Abstract：
(1) Background: Hand-assisted laparoscopic surgery for liver resection is a globally established technique. In this study, we report on the incidence and risk factors for postoperative incisional hernia (IH) after hand-assisted laparoscopic surgery for colorectal liver metastasis. (2) Methods: This was retrospective analysis of 89 consecutive hand-assisted laparoscopic surgery for colorectal liver metastasis. (3) Results: Participants were 39 females and 50 males. Median age was 65 years, and in 63%, the BMI was ≥25. Postoperative complications were encountered in 18% of the patients. Seven patients (7.8%) had postoperative incisional hernia in the hand port site. There was significantly higher incidence of incisional hernia in overweight patients (BMI ≥ 25) (p = 0.04), and in cases with simultaneous liver and colon resection (p = 0.02). In univariant and multivariant analyses, simultaneous liver and colon resection (p = 0.004 and 0.03, respectively), and platelet-to-lymphocyte ratio ≤ 200 (p = 0.03, 0.04, respectively) were both independent risk factors for developing postoperative incisional hernia. (4) Conclusions: Both simultaneous liver and colon resection, and platelet-to-lymphocyte ratio ≤ 200 are independent risk factors for postoperative incisional hernia after hand-assisted laparoscopic surgery for colorectal liver metastasis.
摘要：
（1）背景：手助腹腔镜肝切除术是一种全球公认的技术。在这项研究中,我们报告了手辅助腹腔镜结直肠肝转移术后切口疝（IH）的发生率和危险因素。(2)方法:回顾性分析89例连续手助腹腔镜手术治疗结直肠癌肝转移的临床资料。(3)结果：研究对象为女性39例，男性50例。中位年龄为65岁,在63%中，BMI≥25。18％的患者遇到了术后并发症。7例患者（7.8％）在手口部位发生了术后切口疝。超重患者（BMI≥25）的切口疝发生率明显较高（p=0.04），在同时进行肝和结肠切除的情况下（p=0.02）。在单变量和多变量分析中，同时进行肝和结肠切除术（分别为p=0.004和0.03），血小板与淋巴细胞比值≤200(p=0.03,0.04)均为术后切口疝的独立危险因素.(4)结论:肝、结肠同时切除,血小板与淋巴细胞比值≤200是手助腹腔镜结直肠肝转移术后切口疝的独立危险因素。
