切口疝 (IH) 会导致患者显着发病，并给医疗保健系统带来经济负担。我们的目的是确定远端胰腺切除术 (DP) 患者 IH 的发生率，并按标本提取部位进行分层。对手术方法不知情的放射科医生对我们机构 2016 年至 2021 年 DP 患者的影像学进行了审查。标本提取部位分为上中线/脐 (UM) 与 Pfannenstiel。 IH 被定义为术后影像学上的筋膜缺损。排除术前和术后未进行影像学检查的患者。 在符合我们选择标准的 219 名患者中，中位年龄为 64 岁，54% 为女性，64% 为白人。大多数是微创 (MIS) 手术（n = 131，60%），其中 52%（n = 64）采用 UM 切口进行标本提取，包括 45 例手辅助手术和 19 例纯腹腔镜手术。采用 Pfannenstiel 切口进行标本提取的 MIS 率为 48% (n = 58)，其中包括 44 例机器人手术和 14 例纯腹腔镜手术。平均随访时间为 16.3 个月（标准差 [SD] 20.8）。 UM 切口 MIS 手术的随访时间为 16.6 个月 (SD 21.8)，而 Pfannenstiel 组为 15.5 个月 (SD 18.6) (p = 0.30)。与采用 Pfannenstiel 提取部位的 MIS 手术相比，采用 UM 切口进行标本提取的 MIS 手术发生 IH 的几率增加了 17.8 倍 (p = 0.01)。每个月随访，发生 IH 的总体几率增加 4%（比值比 1.04；p < 0.001）。如果可行，在纯粹腹腔镜或机器人远端胰腺切除术的情况下，应进行 Pfannenstiel 切口以提取标本。 © 2024。肿瘤外科学会。

Incisional hernia (IH) results in significant morbidity to patients and financial burden to healthcare systems. We aimed to determine the incidence of IH in distal pancreatectomy (DP) patients, stratified by specimen extraction sites.Imaging in DP patients in our institution from 2016 to 2021 were reviewed by radiologists blinded to the operative approach. Specimen extraction sites were stratified as upper midline/umbilical (UM) versus Pfannenstiel. IH was defined as fascial defect on postoperative imaging. Patients without preoperative and postoperative imaging were excluded.Of the 219 patients who met our selection criteria, the median age was 64 years, 54% were female, and 64% were White. The majority were minimally invasive (MIS) procedures (n = 131, 60%), of which 52% (n = 64) had a UM incision for specimen extraction, including 45 hand-assist and 19 purely laparoscopic procedures. MIS with Pfannenstiel incisions for specimen extraction was 48% (n = 58), including 44 robotic and 14 purely laparoscopic procedures. Mean follow-up time was 16.3 months (standard deviation [SD] 20.8). Follow-up for MIS procedures with UM incisions was 16.6 months (SD 21.8) versus 15.5 months (SD 18.6) in the Pfannenstiel group (p = 0.30). MIS procedures with UM incisions for specimen extraction had a 17.8 times increase in odds of developing an IH compared with MIS procedures with Pfannenstiel extraction sites (p = 0.01). The overall odds of developing an IH increased by 4% for every month of follow-up (odds ratio 1.04; p < 0.001).A Pfannenstiel incision should be performed for specimen extraction in cases with purely laparoscopic or robotic distal pancreatectomy, when feasible.© 2024. Society of Surgical Oncology.