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Frequency of Incisional Hernia After Kidney Cancer Surgery: Swedish Population-Based Study

By: Julia Fiederlein
Posted: Friday, October 8, 2021

Incisional hernia is a frequent complication of abdominal cavity surgery. However, according to Gabriel Sandblom, MD, PhD, of the Karolinska Institute, Stockholm, and colleagues, there are limited data regarding the rate of incisional hernia after surgery for renal cell carcinoma. The results of a nationwide, population-based study, which were published in the Scandinavian Journal of Urology, revealed that open surgery seemed to be associated with a significantly higher risk of developing incisional hernia in these patients.

“The trend toward minimally invasive renal cell carcinoma surgery will probably lead to a lower rate of incisional hernia in the future,” the investigators explained. “However, open surgery will still be required, so knowledge of risk factors for incisional hernia after renal cell carcinoma surgery and how to prevent incisional hernia will continue to be of great importance in the future.”

Using data from the Renal Cell Cancer Database Sweden, the investigators identified 9,638 patients who were diagnosed with renal cell carcinoma. Of this study population, 6,417 underwent surgery; open surgery was performed more frequently than minimally invasive surgery (81% vs. 19%). A total of 140 patients were diagnosed with incisional hernia. The cumulative rates of incisional hernia after open and minimally invasive surgeries were 5.2% and 2.4%, respectively, after 5 years (P < .05). Based on the Cox proportional hazard analyses, age and left-sided surgery seemed to be associated with incisional hernia in patients who underwent open surgery (P < .05 for both); however, in those who underwent minimally invasive surgery, no statistically significant risk factors for incisional hernia were identified.

“If open surgery is the only option, care should be taken when choosing the approach and closing the wound,” the investigators concluded. “More studies are needed to find strategies to reduce the risk of abdominal wall complications following open kidney surgery.”

Disclosure: The study authors reported no conflicts of interest.



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