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Gefässchirurgie

, Volume 23, Issue 3, pp 157–165 | Cite as

Die Inzidenz von Narbenhernien nach Aortenaneurysma ist nicht höher als nach benignen kolorektalen Eingriffen

Eine retrospektive Matched-control-Kohortenstudie
  • A. Wiegering
  • D. Liebetrau
  • S. Menzel
  • C. Bühler
  • R. Kellersmann
  • U. A. Dietz
Leitthema
  • 98 Downloads

Zusammenfassung

Hintergrund

Das abdominelle Aortenaneurysma (AAA) hat eine inflammatorische Genese, wobei die Elastica die eigentlich beteiligte Schicht ist. Parallel dazu wurde die Technik des Bauchdeckenverschlusses im Laufe der letzten Jahrzehnte signifikant verbessert.

Fragestellung

Die Studie geht der Frage nach, ob sich die Inzidenzrate von Narbenhernien nach Laparotomie aufgrund eines AAA oder kolorektalen Eingriffs unterscheidet.

Material und Methoden

Dies ist eine retrospektive Matched-control-Kohortenstudie. Nach Screening von 403 kolorektalen Patienten und 96 AAA Patienten wurden 27 und 72 Patienten eingeschlossen. Match-Kriterien für den Einschluss kolorektaler Patienten waren: Alter, benigne Grunderkrankung und median-xiphopubische Laparotomie. Das primäre Ergebnis war die Inzidenz einer Narbenhernie im Verlauf. Sekundäre Ergebnisse waren das Risikoprofil, der Aufenthalt auf Intensivstation und postoperative Komplikationen. Die Datenanalyse erfolgte im konsekutiven Kollektiv der Jahre 2006 bis 2008.

Ergebnisse

In der Gruppe der AAA betrug das mittlere Follow-up 34,5 ± 18,1 Monate, in der Gruppe der kolorektalen Eingriffe 35,7 ± 21,4 Monate. Die Narbenhernieninzidenz in beiden Gruppen unterschied sich nicht signifikant: In der AAA-Gruppe hatten 10 Patienten (13,8 %) eine Narbenhernie entwickelt, wohingegen 7 kolorektale Patienten (25,9 %) eine Narbenhernie ausbildeten.

Schlussfolgerungen

Im eigenen Patientenkollektiv haben Patienten mit AAA im Vergleich zu kolorektalen Patienten mit vergleichbar großem Laparotomiezugang und Alter keine erhöhte Narbenhernieninzidenz. Die Qualität des Bauchdeckenverschlusses scheint ein wichtiger Faktor bei der Prävention der Narbenhernie zu sein.

Schlüsselwörter

Retrospektive Studie Bauchdecke Laparotomie Postoperative Komplikationen Intensivstation 

The incidence of incisional hernia after aortic aneurysm is not higher than after benign colorectal interventions

A retrospective control matched cohort study

Abstract

Background

Abdominal aortic aneurysms (AAA) have an inflammatory origin, whereby the elastica is the layer actually involved. Parallel to this the technique of closure of the abdominal wall has significantly improved over the last decade.

Objectives

The aim of the study was to investigate whether the incidence of incisional hernia following laparotomy due to AAA differs from that of colorectal interventions.Material and methods

Material and methods

This was a retrospective control matched cohort study. After screening of 403 patients with colorectal interventions and 96 patients with AAA, 27 and 72 patients, respectively were included. The match criteria for inclusion of patients with colorectal interventions were: age, benign underlying disease and median xiphopubic laparotomy. The primary endpoint was the incidence of an incisional hernia. The secondary endpoints were the risk profile, length of stay in the intensive care unit and postoperative complications. Data analysis was carried in the consecutive collective from 2006 to 2008.

Results

In the group with AAA the mean follow-up was 34.5±18.1 months and in the group with colorectal interventions 35.7±21.4 months. The incidence of incisional hernias showed no significant differences between the two groups. In the AAA group 10 patients (13.8%) developed an incisional hernia in contrast to 7 patients in the colorectal intervention group (25.9%).

Conclusions

In our collective patients with AAA did not show an increased incidence of incisional hernia in comparison to patients with colorectal interventions with comparable size of the laparotomy access and age. The quality of closure of the abdominal wall seems to be an important factor for the prevention of incisional hernia.

Keywords

Retrospective studies Abdominal wall Laparotomy Postoperative complications Intensive care unit 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

A. Wiegering, D. Liebetrau, S. Menzel, C. Bühler, R. Kellersmann und U.A. Dietz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • A. Wiegering
    • 1
    • 2
  • D. Liebetrau
    • 1
  • S. Menzel
    • 1
  • C. Bühler
    • 1
  • R. Kellersmann
    • 1
  • U. A. Dietz
    • 1
    • 3
  1. 1.Klinik und Poliklinik für Allgemein‑, Viszeral‑, Gefäß- und KinderchirurgieUniversitätsklinikum WürzburgWürzburgDeutschland
  2. 2.Lehrstuhl für Biochemie und MolekularbiologieUniversität WürzburgWürzburgDeutschland
  3. 3.Klinik für Viszeral‑, Gefäss- und ThoraxchirurgieKantonsspital OltenOltenSchweiz

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