title: Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors.
abstract: To access the incidence and predictive factors of incisional hernia after single-incision laparoscopic cholecystectomy (SILC).
  
  
  
  Eighty-two consecutive patients operated on for uncomplicated cholelithiasis between 2009 and 2013 were eligible for the study. Clinical outcome was assessed by a combination of case notes review, office consultation and telephone interview. Long-term incisional hernia rate was the major outcome of the study. Secondary outcome was the evaluation of predictive factors. Univariate and multivariate statistical analyses were performed using the following variables: age, gender, ASA score, BMI, risk, or comorbidity factors and surgical site infection.
  
  
  
  Six patients (7 %) were lost to follow-up after the 1-month office visit and excluded. The study group consisted of 16 men and 60 women with a median age of 42 years (range 18-69) and a BMI of 25 (range 19-34). Eight patients had risk or comorbidity factors, 46 were classified ASA I, and 30 ASA II. Early postoperative course was uneventful in all cases but two patients developed a superficial wound abscess after hospital discharge. With a median follow-up of 44 months (range 12-72), incisional hernia was noted in six patients (7.9 %). Multivariate logistic analysis revealed that age (OR 1.08, 95 % CI 1.00-1.16, p < 0.038) and BMI (OR 1.37, 95 % CI 1.03-1.82, p < 0.029) were independent predictive factors of developing an incisional hernia. The incidence of hernia was, respectively, 15 % in patients with an age ≥ 50 and 33 % in patients with a BMI ≥ 30.
  
  
  
  After SILC, we noted an incisional hernia rate of 8 %. To decrease the risk of developing that specific complication, SILC should only be proposed to young and non-obese patients.
authors.affiliation: Department of Surgery, CH Wapi, 9 Avenue Delmée, 7500, Tournai, Belgium.
authors.forename: O
authors.initials: O
authors.lastname: Julliard
authors.affiliation: Department of Surgery, CH Wapi, 9 Avenue Delmée, 7500, Tournai, Belgium. ph.hauters@bipweb.be.
authors.forename: P
authors.initials: P
authors.lastname: Hauters
authors.affiliation: Department of Surgery, CH Wapi, 9 Avenue Delmée, 7500, Tournai, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Possoz
authors.affiliation: Department of Surgery, CH Wapi, 9 Avenue Delmée, 7500, Tournai, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Malvaux
authors.affiliation: Department of Surgery, CH Wapi, 9 Avenue Delmée, 7500, Tournai, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Landenne
authors.affiliation: Department of Surgery, CH Wapi, 9 Avenue Delmée, 7500, Tournai, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Gherardi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D000069290:Incisional Hernia / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D055815:Young Adult
keywords: Cholecystectomy; Incisional hernia; Port-site hernia; Predictive factors; Single-incision laparoscopy