ArticleHernia : the journal of hernias and abdominal wall surgery2017
Rectus abdominis atrophy after ventral abdominal incisions: midline versus chevron.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 20 citations in OpenAlex.
- Linking factors to incisional hernia following pancreatic surgery: a 14-year retrospective analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Observational
- Enhanced Recovery after Surgery in Open Fetal Spina Bifida Repair.Fetal diagnosis and therapy · 2024Article
- Hernia Active Living Trial (HALT): a feasibility study of a physical activity intervention for people with a bowel stoma who have a parastomal hernia/bulge.Pilot and feasibility studies · 2023Article
- Incisions in Hepatobiliopancreatic Surgery: Surgical Anatomy and its Influence to Open and Close the Abdomen.Journal of abdominal wall surgery : JAWS · 2023Review
- Abdominal wall sonography: a pictorial review.Journal of ultrasound · 2020Review
- Long term outcomes of abdominal wall reconstruction using open component separation and biologic mesh in the liver, kidney, and small bowel transplant population.Hernia : the journal of hernias and abdominal wall surgery · 2020Article
- Rectus abdominis muscle atrophy after thoracotomy.Yeungnam University journal of medicine · 2020Article
- HALT (Hernia Active Living Trial): protocol for a feasibility study of a randomised controlled trial of a physical activity intervention to improve quality of life in people with bowel stoma with a bulge/parastomal hernia.Pilot and feasibility studies · 2020Article
- Comment to: Rectus abdominis atrophy after ventral abdominal incisions: midline versus chevron by Vigneswaran et al.Hernia : the journal of hernias and abdominal wall surgery · 2017Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAlthough many outcomes have been compared between a midline and chevron incision, this is the first study to examine rectus abdominis atrophy after these two types of incisions.
methodsPatients undergoing open pancreaticobiliary surgery between 2007 and 2011 at our single institution were included in this study. Rectus abdominis muscle thickness was measured on both preoperative and follow-up computed tomography (CT) scans to calculate percent atrophy of the muscle after surgery.
resultsAt average follow-up of 24.5 and 19.0 months, respectively, rectus abdominis atrophy was 18.9% greater in the chevron (n = 30) than in the midline (n = 180) group (21.8 vs. 2.9%, p < 0.0001). Half the patients with a chevron incision had >20% atrophy at follow-up compared with 10% with a midline incision [odds ratio (OR) 9.0, p < 0.0001]. No significant difference was observed in incisional hernia rates or wound infections between groups.
conclusionIn this study, chevron incisions resulted in seven times more atrophy of the rectus abdominis compared with midline incisions. The long-term effects of transecting the rectus abdominis and disrupting its innervation creates challenging abdominal wall pathology. Atrophy of the abdominal wall can not be readily fixed with an operation, and this significant side effect of a transverse incision should be factored into the surgeon's decision-making process when choosing a transverse over a midline incision.
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