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Soy, Ebru H. Ayvazoglu; Kırnap, Mahir; Yıldırım, Sedat; Moray, Gökhan; Haberal, Mehmet

doi:10.6002/ect.mesot2016.p65

Cited by 16 publications

(9 citation statements)

References 17 publications

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“…Multiple studies have alluded to an association between prior abdominal surgeries and incisional hernia risk (7, 13). Our inclusion of prior abdominal surgeries to strengthen our original HERNIAscore is therefore not unexpected and is consistent with previous literature.…”

Section: Discussionmentioning

confidence: 99%

External Validation of the HERNIAscore: An Observational Study

Cherla

Moses

Mueck

et al. 2017

Journal of the American College of Surgeons

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Background The HERNIAscore is a ventral incisional hernia (VIH) risk assessment tool that utilizes only preoperative variables and predictable intraoperative variables. The aim of this study was to validate and modify, if needed, the HERNIAscore in an external dataset. Study Design This was a retrospective observational study of all patients undergoing resection for gastrointestinal malignancy 2011–2015 at a safety-net hospital. Primary outcome was clinical postoperative VIH. Patients were stratified into low, medium, and high risk based on HERNIAscore. A Revised HERNIAscore was formed with the addition of prior abdominal surgery as a categorical variable. Cox regression of incisional hernia with stratification by risk class was performed. Incidence rates of clinical VIH formation within each risk class were also calculated. Results 247 patents were enrolled. On Cox regression, in addition to the three variables of the HERNIAscore (BMI, incision length, and COPD), prior abdominal surgery was also predictive of VIH. The Revised HERNIAscore demonstrated improved predictive accuracy for clinical VIH. While the original HERNIAscore effectively stratified the risk of developing an incisional radiographic VIH, the Revised HERNIAscore provided a statistically significant stratification for both clinical and radiographic VIHs in this patient cohort. Conclusion We have externally validated and improved the HERNIAscore. The Revised HERNIAscore utilizes BMI, incision length, COPD, and prior abdominal surgery to predict risk of post-operative incisional hernia. Future research should assess methods to prevent incisional hernias in moderate-to-high risk patients.

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Section: Discussionmentioning

confidence: 99%

External Validation of the HERNIAscore: An Observational Study

Cherla

Moses

Mueck

et al. 2017

Journal of the American College of Surgeons

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“…The incisional hernia is the most common delayed complication following liver transplantation [5] . Diabetes, obesity, male sex, advanced age, incision type, immunosuppression therapy, wound infection and pulmonary complications are the most prevalent risk factors for its development [1] , [2] , [3] , [8] , [18] . The incidence of incisional hernias in our service is 14.5%, consistent with the 35% reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…The most common type of incision used in transplantation is the subcostal bilateral transversal laparotomy, with cranial extension on the medial line, known as Mercedes. It is most associated with the development of incisional hernias in the postoperative phase, compared to the J incision [2] , [3] , [4] , [18] . In our service, the J incision is routinely used for patients submitted to liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

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Component separation of abdominal wall with intraoperative botulinum A presents satisfactory outcomes in large incisional hernias: a case report

Oliveira

Essu

Mesquita

et al. 2017

International Journal of Surgery Case Reports

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“…Within abdominal surgery, the ERAS society has published guidelines for operations ranging from colon resection to pancreaticoduodenectomy. Among other things, these strategies strive to avoid excess fluid administration, and have even adopted the concept of ‘permissive oliguria.’ [1] Recently, patient -specific variables such as advanced age [2] , or emergent presentation, have been found to affect the efficacy of enhanced recovery strategies. As ERAS pathways are currently applied to an increasing variety general surgical procedures, it will be important to consider their effects on unique patient populations within these procedure-specific strategies; unique patient populations deserve unique recovery strategies.…”

Section: Introductionmentioning

confidence: 99%

Postoperative renal impairment is associated with increased length of stay for incisional hernia repair after liver transplantation

Butler

O’Brien

Kays

et al. 2019

Surgery Open Science

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Background Incisional hernia repair is the most common procedure after orthotopic liver transplantation. Although enhanced recovery protocols are increasingly employed, the post–orthotopic liver transplantation patient may not benefit from all aspects of these models. The aim of the present study is to assess which perioperative interventions and patient factors affect hospital length of stay in a cohort of post–orthotopic liver transplantation patients undergoing incisional hernia repair. Methods We conducted a retrospective review of a series of adult patients undergoing incisional hernia repair after orthotopic liver transplantation. The primary endpoint was length of stay. Results were stratified by demographic, intraoperative, and postoperative variables. Results Eleven percent (172/1523) of patients who received orthotopic liver transplantation during the study period underwent subsequent incisional hernia repair. Median length of stay was 5 days (range 2–50). The strongest predictor of length of stay was postoperative renal function. Despite liberal intraoperative administration of volume (median 642 mL/h) and brisk intraoperative urine output (median 72 mL/h), postoperative acute kidney injury occurred in 48% of patients. Those that developed acute kidney injury received less intraoperative volume (6 vs 8.5 mL/kg/h; P = .031) and the severity of postoperative renal injury was inversely related to the amount intraoperative volume given. Conclusions In patients undergoing incisional hernia repair after orthotopic liver transplantation, postoperative renal function is frequently impaired. Although many aspects of current ERAS protocols may be applied to post-transplant patients, restrictive intraoperative fluid administration strategies should be employed with caution given a high propensity for the development of post-operative acute kidney injury in this complex population.

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Untitled

Cited by 16 publications

References 17 publications

External Validation of the HERNIAscore: An Observational Study

External Validation of the HERNIAscore: An Observational Study

Component separation of abdominal wall with intraoperative botulinum A presents satisfactory outcomes in large incisional hernias: a case report

Postoperative renal impairment is associated with increased length of stay for incisional hernia repair after liver transplantation

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