Incidence and risk factors of incisional hernia after CRS and HIPEC for colorectal-appendiceal peritoneal malignancies: a retrospective cohort study.

Authors

Vural Argın, Ahmet Orhan Sunar, Nurdan Bezir, Muhammed İkbal Akın, Ömer Faruk Kandaz, İsmail Ertuğrul, Erdal Polat, Adnan Gündoğdu, Mustafa Duman

Published in

BMC surgery. Volume 26. Issue 1. Jul 31, 2026. Epub Jul 31, 2026.

Abstract

Incisional hernia is a common late complication after extensive abdominal surgery and may significantly impair quality of life. The incidence and risk factors of incisional hernia in patients undergoing cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies of colorectal or appendiceal origin remain insufficiently studied. This study aimed to evaluate the incidence of incisional hernia and to identify factors associated with incisional hernia in this specific patient population.
This retrospective, single-center cohort study included 147 patients who underwent CRS+HIPEC between January 2018 and January 2024. Demographic data, tumor characteristics, surgical details, and comorbidities were obtained from a prospectively maintained database. All patients underwent midline laparotomy, and HIPEC was performed using either mitomycin C or oxaliplatin with 5-fluorouracil/leucovorin via the closed technique at 42-43 °C for 30-90 min. Patients were followed for at least 18 months, and incisional hernia was diagnosed by physical examination and/or radiologic imaging. Univariable and multivariable logistic regression analyses were used to identify associated factors.
The mean age was 54.07 ± 11.70 years, with an equal sex distribution, and the mean follow-up was 30.7 ± 16.2 months. During follow-up, 83 patients (56.5%) developed an incisional hernia. Prior open abdominal surgery (OR 2.621; 95% CI 1.155-5.946; p = 0.021) and a history of hernia (OR 13.682; 95% CI 2.928-63.941; p < 0.001) were significant predictors in univariable analysis and remained independently associated with incisional hernia in multivariable analysis.
The incidence of incisional hernia after CRS+HIPEC is high, and patients with previous open abdominal surgery or preexisting hernia should be considered at increased risk during preoperative assessment and postoperative follow-up.

PMID:
42934663
Bibliographic data and abstract were imported from PubMed on 27 Oct 2026.

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