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Postoperative incisional hernias after open abdominal aortic aneurysm repair

BACKGROUND: The incidence of incisional hernia in the post operatory of patients submitted to open abdominal aortic aneurysm repair is high, ranging from 10 to 37%, and is more than three times higher than the incidence of hernias in patients operated for aorto-iliac occlusion. OBJECTIVE: To evaluate the incidence of incisional hernia in patients followed-up after open repair of an abdominal aortic aneurysm. METHODS: Case series of 144 patients submitted to open abdominal aortic aneurysm repair between June, 1989 and June, 2010 and routinely followed-up at the vascular outpatient clinic. RESULTS: The mean follow-up was 63 months (1 to 238). The mean age was 67 years-old (from 45 to 91). The mean aneurysm diameter was 6.54 cm. There were 130 mid line laparotomies and 13 extraperitonial left flank incisions. The incidence of incisional hernia was respectively 18.5 and 7.7% (p=0.315). One patient presented bulging of the flank musculature. There was one transverse incision, which did not present hernia during the follow-up period. CONCLUSIONS: The incidence of incisional hernia is high in patients submitted to open abdominal aortic aneurysm repair, it is more common in mid-line incisions and is related to the closing surgical technique. The surgeon must be attentive to this surgical step in order to avoid the most common cause of reoperation for this group of patients.

aortic aneurysm; surgery; hernia, ventral


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