Occurrence of abdominal bulging and hernia after open partial nephrectomy: a retrospective cohort study

Figures & data

Table 1. Rates of clinical and radiological bulging and hernia at each follow-up.

	3 Months	12 Months	24 Months
Clinical follow-up	165	106	75
Bulging	38 (23.0)	11 (11.1)	2 (2.7)
Hernia	1 (0.6)	3 (2.8)	3 (4.0)
No. of follow-up visits attended
One (n = 69)	62	7	0
Two (n = 41)	38	34	10
Three (n = 65)	65	65	65
Radiological follow-up	117	128	105
No bulge	67	81	64
Slight bulging	27	20^c	18
Moderate bulging	9	12	10
Severe bulging	4^b	3^c	3
Bulging total	40 (34.2)	35 (27.3)	31 (29.5)
Hernia	3^b (2.6)	9^c (7.0)	5 (4.8)
Could not be assessed^a	8	5	5

Data are shown as n or n (%).

^a Image where presence of bulge or hernia could not be assessed; ^bone patient with both hernia and bulge; ^ctwo patients with both hernia and bulge.

Table 2. Demographics and differences between hospitals.

	Overall	NUS	SHH	p
n	184	158	26
Male	119 (64.7)	104 (65.8)	15 (57.7)	0.42
Right-sided surgery	95 (51.6)	83 (52.5)	12 (46.2)	0.55
Age (years)	64.7 (63.0–66.4)	65.3 (63.5–67.0)	61.1 (55.9–66.3)	0.12
BMI (kg/m^2)	27.6 (26.9–28.3)	27.7 (26.9–28.5)	26.9 (25.1–28.7)	0.38
Malignant tumour	137 (74.5)	120 (76.0)	17 (65.4)	0.25
Clinical follow-up	167 (90.1)	141 (89.2)	26 (100)	0.08
Clinical bulge	20 (10.9)	17 (10.8)	3 (12.0)	0.95
Radiological follow-up	158 (85.9)	137 (86.7)	21 (80.1)	0.38
Radiological bulge	35 (22.2)	28 (20.4)	7 (33.3)	0.10
Radiological hernia	10 (6.3)	7 (5.2)	3 (11.5)	0.09

Data are shown as n, n (%) or mean (95% confidence interval).

NUS: Umea University Hospital; SHH: Sundsvall-Härnösand Regional Hospital; BMI: body mass index.

Table 3. Comparison of patients with persistent clinical bulge versus patients without clinical bulge or hernia.

	No clinical bulge or hernia (n = 142)	Persistent clinical bulge (n = 20)	p
Male	93 (65.5)	11 (55.0)	0.36
Right-sided surgery	73 (51.4)	10 (50.0)	0.91
Age (years)	66 (57–74)	70 (60–75)	0.35
BMI (kg/m^2)	26 (24–29)	27 (25–31)	0.17
Malignant tumour	111 (78.2)	11 (55.0)	0.02
Duration of surgery (min)	154 (120–197)	178 (126–225)	0.36
Blood loss during surgery (ml)	200 (100–400)	350 (200–500)	0.05
Postoperative care (days)	6 (4–8)	6 (5–7)	0.67
Plasma albumin (g/dl)	43 (41–45)	43 (42–46)	0.17
ESR (mm/h)	13 (6–20)	8 (4.5–16.5)	0.15
β-Haemoglobin (g/l)	139 (126–147)	143.5 (134.5–151.5)	0.17

Data are shown as n (%) or median (interquartile range).

BMI: body mass index; ESR: erythrocyte sedimentation rate.

Table 4. Comparison of patients with persistent radiological bulge versus patients without radiological bulge or hernia.

	No radiological bulge or hernia (n = 113)	Persistent radiological bulge (n = 35)	p
Male	74 (65.5)	22 (62.9)	0.78
Right-sided surgery	58 (51.3)	22 (62.9)	0.23
Age (years)	66.3 (57.7–73-0)	65.4 (59.6–72.4)	0.96
BMI (kg/m^2)	26 (24–29)	27 (25–31)	0.13
Malignant tumour	94 (83.2)	30 (85.7)	0.72
Duration of surgery (min)	162 (120–197)	160 (124–212)	0.64
Blood loss during surgery (ml)	200 (100–500)	300 (100–850)	0.38
Postoperative care (days)	6 (4–7)	6 (4–9)	0.66
Plasma albumin (g/dl)	43 (41–45)	43 (42–44)	0.66
ESR (mm/h)	11 (6–23)	13 (6–18)	0.88
β-Haemoglobin (g/l)	140 (127–147)	141 (128–147)	0.86

Data are shown as n (%) or median (interquartile range).

BMI: body mass index; ESR: erythrocyte sedimentation rate.

Table 5. Degree of bulge on last reviewed radiological image versus occurrence of bulge at last clinical follow-up.

	Radiological images
	No bulge	Slight bulging	Moderate bulging	Severe bulging
No clinical bulge	85	19	7	3
Clinical bulge	9	1	2	1

Table 6. Distribution of patients according to method of diagnosing the bulge.^a

	Clinical evaluation
CT	No bulge	Bulge	Unknown	Total
No bulge	90	10	13	113
Bulge	27	4	4	35
Unknown	21	5	0	26
Total	138	19	17	174

^a Patients with hernia (n = 10) excluded.

CT: computed tomography.