Incidence and risk factors for the development of incisional hernia following elective laparoscopic versus open colon resections

BACKGROUND: There are few studies that compare the incidence of incisional hernia following elective laparoscopic colon resection to open colectomy and determine the risk factors for its development. METHODS: Elective open and laparoscopic colon resections performed between February 2002 and May 2007 were reviewed. In the laparoscopic group, mesenteric transection was performed via intracorporeal division for left-sided colectomy and via extracorporeal technique for right-sided colectomy. The ileocolic anastomosis was performed by extracorporeal stapling for right colectomies and by intracorporeal for left colectomies. RESULTS: Two hundred eighteen patients (Mean age 62 years, 52% male) underwent elective colon resection (50% open, 5% hand-assisted, and 45% laparoscopic). Six percent of the cases that started as laparoscopic were converted and are included in the open group. Mean follow-up was 26 months. The overall incisional hernia rate was 16% (open and minimally invasive group 17% vs 15%, P=.14). Hernia was not dependent on the type of resection, indication, or extraction site. Body mass index >36 kg/m(2), male gender, and surgical site infection were risk factors for hernia development. CONCLUSIONS: Laparoscopic colectomy does not reduce the development of incisional hernia. (C) 2010 Elsevier Inc. All rights reserved.