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Diastasis recti is associated with incisional hernia after midline abdominal surgery.
Booth, A T; Gillen, K J; Visintin, I; Ford, W F; Kovacs, M D; Edgerton, C A; George, V V; Curran, T.
Afiliación
  • Booth AT; Department of Surgery, Medical University of South Carolina, 169 Ashley Avenue, Room 202, Charleston, SC, 29425, USA. boothal@musc.edu.
  • Gillen KJ; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
  • Visintin I; Department of Surgery, Medical University of South Carolina, 169 Ashley Avenue, Room 202, Charleston, SC, 29425, USA.
  • Ford WF; Department of Surgery, Medical University of South Carolina, 169 Ashley Avenue, Room 202, Charleston, SC, 29425, USA.
  • Kovacs MD; Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
  • Edgerton CA; Department of Surgery, Medical University of South Carolina, 169 Ashley Avenue, Room 202, Charleston, SC, 29425, USA.
  • George VV; Department of Surgery, Medical University of South Carolina, 169 Ashley Avenue, Room 202, Charleston, SC, 29425, USA.
  • Curran T; Department of Surgery, Medical University of South Carolina, 169 Ashley Avenue, Room 202, Charleston, SC, 29425, USA.
Hernia ; 27(2): 363-371, 2023 04.
Article en En | MEDLINE | ID: mdl-36136228
PURPOSE: Incisional hernia occurs in up to 20% of patients after abdominal surgery and is most common after vertical midline incisions. Diastasis recti may contribute to incisional hernia but has not been explored as a risk factor or included in hernia risk models. We examined the association between diastasis recti and incisional hernia after midline incisions. METHODS: In this single-center study, all patients undergoing elective gastrointestinal surgery with a midline open incision or extraction site in a prospective surgical quality collaborative database between 2016 and 2020 were included. Eligible patients had axial imaging within 6 months prior to surgery and no less than 6 months after surgery to determine the presence of diastasis recti and incisional hernia, respectively. Radiographic hernia-free survival was assessed with log-rank tests and multivariable Cox regression, comparing patients with and without diastasis width > 25 mm. RESULTS: Of 156 patients, forty-four (28.2%) developed radiographic hernia > 1 cm. 36 of 85 patients (42.4%) with DR width > 25 mm developed IH, compared to 9 of 71 (12.7%) without DR (p < 0.001). Hernia-free survival differed by DR width on bivariate and multivariable Cox regression, adjusted hazard ratio: 3.87, 95% confidence interval: 1.84-8.14. CONCLUSION: Diastasis recti is a significant risk factor for incisional hernia after midline abdominal surgery. When present, surgeons can include these data when discussing surgical risks and should consider a lower risk, off-midline approach when feasible. Incorporating diastasis into larger studies may improve comprehensive models of incisional hernia risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos del Sistema Digestivo / Hernia Incisional / Hernia Ventral Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos del Sistema Digestivo / Hernia Incisional / Hernia Ventral Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia