Avaliação do Perfil de Pacientes com Deiscência da Aponeurose após Colectomias e Indicação de Tela Profilática segundo o Escore de Vidal

Cristiano Marciano Duarte; Marco Aurelio Leão Beltrami; Claudia Nishida Hasimoto; Walmar Kerche De Oliveira; Marcone Lima Sobreira

doi:10.53843/bms.v10i14.845

Authors

Cristiano Marciano Duarte Universidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatu-SP https://orcid.org/0000-0002-9567-2023
Marco Aurelio Leão Beltrami Universidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatu-SP
Claudia Nishida Hasimoto Universidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatu-SP https://orcid.org/0000-0003-4857-7346
Walmar Kerche De Oliveira Universidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatu-SP
Marcone Lima Sobreira Universidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatu-SP

DOI:

https://doi.org/10.53843/bms.v10i14.845

Keywords:

Colorectal Surgery, Incisional Hernia, Surgical Wound Dehiscence, Epidemiology

Abstract

Introdução: The postoperative period for patients undergoing colectomies is typically characterized by the occurrence of incisional hernia. This outcome is attributed to perioperative factors associated with high morbidity and mortality rates. This study assesses the profile of patients with aponeurotic dehiscence (DA), quantifies its prevalence, and evaluates the indication for prophylactic mesh according to the Vidal score.

Métodos: Patient records were analyzed for those who underwent elective colectomy of any segment with a median infraumbilical incision at “XXXX” between 06/01/2020 and 06/30/2021.

Resultados: The sample (n=73) has an average age of 61.2 years with a predominance of female patients. Among them, 26 exhibited aponeurotic dehiscence (DA+). This group consists of individuals over 40 years old [96.15% (n=26)], with ascites [7.69% (n=26)], jaundice [3.85% (n=26)], and anemia [38.46% (n=26)]. Major comorbidities in the DA+ group include malignant neoplasms [80.77% (n=26)], obesity [26.96% (n=26)], and smoking [19.23% (n=26)]. The Vidal score indicated that 92.30% of DA+ patients and 77.77% of DA- patients were recommended for prophylactic mesh use.

Discussão: Anemia, jaundice, ascites, malignant neoplasms, obesity, smoking, and malnutrition were associated with aponeurotic dehiscence. It is notable that some of these risk factors are modifiable and can be targeted for interventions to reduce the incidence of DA. The use of the Vidal score for risk stratification may aid in the early identification of patients with a higher likelihood of postoperative complications. The study is limited by its focus solely on preoperative factors.

Conclusão: The profile is predominantly characterized by female sex and advanced age, as well as risk factors such as anemia and ascites, and comorbidities like malignant neoplasms and obesity. Aponeurotic dehiscence affected 35.61% (n=73) of the patients, and 92.3% of those with DA+ had an indication for prophylactic mesh use.

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