7, 95%-CI:1.1–2.8) were significant risk factors for IH. Whilst age at surgery, surgical approach and total number of operations did not significantly influence IH development. The IH resolved in 15% (16/107) without surgery. Conclusion: One in twenty infants experiences IH following abdominal surgery, which is higher than previously described. Understanding the incidence of IH and associated risk factors will allow physicians to identify infants that may be at increased risk for IH and to possibly act pre-emptively.
KW - Abdominal surgery
KW - Incisional hernia
KW - Neonatal surgery
KW - Paediatric surgery
KW - Post-operative complications
KW - Ventral hernia
UR - http://www.scopus.com/inward/record.url?scp=85101157288&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jpedsurg.2021.01.037
DO - https://doi.org/10.1016/j.jpedsurg.2021.01.037
M3 - Article
C2 - 33618851
SN - 0022-3468
VL - 56
SP - 2107
EP - 2112
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 11
ER -