Chemotherapy and patient co-morbidity in ventral site hernia development.
10.3802/jgo.2009.20.4.246
- Author:
Mark A RETTENMAIER
1
;
Lisa N ABAID
;
John V BROWN
;
John P MICHA
;
Bram H GOLDSTEIN
Author Information
1. Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, Newport Beach, CA, USA. bram@gynoncology.com
- Publication Type:Original Article
- Keywords:
Herniorrhaphy;
Gynecologic cancer surgery;
Ventral site hernia;
Treatment
- MeSH:
Antibodies, Monoclonal, Humanized;
Bevacizumab;
Body Mass Index;
Cardiovascular Diseases;
Demography;
Doxorubicin;
Hernia;
Hernia, Ventral;
Herniorrhaphy;
Humans;
Incidence;
Length of Stay;
Risk Factors;
Wound Healing
- From:Journal of Gynecologic Oncology
2009;20(4):246-250
- CountryRepublic of Korea
- Language:English
-
Abstract:
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). CONCLUSION: 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.
