Laurens Schattenkerk

127 Incisional hernia after surgical correction of abdominal congenital anomalies in infants Chapter 5 Introduction Incisional hernia (IH) is a dreaded complication after abdominal surgery in children. It may result in serious life-threatening complications, including incarceration and bowel strangulation [313, 314]. In addition, it is is a burden on the quality of life and may affect the development of the child [315, 316]. The incidence and risk factors of IH in neonates are scarcely reported and therefore surgeons often refer to studies done in the adult population. For obvious reasons though, taking measures to prevent smoking and obesity in the infantile cohort would not aid in lowering IH rate [317]. The studies that do report IH in the paediatric population reported an incidence between 0.7 and 3.2% [16, 17, 318, 319]. During the last decades major advancements have been made in the postnatal care of neonates with congenital anomalies. Those developments, such as extracorporeal membrane oxygenation (ECMO) and total parenteral nutrition, have increased survival of this crucial period [320]. Because more neonates survive, there has been an increase in abdominal paediatric surgery procedures [320, 321]. As the total numbers of abdominal procedures rises, an increase in total accounts of IH is also to be expected. IH correction may require extensive surgery and a long recovery program. Identifying infants and birth defects at risk, may lead to a different approach during the primary surgery. Therefore, the aim of this review is to estimate the incidence of incisional hernia following surgery for congenital anomalies in infants (less than two years of age) with a systematic review. Methods Studies were selected according to the criteria outlined below based on the PRISMA Guidelines [31]. Our protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 7 March 2019 (registration number: CRD42019119268). Participants All studies reporting on IH after surgical correction of abdominal congenital anomalies in infants were considered for this review. Studies reporting on other complications, animal studies, in vitro studies, non-English, conference abstracts and studies with less than ten cases were excluded.

RkJQdWJsaXNoZXIy MTk4NDMw