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Incidence of Clinically Relevant Incisional Hernia After Colon Cancer Surgery and Its Risk Factors: A Nationwide Claims Study

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Abstract

Background

As there is scant literature focusing on incisional hernia for which hospital care is sought, the aim of this study was to elucidate the incidence and risk factors of overt incisional hernia (OIH) after colon cancer surgery using nationwide claims data.

Methods

Claims data of colon cancer patients who underwent regional colectomy were obtained from the Health Insurance Review and Assessment Service database of South Korea. Data from 2010 to 2012 were collected to ensure adequate follow-up. OIH was considered to be present when either the diagnosis code for IH or the claim code for IH repair was entered after index colectomy for colon cancer.

Results

A total of 24,645 patients underwent regional colectomy for colon cancer during the study period. Of these, 376 (1.5%) patients had an OIH within 3 years after surgery, and 50.3% of OIHs developed within the first year after the index colectomy (883.7 cases/10,000 patient-years). The Cox proportional hazard model showed that age >65 years, female gender, open colectomy, and institution volume <100 colectomies per year were statistically significant risk factors for OIH. The 3-year cumulative OIH incidence rates according to age >65 years, female gender, open colectomy, and institution volume <100 colectomies per year were 2.1, 2.1, 2.0, and 2.1%, respectively.

Conclusions

Several risk factors for OIH and its incidence after regional colectomy for colon cancer were identified. These findings are helpful for classifying patients undergoing segmental colectomy who have increased the likelihood of developing IH and are informative for patients and medical providers performing the surgery.

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Author information

Authors and Affiliations

  1. Health Insurance Review and Assessment Service, Seoul, Korea

    Gi Hyeon Seo

  2. Department of Surgery, Seoul National University Hospital Healthcare System Gangnam Center, 39FL Gangnam Finance Center 152, Teheran-ro, Gangnam-gu, Seoul, 135-984, South Korea

    Eun Kyung Choe

  3. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea

    Kyu Joo Park

  4. Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea

    Young Jun Chai

Authors
  1. Gi Hyeon Seo
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  2. Eun Kyung Choe
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Correspondence to Eun Kyung Choe.

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Seo, G.H., Choe, E.K., Park, K.J. et al. Incidence of Clinically Relevant Incisional Hernia After Colon Cancer Surgery and Its Risk Factors: A Nationwide Claims Study. World J Surg 42, 1192–1199 (2018). https://doi.org/10.1007/s00268-017-4256-4

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  • DOI: https://doi.org/10.1007/s00268-017-4256-4

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