• José Antonio Pereira, Miguel Pera, Manuel López-Cano, Marta Pascual, Sandra Alonso, Silvia Salvans, Marta Jiménez-Toscano, Alba González-Martín, and Luis Grande-Posa.
• Departmento de Cirugía General y Digestiva, Parc de Salut Mar, Hospital del Mar, Barcelona, España; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, España. Electronic address: 86664@parcdesalutmar.cat.
• Cir Esp. 2019 Jan 1; 97 (1): 20-26.

ObjectivesTo determine the incidence of incisional hernia (IH) in the extraction incision (EI) in colorectal resection for cancer. To analyze whether the location of the incision has any relationship with the incidence of hernias and whether mesh could be useful for prevention in high-risk patients.MethodsRetrospective review of the colon and rectal surgery database from January 2015 to December 2016. Data were classified into 2groups, transverse (TI) and midline incision (MI), and the latter was divided into 2subgroups (mesh [MIM] and suture [MIS]). Patients were classified using the HERNIAscore. Hernias were diagnosed by clinical and/or CT examination.ResultsA total of 182 out of 210 surgical patients were included. After a median follow-up of 13.0 months, 39 IH (21.9%) were detected, 23 of which (13.4%) were in the EI; their frequency was lower in the TI group (3.4%) and in the MIM group (5.9%) than in the MIS group (29.5%; p=0.007). The probability of developing IH in the MIS group showed an OR=11.7 (95%CI: 3.3-42.0) compared to the TI group and 4.3 (IC 95%: 1.1-16.3) versus the MIM group.ConclusionsThe location of the incision is relevant to avoid incisional hernias. Transverse incisions should be used as the first option. When a midline incision is needed, a prophylactic mesh could be considered in high risk patients because it is safe and associated with low morbidity.Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

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