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Risk of incisional hernia repair in patients with inflammatory bowel disease

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  • Hans Lovén, Sjællands Universitetshospital
  • ,
  • Rune Erichsen
  • Anders Tøttrup
  • ,
  • Thue Bisgaard, Sjællands Universitetshospital

Aim: Patients with inflammatory bowel disease (IBD) may undergo several abdominal surgeries with a risk of incisional hernia repair (IHR). The objectives of this study were to establish the risk of IHR and to analyse predictors of IHR after a first-time abdominal surgery for IBD. Method: This Danish nationwide register-based cohort study (1996–2018) followed IBD patients from index operation until the date of IHR. The absolute risk was calculated as the cumulative incidence proportion treating death as a competing risk. Cox proportional hazard regression was used to compare the risk of IHR among different subtypes of IBD and to explore predictors of IHR. IBD subtypes were classified as ulcerative colitis (UC), Crohn's disease (CD) or unclassified IBD (IBD-U). Results: In total, 10 130 patients with IBD (UC 3911 [39%]; CD 4210 [41%]; IBD-U 2009 [20%]) underwent either an open or a laparoscopic index operation. The 10-year cumulative incidence of IHR varied between 5.0% and 6.3%, with a significantly higher risk in patients with UC and IBD-U. Patients with UC (75.9%) and IBD-U (91.9%) had more (two or more) abdominal surgeries in the follow-up period compared with CD (51.9%). The risk of IHR increased dramatically with the number of surgeries, although not as markedly if a laparoscopic approach was used. Male sex, age, comorbidity, fascial dehiscence, wound infection and presence of stoma were predictors of IHR for patients with IBD. Conclusion: The long-term risk of IHR was roughly 5%–6%, with a higher risk in patients with UC and IBD-U. Open surgical approach and number of previous surgeries were, among other things, important predictors of IHR.

Original languageEnglish
JournalColorectal Disease
Pages (from-to)964-975
Number of pages12
Publication statusPublished - May 2023

Bibliographical note

Publisher Copyright:
© 2023 Association of Coloproctology of Great Britain and Ireland.

    Research areas

  • IBD, incisional hernia, incisional hernia repair

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