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Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults

OBJECTIVES: To evaluate the incidence and risk factors for the development of flank incisional hernias or bulges following surgical flank approaches to the kidney. PATIENTS AND METHODS: In all, 100 consecutive adult patients who underwent variable renal surgeries via flank approaches were included i...

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Autores principales: Osman, Tarek, Emam, Ahmed, Farouk, Ahmed, ElSaeed, Karim, Tawfeek, Ahmed M., AbuHalima, Abdelawal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277261/
https://www.ncbi.nlm.nih.gov/pubmed/30534447
http://dx.doi.org/10.1016/j.aju.2018.06.001
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author Osman, Tarek
Emam, Ahmed
Farouk, Ahmed
ElSaeed, Karim
Tawfeek, Ahmed M.
AbuHalima, Abdelawal
author_facet Osman, Tarek
Emam, Ahmed
Farouk, Ahmed
ElSaeed, Karim
Tawfeek, Ahmed M.
AbuHalima, Abdelawal
author_sort Osman, Tarek
collection PubMed
description OBJECTIVES: To evaluate the incidence and risk factors for the development of flank incisional hernias or bulges following surgical flank approaches to the kidney. PATIENTS AND METHODS: In all, 100 consecutive adult patients who underwent variable renal surgeries via flank approaches were included in this prospective study. The incidence and risk factors for flank hernias and bulges were studied at 1- and 6-months postoperatively. RESULTS: At 6 months postoperatively, the incidence of flank bulge was 14% and for lumbar hernia was 10%. The univariate analysis showed 13 significant factors to be associated with the occurrence of a flank bulge or hernia following flank incisions. When the significant risk factors in the univariate analysis were studied by multivariate analysis, using a logistic regression analysis, four independent risk factors were identified. These were: body mass index (BMI) ≥26.3 kg/m(2) (P = 0.04), the use of a self-retaining retractor during surgery (P = 0.02), not preserving or identifying the neurovascular bundle (NVB) during surgery (P = 0.028), and postoperative abdominal distention (P = 0.001). Moreover, all cases included in our study who underwent en masse wound closure, developed surgical wound infection or who had constipation developed postoperative flank bulge or hernia. CONCLUSION: High BMI, the use of self-retaining retractor, not identifying or preserving the NVB, postoperative abdominal distention, en masse wound closure, surgical wound infection, and constipation are significant risk factors associated with postoperative flank hernia and bulge.
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spelling pubmed-62772612018-12-10 Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults Osman, Tarek Emam, Ahmed Farouk, Ahmed ElSaeed, Karim Tawfeek, Ahmed M. AbuHalima, Abdelawal Arab J Urol General Urology OBJECTIVES: To evaluate the incidence and risk factors for the development of flank incisional hernias or bulges following surgical flank approaches to the kidney. PATIENTS AND METHODS: In all, 100 consecutive adult patients who underwent variable renal surgeries via flank approaches were included in this prospective study. The incidence and risk factors for flank hernias and bulges were studied at 1- and 6-months postoperatively. RESULTS: At 6 months postoperatively, the incidence of flank bulge was 14% and for lumbar hernia was 10%. The univariate analysis showed 13 significant factors to be associated with the occurrence of a flank bulge or hernia following flank incisions. When the significant risk factors in the univariate analysis were studied by multivariate analysis, using a logistic regression analysis, four independent risk factors were identified. These were: body mass index (BMI) ≥26.3 kg/m(2) (P = 0.04), the use of a self-retaining retractor during surgery (P = 0.02), not preserving or identifying the neurovascular bundle (NVB) during surgery (P = 0.028), and postoperative abdominal distention (P = 0.001). Moreover, all cases included in our study who underwent en masse wound closure, developed surgical wound infection or who had constipation developed postoperative flank bulge or hernia. CONCLUSION: High BMI, the use of self-retaining retractor, not identifying or preserving the NVB, postoperative abdominal distention, en masse wound closure, surgical wound infection, and constipation are significant risk factors associated with postoperative flank hernia and bulge. Elsevier 2018-07-04 /pmc/articles/PMC6277261/ /pubmed/30534447 http://dx.doi.org/10.1016/j.aju.2018.06.001 Text en © 2018 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle General Urology
Osman, Tarek
Emam, Ahmed
Farouk, Ahmed
ElSaeed, Karim
Tawfeek, Ahmed M.
AbuHalima, Abdelawal
Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults
title Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults
title_full Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults
title_fullStr Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults
title_full_unstemmed Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults
title_short Risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults
title_sort risk factors for the development of flank hernias and bulges following surgical flank approaches to the kidney in adults
topic General Urology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277261/
https://www.ncbi.nlm.nih.gov/pubmed/30534447
http://dx.doi.org/10.1016/j.aju.2018.06.001
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