Risk Factors for Postoperative Incisional Hernia and Its Effects on Long-Term Outcomes After Gastrointestinal and Hepatopancreaticobiliary Cancer Surgery

PurposeIncisional hernia (IH) is a common postoperative complication after abdominal surgery, but its predictors and impact on prognosis remain unclear in gastrointestinal (GI) and hepatopancreaticobiliary (HPB) cancer patients.MethodsWe retrospectively analyzed 505 patients who underwent elective tumor resection for GI and HPB malignancies at two institutions (2018-2021).ResultsThe overall incidence rate of IH within 2 years after surgery was 15.6% (79/505). We divided the patients into two groups: those who developed IH (IH group) and those who did not (non-IH group). Multivariate analysis identified higher body mass index (BMI) (odds ratio [OR]: 1.19[1.11-1.27], <i>P</i> < 0.001), occurrence of wound infection (OR: 4.55[1.50-12.72], <i>P</i> = 0.007), lower albumin level (OR: 1.75[1.04-2.94], <i>P</i> = 0.04), and advanced cancer stage (OR: 1.38[1.02-1.87], <i>P</i> = 0.04) as significant risk factors for IH. Patients in the IH group had shorter overall survival than those in the non-IH group (<i>P</i> < 0.001).ConclusionThe findings underscore the importance of being cautious regarding the risk of postoperative IH in patients with higher BMI, low serum albumin level, and advanced stage cancer and of taking preventive care measures against postoperative wound infection. Patients who develop IH may have poorer long-term outcomes.