Ventral hernia following primary laparotomy for ovarian, fallopian tube, and primary peritoneal cancers

Gynecol Oncol. 2011 Jan;120(1):33-7. doi: 10.1016/j.ygyno.2010.09.015. Epub 2010 Oct 13.


Objectives: To evaluate the incidence and risk factors for ventral hernia development following primary laparotomy for ovarian, fallopian tube, and peritoneal cancers.

Methods: All patients who underwent primary laparotomy for ovarian, tubal, or peritoneal cancer from 3/05 to 12/07 were identified. Hernias were identified radiographically or during physical exam. One-year and 2-year hernia rates were calculated. Clinicopathologic factors were evaluated for an association with the development of hernia using univariate and multivariate analysis.

Results: We identified 239 cases with 12 months of follow-up. Median age was 60 years (17-89 years), and median body mass index (BMI) was 25.0 kg/m(2) (16.9-58.5 kg/m(2)). Advanced stage disease (FIGO stage III/IV) was diagnosed in 182/239 (76%). The 1-year hernia rate was 8.8% (21/239): 13/21 (61.9%) were symptomatic, and 8/21 (38.1%) underwent hernia repair operations. On multivariate analysis, only BMI (p=0.004) and intraperitoneal (IP) chemotherapy (p=0.016) retained their independent association with hernia development by 12 months. Of the 239 patients, 167 had 24 months of follow-up. The 2-year hernia rate was 23.4% (39/167): 25/39 (64.1%) were symptomatic, and 17/39 (43.6%) underwent hernia repair operations. Multivariate analysis in this group demonstrated that advanced stage (p=0.033), wound complications (p=0.029), and BMI (p=0.012) were independently associated with hernia development by 24 months.

Conclusions: The development of ventral hernia is a significant postoperative morbidity in patients undergoing primary surgery for ovarian, tubal, or peritoneal cancer. Independent associations with hernia development include: BMI and IP chemotherapy by Year 1, and BMI, wound complications and advanced stage by Year 2.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Fallopian Tube Neoplasms / pathology
  • Fallopian Tube Neoplasms / surgery*
  • Female
  • Gynecologic Surgical Procedures / adverse effects*
  • Hernia, Ventral / etiology*
  • Hernia, Ventral / pathology
  • Humans
  • Incidence
  • Laparotomy / adverse effects
  • Middle Aged
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery*
  • Risk Factors
  • Young Adult