Incisional Hernia Clinical Trial
Official title:
Incidence and Risk Factors for Trocar Site Incisional Hernia Detected by Clinical and Ultrasonographic Examination.
Trocar site incisional hernia (TSIH) is the most frequent complication associated to
laparoscopic surgery. Few studies currently describes its real prevalence or risk factors.
The aim of this study is to determine the real incidence of TSIH and to identify risk factors
in the investigator's series of patients.
A cross sectional, prospective study is performed including consecutive patients who
underwent a laparoscopic procedure during a four months period. All the patients are assessed
both clinically (TSIHc) and by an ultrasonographic exam (TSIHu). Main variable studied is the
incidence of TSIH. A multivariate analysis is performed to identify risk factors.
Single-centre cross-sectional study based on prospective clinical and radiological assessment
and retrospective risk factor analyses performed at a single hospital.
All consecutive patients who underwent laparoscopic surgery (cholecystectomy, colon
resection, adrenalectomy, Nissen fundoplication and appendectomy) during a four months period
were included in the study. At least 30 months after hospital discharge, they were invited by
telephone to participate in the study. Detailed project information was provided, and those
who accepted received an appointment for an outpatient visit and a dynamic ultrasound.
Informed consent was obtained from all participants. In all patients, the umbilical trocar
wound was closed with an interrupted suture with synthetic braided absorbable 2/0 suture
(Novosyn® or Safil®). During the postoperative outpatient visit, clinical and
ultrasonographic examinations were performed. To increase study homogeneity, all clinical
examinations and ultrasounds were performed by a single surgeon and a single radiology
resident supervised by the same abdominal radiology consultant, respectively. Sonography was
performed with an Applio 500 equipment (Toshiba, Japan) with a 3.5MHz convex probe and a 7MHz
linear probe. The ultrasound diagnosis was based on the identification of an abdominal wall
defect with intraabdominal tissue protrusion. The main variables of the study were clinical
(TSIHc) and ultrasound (TSIHu) diagnosis of incisional hernia. All results and variables were
introduced in a previous specifically designed database (File MakerPro 11.0v3 © 1984-2011
FileMaker, Inc.). Data were collected from clinical interviews, physical and radiological
examinations and the electronic medical record. Statistical analyses were performed using the
SPSS statistical software (IBM SPSS® Statistics).
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