Research on the correlation between visceral fat area and postoperative incisional hernia of colorectal cancer based on the propensity score matching method

doi:10.3877/cma.j.issn.1674-392X.2026.04.005

Abstract

Abstract:

Objective

To explore the correlation between visceral fat area(VFA) and the occurrence of incisional hernia after colorectal cancer surgery.

Methods

A retrospective analysis was conducted on the clinical data of 246 patients who underwent laparoscopic radical resection for colorectal cancer in the Sixth Affiliated Hospital of Sun Yat-sen University in 2020. Patients were divided into groups according to the occurrence of incisional hernia, and multivariate analysis was performed to identify the risk factors for incisional hernia. According to VFA, patients were classified into the high-fat group (VFA≥130 cm²) and the low-fat group (VFA<130 cm²). Propensity score matching (PSM) method was adopted with a 1:1 matching ratio, using seven indicators including age, gender, body mass index, preoperative neoadjuvant chemotherapy, postoperative surgical site infection, diabetes mellitus, and cardiovascular disease as covariates, and the matching tolerance was set at 0.02. Eventually, 49 pairs of patients were successfully matched, and the incidence of incisional hernia was compared between the two groups.

Results

Multivariate analysis showed that incision infection (OR=15.807, 95% CI 3.372-74.095, P<0.001) and VFA≥130 cm² (OR=2.487, 95% CI 1.249-4.951, P=0.010) were independent risk factors for incisional hernia. After PSM, the baseline data of the two groups were balanced and comparable (P>0.05). The incidence of incisional hernia in the high-fat group (46.9%) was significantly higher than that in the low-fat group (22.4%), with a statistically significant difference (OR=3.06, P=0.01).

Conclusion

VFA≥ 130 cm² is an important risk factor for incisional hernia after colorectal cancer surgery. Prophylactic mesh placement may reduce the risk of incisional hernia in such patients.

Key words: Incisional hernia, Colorectal cancer, Visceral fat area, Propensity score matching

Jialin Chen, Shaohui Yu, Ruchun Li, Taicheng Zhou. Research on the correlation between visceral fat area and postoperative incisional hernia of colorectal cancer based on the propensity score matching method[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2026, 20(04): 379-385.

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References 26

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观察指标	切口疝组(n=82)	非切口疝组(n=164)	t/χ²值	P值
年龄(岁,±s)	63.94±6.907	63.71±6.802	0.249	0.803
性别[例(%)]			1.185	0.276
男性	50(61.0)	88(53.7)
女性	32(39.0)	76(46.3)
体重指数(kg/m²,±s)	25.17±3.92	23.30±2.80	4.417	<0.001
肿瘤分期[例(%)]			4.686	0.096
Ⅰ期	17(20.7)	26(15.9)
Ⅱ期	31(37.8)	86(52.4)
Ⅲ期	34(41.5)	52(31.7)
术前化学治疗[例(%)]	7(8.5)	36(22.0)	6.831	0.009
肠造口[例(%)]	21(25.6)	32(19.5)	1.204	0.273
切口感染[例(%)]	17(20.7)	2(1.2)	28.143	<0.001
糖尿病[例(%)]	19(23.2)	20(12.2)	4.973	0.026
心血管疾病[例(%)]	26(31.7)	38(23.2)	2.071	0.150
内脏脂肪面积≥130 cm²[例(%)]	56(68.3)	62(37.8)	19.734	<0.001

观察指标	切口疝组(n=82)	非切口疝组(n=164)	t/χ²值	P值
年龄(岁,±s)	63.94±6.907	63.71±6.802	0.249	0.803
性别[例(%)]			1.185	0.276
男性	50(61.0)	88(53.7)
女性	32(39.0)	76(46.3)
体重指数(kg/m²,±s)	25.17±3.92	23.30±2.80	4.417	<0.001
肿瘤分期[例(%)]			4.686	0.096
Ⅰ期	17(20.7)	26(15.9)
Ⅱ期	31(37.8)	86(52.4)
Ⅲ期	34(41.5)	52(31.7)
术前化学治疗[例(%)]	7(8.5)	36(22.0)	6.831	0.009
肠造口[例(%)]	21(25.6)	32(19.5)	1.204	0.273
切口感染[例(%)]	17(20.7)	2(1.2)	28.143	<0.001
糖尿病[例(%)]	19(23.2)	20(12.2)	4.973	0.026
心血管疾病[例(%)]	26(31.7)	38(23.2)	2.071	0.150
内脏脂肪面积≥130 cm²[例(%)]	56(68.3)	62(37.8)	19.734	<0.001

危险因素	P值	OR	95% CI
体重指数	0.158	1.081	0.970~1.205
术前化学治疗	0.038	0.337	0.121~0.942
切口感染	<0.001	15.807	3.372~74.095
糖尿病	0.059	2.167	0.971~4.838
内脏脂肪面积≥130 cm²	0.010	2.487	1.249~4.951

危险因素	P值	OR	95% CI
体重指数	0.158	1.081	0.970~1.205
术前化学治疗	0.038	0.337	0.121~0.942
切口感染	<0.001	15.807	3.372~74.095
糖尿病	0.059	2.167	0.971~4.838
内脏脂肪面积≥130 cm²	0.010	2.487	1.249~4.951

组别	例数	内脏脂肪面积(cm²,±s)	切口疝[例(%)]
高脂肪组	118	180.81±43.63	56(47.5)
低脂肪组	128	88.69±31.05	26(20.3)
t/χ²值		19.19	20.36
P值		<0.001	<0.001

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