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Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery

Alethea Tang, Naomi Spencer, Kristie Parkins, Victoria Bevan, Gregory Taylor, Derrian Markham, Peter Drew, Rhiannon L. Harries

Colorectal Disease, Volume: 25, Issue: 4

Swansea University Author: Alethea Tang

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DOI (Published version): 10.1111/codi.16400

Abstract

AimThe vertical rectus abdominis myocutaneous (VRAM) flap is commonly used to reconstruct perineal defects for low rectal and anal cancer. The incidence of midline incisional hernias after VRAM reconstruction varies from 3.6% when detected clinically to 50% when detected radiologically. The aim of t...

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Published in: Colorectal Disease
ISSN: 1462-8910 1463-1318
Published: Wiley 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa61791
first_indexed 2022-11-07T10:21:22Z
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spelling 2023-06-12T16:43:28.9206355 v2 61791 2022-11-07 Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery 6650ebd828f3596d5da522ebd2c8b51d Alethea Tang Alethea Tang true false 2022-11-07 AimThe vertical rectus abdominis myocutaneous (VRAM) flap is commonly used to reconstruct perineal defects for low rectal and anal cancer. The incidence of midline incisional hernias after VRAM reconstruction varies from 3.6% when detected clinically to 50% when detected radiologically. The aim of this study is to accurately determine the radiological incidence of donor-site incisional and parastomal hernia following VRAM reconstruction.MethodsRetrospective cohort study of patients undergoing colorectal surgery requiring VRAM reconstruction over 10 years. Data were collected on patient demographics, indication for surgery and surgical procedure including details of any hernia repair. Images from surveillance CTs were reviewed for presence and size of midline incisional and/or parastomal hernias. Parastomal hernias were classified based on the European Hernia Society (EHS) classification.Results173 patients were included in the analysis. The median age was 67 years (range 29 – 88 years) and median length of follow up was 49 months (IQR 24.3 – 71.0 months). The cumulative incidence of donor-site incisional hernia after VRAM at 1, 2 and 5 years was 15.1%, 25.4% and 29.1%. The cumulative incidence for PSH at 1, 2 and 5 years was 33.1%, 46.6% and 53.3% (95%CI 45.4% - 60.5%).ConclusionMost patients who develop donor-site incisional hernia and parastomal herniation following VRAM tend to do so within the first two years. Although the use of CT imaging improves the diagnosis of donor-site incisional and parastomal hernias, the clinical significance of this is unknown. Journal Article Colorectal Disease 25 4 Wiley 1462-8910 1463-1318 colorectal cancer, incisional hernia, parastomal hernia, radiology, Vertical Abdominus Myocutaneous flap 20 11 2022 2022-11-20 10.1111/codi.16400 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) 2023-06-12T16:43:28.9206355 2022-11-07T10:18:59.5567758 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Alethea Tang 1 Naomi Spencer 2 Kristie Parkins 3 Victoria Bevan 4 Gregory Taylor 5 Derrian Markham 6 Peter Drew 7 Rhiannon L. Harries 8 61791__25941__efe11525dd024bcd92bcfae0760cdc8f.pdf 61791.pdf 2022-11-28T16:15:31.4813812 Output 4828026 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/
title Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery
spellingShingle Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery
Alethea Tang
title_short Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery
title_full Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery
title_fullStr Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery
title_full_unstemmed Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery
title_sort Radiological incidence of donor‐site incisional hernia and parastomal hernia after vertical rectus abdominus myocutaneous flap‐based reconstruction following colorectal surgery
author_id_str_mv 6650ebd828f3596d5da522ebd2c8b51d
author_id_fullname_str_mv 6650ebd828f3596d5da522ebd2c8b51d_***_Alethea Tang
author Alethea Tang
author2 Alethea Tang
Naomi Spencer
Kristie Parkins
Victoria Bevan
Gregory Taylor
Derrian Markham
Peter Drew
Rhiannon L. Harries
format Journal article
container_title Colorectal Disease
container_volume 25
container_issue 4
publishDate 2022
institution Swansea University
issn 1462-8910
1463-1318
doi_str_mv 10.1111/codi.16400
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description AimThe vertical rectus abdominis myocutaneous (VRAM) flap is commonly used to reconstruct perineal defects for low rectal and anal cancer. The incidence of midline incisional hernias after VRAM reconstruction varies from 3.6% when detected clinically to 50% when detected radiologically. The aim of this study is to accurately determine the radiological incidence of donor-site incisional and parastomal hernia following VRAM reconstruction.MethodsRetrospective cohort study of patients undergoing colorectal surgery requiring VRAM reconstruction over 10 years. Data were collected on patient demographics, indication for surgery and surgical procedure including details of any hernia repair. Images from surveillance CTs were reviewed for presence and size of midline incisional and/or parastomal hernias. Parastomal hernias were classified based on the European Hernia Society (EHS) classification.Results173 patients were included in the analysis. The median age was 67 years (range 29 – 88 years) and median length of follow up was 49 months (IQR 24.3 – 71.0 months). The cumulative incidence of donor-site incisional hernia after VRAM at 1, 2 and 5 years was 15.1%, 25.4% and 29.1%. The cumulative incidence for PSH at 1, 2 and 5 years was 33.1%, 46.6% and 53.3% (95%CI 45.4% - 60.5%).ConclusionMost patients who develop donor-site incisional hernia and parastomal herniation following VRAM tend to do so within the first two years. Although the use of CT imaging improves the diagnosis of donor-site incisional and parastomal hernias, the clinical significance of this is unknown.
published_date 2022-11-20T20:17:04Z
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