High Lymphocyte Count as a Significant Risk Factor for Incisional Hernia After Laparoscopic Colorectal Surgery

医学 体质指数 切口疝 入射(几何) 优势比 腹腔镜手术 腹腔镜检查 胃肠病学 内科学 结肠切除术 风险因素 结直肠癌 外科 癌症 光学 物理
作者
Koki Tamai,Shu Okamura,Yu Kamakura,Masahiro Koh,Koji Hayashi,Akio Hara,Yoshiteru Katsura,Hajime Hirose,Natsumi Tanaka,Chikara Ebisui,Hideoki Yokouchi,Masahiko Yano
出处
期刊:Surgical laparoscopy, endoscopy & percutaneous techniques [Lippincott Williams & Wilkins]
卷期号:33 (1): 69-75
标识
DOI:10.1097/sle.0000000000001142
摘要

In the era of laparoscopic surgery, incisional hernia (IH) remains a common complication of colorectal surgery. Various risk factors for IH have been evaluated to reduce the incidence, but the impact of nutrition on IH has not been well discussed. The aim of this study is to evaluate the relationship between nutritional status and the development of IH after laparoscopic colorectal surgery.We retrospectively evaluated 342 colorectal cancer patients undergoing laparoscopic colectomy or proctectomy between January 2012 and December 2018. Postoperative computed tomography was used to diagnose the IH. Patient characteristics, including preoperative albumin and lymphocyte counts, were evaluated for the risk of development of IH. Further investigations were conducted regarding the impact of nutritional status on the development of IH in each patient of body mass index (BMI) under and over 25.0 kg/m 2 .IH was observed in 37 patients (10.8%), with a median follow-up period of 48.5 months. Female [odds ratio (OR)=3.43, P <0.01], BMI ≥25 kg/m 2 (OR=2.9, P <0.01), lymphocyte count ≥1798/µL (OR=3.37, P <0.01), and operative time ≥254 minutes (OR=3.90, P <0.01) had statistically significant relationships to IH in multivariate analysis. Low albumin was related to IH in BMI ≥25 kg/m 2 ( P =0.02), but was not in BMI<25 kg/m 2 ( P =0.21). On the other hand, a high lymphocyte count was related to IH regardless of BMI (BMI ≥25 kg/m 2 : P =0.01, BMI<25 kg/m 2 : P =0.04).A high preoperative lymphocyte count is an independent risk factor for IH, whereas a low albumin count is limited regarding predicting IH.

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