title: The influence of laparoscopy on incisional hernia rates: a retrospective analysis of 1057 colorectal cancer resections.
abstract: OBJECTIVE
  The aim of this study was to evaluate the incidence of incisional hernia formation after laparoscopic and open surgery for colorectal cancer.
  
  
  METHODS
  A retrospective analysis was conducted of 1057 colorectal cancer resection cases (289 laparoscopic, 768 open) performed in a single national laparoscopic training centre between January 2006 and December 2011. Clinical notes and serial computed tomography scans were reviewed, with any incisional hernia including those at a surgical incision, port site, stoma and stoma closure site identified and the size of the defect measured.
  
  
  RESULTS
  The overall incisional hernia rate was 14.8%. There was no significant difference between the open and laparoscopic groups (14.4% vs 15.9%, P = 0.566). Excluding stoma-related hernia, 10.7% of the open group developed a surgical wound hernia, and 11.1% of the laparoscopic group developed a hernia at a port site, extraction site or surgical midline incision. There was no statistical difference between the two groups (P = 0.853). The defects were smaller in the laparoscopic group (P < 0.005). There were significantly more parastomal hernias in the laparoscopic group (40%) than in the open group (12.7%, P < 0.001).
  
  
  CONCLUSIONS
  The incidence of incisional hernia formation was similar after laparoscopic or open surgery for colorectal cancer. Parastomal hernia was more frequent after laparoscopic surgery.
authors.affiliation: Department of Colorectal Surgery, Queens Medical Centre, Nottingham University Hospitals, Nottingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mishra
authors.forename: B D
authors.initials: BD
authors.lastname: Keeler
authors.forename: C
authors.initials: C
authors.lastname: Maxwell-Armstrong
authors.forename: J A
authors.initials: JA
authors.lastname: Simpson
authors.forename: A G
authors.initials: AG
authors.lastname: Acheson
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects; D061887:Conversion to Open Surgery / Q000009:adverse effects; D005260:Female; D006555:Hernia, Ventral / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Laparoscopy; cancer; parastomal hernia; surgery; ventral hernia