CHRONOLOGY OF INCISIONAL HERNIA DEVELOPMENT: KEY RISK PERIODS

Summary. Introduction. Analysis of the literature shows that currently postoperative hernias occur in 10–30% of patients undergoing median laparotomy, depending on risk factors. This is a fairly common complication of abdominal surgery, which significantly worsens the quality of life of patients and carries a risk of dangerous complications. Known risk factors for the development of postoperative hernia in general are wound infection, high body mass index, smoking, median laparotomy, and emergency surgery. Objective. To determine the optimal follow-up periods for patients after abdominal surgical interventions to assess the incidence of incisional hernias. Materials. This was a retrospective study. We analyzed the medical records of 315 patients with incisional ventral hernias. The cohort included 54 (17.1%) men and 261 (82.9%) women. The highest incidence (48.6%) of incisional ventral hernias was observed in patients aged 61–70 years (29 men and 124 women). The hernia localization was distributed as follows: M1 – 70 cases (22.2%), M2 – 153 cases (48.6%), M3 – 31 cases (9.8%), M4 – 17 cases (5.4%), and L – 44 cases (13.9%). The defect sizes were classified as follows: W1 in 113 cases (35.8%), W2 in 177 cases (56.2%), and W3 in 25 cases (7.9%). Open surgery was the cause of hernia formation in 237 cases (75.2%), while laparoscopic surgery accounted for 78 cases (24.7%). Results. The mean time to incisional hernia onset was (21.66±13.73) months (median – 18.0 months, upper quartile – 24.0 months, lower quartile – 12.0 months). After laparoscopic surgery, the mean time was 11.80±4.59 months (median – 12 months, lower quartile – 9 months, upper quartile – 12 months). After open surgery, the mean time was 24.91±14.19 months (median – 24 months, lower quartile – 12 months, upper quartile – 36 months). The mean time to incisional hernia onset after emergency surgery was (22.04±12.78) months, while after elective surgery, it was (21.38±14.44) months. This difference was not statistically significant (p>0.05). There were no significant differences in key follow-up points for patients after emergency and elective surgery. Conclusions. The optimal key follow-up period for assessing incisional hernia occurrence after laparoscopic surgery is 12 months, while after open surgery, it is 36 months. The optimal follow-up period is 12 months after surgery on the stomach, duodenum, and small intestine; 24 months after colorectal surgery; 36 months after pancreatobiliary surgery; 24 months after vascular surgery; 27 months after gynaecological surgery; and 42 months after urological surgery.