Abdominal wall reconstruction for large incisional hernia restores expiratory lung function.
Respiratory complications secondary to intermittent intra-abdominal hypertension and/or atelectasis are common after abdominal wall reconstruction for large incisional hernias. It is unknown if the respiratory function of this patient group is affected long term or impairs activities of daily living. We hypothesized that abdominal wall reconstruction for large incisional hernia would not lead to improved, long-term pulmonary function or respiratory quality of life.



Eighteen patients undergoing open abdominal wall reconstruction with mesh for a large incisional hernia (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow, maximal in- and expiratory mouth pressure, and 2 validated questionnaires on respiratory quality of life. In order to decrease heterogeneity, objectively examined parameters were presented relative to the predicted values, which were normality adjusted pulmonary measures.



At 1-year follow-up, the abdominal wall reconstruction group showed significant improvement in percent predicted peak expiratory flow and maximal expiratory mouth pressure, whereas all other measurements of lung function remained unchanged. Respiratory quality of life did not change significantly. Patients who underwent abdominal wall reconstruction showed a significantly greater improvement of percent predicted peak expiratory flow compared with patients undergoing colorectal resection.



Abdominal wall reconstruction for large incisional hernia improved long-term expiratory lung function. Respiratory quality of life did not change significantly after abdominal wall reconstruction.
Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. Electronic address: mail@kristiankiim.dk.
Kristian K
KK
Jensen
Department of Pulmonary Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Vibeke
V
Backer
Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Lars N
LN
Jorgensen
D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D016022:Case-Control Studies; D003107:Colorectal Surgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D000069290:Incisional Hernia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D012016:Reference Values; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013526:Surgical Mesh; D016896:Treatment Outcome