J Gynecol Oncol.  2009 Dec;20(4):246-250. 10.3802/jgo.2009.20.4.246.

Chemotherapy and patient co-morbidity in ventral site hernia development

• Rettenmaier MA
• Abaid LN
• Brown JV
• Micha JP
• Goldstein

• KMID: 2288591
• DOI: http://doi.org/10.3802/jgo.2009.20.4.246

Abstract

OBJECTIVE
The risk factors associated with early ventral site hernia development following cancer surgery are ill defined and associated with an undetermined incidence.
METHODS
We analyzed 1,391 gynecologic cancer patient charts to identify the number of post-operative ventral site hernias over a nearly 6 year period. The following study variables were noted for evaluation: patient demographics, disease co-morbidity (hypertension, cardiovascular disease, diabetes), body mass index (BMI), treatment (e.g., chemotherapy regimen), intra-operative (e.g., bleeding) and postoperative (e.g., infection) complications, time to hernia development and length of hospital stay.
RESULTS
Twenty-six gynecologic cancer patients who developed a post-operative ventral hernia and subsequently underwent herniorrhaphy by our gynecologic oncology service were identified. The patient group's overall time to initial hernia development was 11.23 months. Following a multiple regression analysis, we found that treatment (e.g., bevacizumab, liposomal doxorubicin or radiotherapy associated with compromised wound healing [p=0.0186] and disease co-morbidity [0.0432]) were significant prognostic indicators for an accelerated time to hernia development. Moreover, five patients underwent treatment associated with compromised wound healing and also had disease co-morbidity. In this sub-group, post-operative hernia development occurred more rapidly (3.8 months) than the overall group of patients. BMI and age did not impact time to hernia development (p>0.05). CONCLUSION: In the present gynecologic cancer patient series, a tendency for early post-operative hernia development appeared to coincide with treatment associated with compromised wound healing and disease co-morbidity. Gynecologic cancer surgeons should anticipate this potential complication and consider employing prophylactic intra-operative mesh to potentially prevent this condition.

Keyword

Herniorrhaphy; Gynecologic cancer surgery; Ventral site hernia; Treatment

MeSH Terms

Antibodies, Monoclonal, Humanized
Bevacizumab
Body Mass Index
Cardiovascular Diseases
Demography
Doxorubicin
Hernia
Hernia, Ventral
Herniorrhaphy
Humans
Incidence
Length of Stay
Risk Factors
Wound Healing
Antibodies, Monoclonal, Humanized
Doxorubicin

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