J Minim Invasive Surg.  2021 Jun;24(2):84-90. 10.7602/jmis.2021.24.2.84.

Incisional hernia after minimally invasive gastrectomy in gastric cancer patients

• Cho SC
• Eom BW
• Yoon HM
• Kim YW
• Ryu KW

• KMID: 2520217
• DOI: http://doi.org/10.7602/jmis.2021.24.2.84

Abstract

Purpose
Although there are several studies on the incidence and risk factors for incisional hernia (IH) after open surgery, data about IH after minimally invasive surgery (MIS) for gastric cancer is rare. This study aimed to identify the incidence and risk factors for IH after MIS in gastric cancer patients.
Methods
We analyzed the clinicopathologic data of patients who had laparoscopic or robotic gastric cancer surgeries between January 2006 and July 2019 at National Cancer Center, South Korea. Risk factors for development of IH were investigated with univariate and multivariate analyses.
Results
A total of 2,769 patients underwent laparoscopic-assisted or robot-assisted gastrectomy with extracorporeal gastric resection and reconstruction, while 1,469 underwent totally laparoscopic or totally robotic gastrectomy (TLRG) with intracorporeal gastric resection and reconstruction. IH repair was performed in 23 patients (0.5%) after gastric cancer surgery. In the multivariate analysis, female sex (odds ratio [OR], 5.23; 95% confidence interval [CI], 2.03–13.43; p = 0.001), high body mass index (BMI) of ≥25 kg/m² (OR, 4.23; 95% CI, 1.73–10.35; p = 0.002), larger tumor size (OR, 21.67; 95% CI, 5.37–87.34; p < 0.001), and intracorporeal procedure (OR, 5.63; 95% CI, 2.15–14.61; p < 0.001) were independent significant risk factors for IH.
Conclusion
IH after MIS for gastric cancer is not common. Female sex, high BMI, large tumor size, and intracorporeal procedure were significant risk factors for it in this study. Therefore, in patients with risk factors, surgeons should cautiously close the abdominal wall access wound after MIS for gastric cancer, to prevent IH.

Keyword

Stomach neoplasms; Minimally invasive surgical procedures; Incisional hernia