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KMID : 1137020090200040246
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Journal of Gynecologic Oncology
2009 Volume.20 No. 4 p.246 ~ p.250
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Chemotherapy and patient co-morbidity in ventral site hernia development
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Rettenmaier Mark A.
Abaid Lisa N.
Brown John V.
Micha John P.
Goldstein Bram H.
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Abstract
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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).
Conslusion: 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.
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KEYWORD
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Herniorrhaphy, Gynecologic cancer surgery, Ventral site hernia, Treatment
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