Abdominal wall reconstruction for large incisional hernia restores expiratory lung function
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Abdominal wall reconstruction for large incisional hernia restores expiratory lung function. / Jensen, Kristian K; Backer, Vibeke; Jorgensen, Lars N.
In: Surgery, Vol. 161, No. 2, 2017, p. 517-524.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Abdominal wall reconstruction for large incisional hernia restores expiratory lung function
AU - Jensen, Kristian K
AU - Backer, Vibeke
AU - Jorgensen, Lars N
N1 - Copyright © 2016 Elsevier Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Respiratory complications secondary to intermittent intra-abdominal hypertension and/or atelectasis are common after abdominal wall reconstruction for large incisional hernias. It is unknown if the respiratory function of this patient group is affected long term or impairs activities of daily living. We hypothesized that abdominal wall reconstruction for large incisional hernia would not lead to improved, long-term pulmonary function or respiratory quality of life.METHODS: Eighteen patients undergoing open abdominal wall reconstruction with mesh for a large incisional hernia (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow, maximal in- and expiratory mouth pressure, and 2 validated questionnaires on respiratory quality of life. In order to decrease heterogeneity, objectively examined parameters were presented relative to the predicted values, which were normality adjusted pulmonary measures.RESULTS: At 1-year follow-up, the abdominal wall reconstruction group showed significant improvement in percent predicted peak expiratory flow and maximal expiratory mouth pressure, whereas all other measurements of lung function remained unchanged. Respiratory quality of life did not change significantly. Patients who underwent abdominal wall reconstruction showed a significantly greater improvement of percent predicted peak expiratory flow compared with patients undergoing colorectal resection.CONCLUSION: Abdominal wall reconstruction for large incisional hernia improved long-term expiratory lung function. Respiratory quality of life did not change significantly after abdominal wall reconstruction.
AB - BACKGROUND: Respiratory complications secondary to intermittent intra-abdominal hypertension and/or atelectasis are common after abdominal wall reconstruction for large incisional hernias. It is unknown if the respiratory function of this patient group is affected long term or impairs activities of daily living. We hypothesized that abdominal wall reconstruction for large incisional hernia would not lead to improved, long-term pulmonary function or respiratory quality of life.METHODS: Eighteen patients undergoing open abdominal wall reconstruction with mesh for a large incisional hernia (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow, maximal in- and expiratory mouth pressure, and 2 validated questionnaires on respiratory quality of life. In order to decrease heterogeneity, objectively examined parameters were presented relative to the predicted values, which were normality adjusted pulmonary measures.RESULTS: At 1-year follow-up, the abdominal wall reconstruction group showed significant improvement in percent predicted peak expiratory flow and maximal expiratory mouth pressure, whereas all other measurements of lung function remained unchanged. Respiratory quality of life did not change significantly. Patients who underwent abdominal wall reconstruction showed a significantly greater improvement of percent predicted peak expiratory flow compared with patients undergoing colorectal resection.CONCLUSION: Abdominal wall reconstruction for large incisional hernia improved long-term expiratory lung function. Respiratory quality of life did not change significantly after abdominal wall reconstruction.
KW - Abdominal Wall/surgery
KW - Aged
KW - Case-Control Studies
KW - Colorectal Surgery/adverse effects
KW - Female
KW - Follow-Up Studies
KW - Herniorrhaphy/adverse effects
KW - Humans
KW - Incisional Hernia/surgery
KW - Male
KW - Middle Aged
KW - Postoperative Complications/diagnosis
KW - Quality of Life
KW - Reconstructive Surgical Procedures/methods
KW - Reference Values
KW - Respiratory Function Tests
KW - Severity of Illness Index
KW - Surgical Mesh
KW - Treatment Outcome
U2 - 10.1016/j.surg.2016.08.015
DO - 10.1016/j.surg.2016.08.015
M3 - Journal article
C2 - 27816206
VL - 161
SP - 517
EP - 524
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 2
ER -
ID: 197003980