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Intramuscular Adipose Tissue Content as a Predictor of Incisional Hernia after Hepatic Resection

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Abstract

Background

Incisional hernia (IH) is a common surgical complication, with an incidence of 6–31% following major abdominal surgery. This study aimed to investigate the impact of intramuscular adipose tissue content (IMAC) on the incidence of IH in patients who underwent hepatic resection.

Methods

Data of 205 patients who underwent open hepatic resection between 2007 and 2019 at Ehime University Hospital were retrospectively analyzed. Patient characteristics, perioperative findings, and body composition were compared between patients with IH and those without IH. The quantity and quality of skeletal muscle, calculated as skeletal muscle index and IMAC, were evaluated using preoperative computerized tomography images.

Results

Forty (19.5%) patients were diagnosed with IH. The cumulative incidence rates were 15.6% at 1 year and 19.6% at 3 years. On univariate analysis, body mass index, areas of subcutaneous and visceral fat, and IMAC were significantly higher in the IH group than in the non-IH group (p = 0.0023, 0.0070, 0.0047, and 0.0080, respectively). No significant difference in skeletal muscle index was found between the groups (p = 0.3548). The incidence of diabetes mellitus, intraoperative transfusion, and postoperative wound infection was significantly higher in the IH group than in the non-IH group (p = 0.0361, 0.0078, and 0.0299, respectively). On multivariate analysis, a high IMAC and wound infection were independent risk factors for IH (adjusted odds ratio, 2.83 and 4.52, respectively; p = 0.0152 and 0.0164, respectively).

Conclusion

IMAC can predict the incidence of IH in patients undergoing hepatic resection.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

None.

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Tomoyuki Nagaoka, Katsunori Sakamoto, Kohei Ogawa, Chihiro Ito, Miku Iwata, Akimasa Sakamoto, Takashi Matsui, Yusuke Nishi, Mikiya Shine, Mio Uraoka, Masahiko Honjo, Takeshi Utsunomiya, Kei Tamura, Naotake Funamizu & Yasutsugu Takada

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  1. Tomoyuki Nagaoka
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  2. Katsunori Sakamoto
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Contributions

TN conceived and designed the study; analyzed and interpreted the data; drafted the article; critically revised the article for important intellectual content; and gave the final approval of the article. CI, MI, AS, YN, TM, MS, MU, MH, TU, KT, and NF acquired the data; drafted the article; and gave the final approval of the article. KS, KO, and YT conceived and designed the study; critically revised the article for important intellectual content; and gave the final approval of the article.

Corresponding author

Correspondence to Tomoyuki Nagaoka.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was conducted in accordance with the ethical guidelines of the 2013 Declaration of Helsinki and was approved by our institutional review board in 2020 (No. 2011025).

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Informed consent was obtained from all individual participants included in the study.

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Nagaoka, T., Sakamoto, K., Ogawa, K. et al. Intramuscular Adipose Tissue Content as a Predictor of Incisional Hernia after Hepatic Resection. World J Surg 47, 260–268 (2023). https://doi.org/10.1007/s00268-022-06795-4

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