THE CONCEPT OF A MATHEMATICAL MODEL FOR PREDICTING THE RISK OF TROCAR HERNIAS AFTER LAPAROSCOPIC CHOLECYSTECTOMY
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i4.15029Keywords:
trocar site hernia, mathematical prediction model, laparoscopic cholecystectomyAbstract
SUMMARY. Postoperative trocar hernia is a complication after laparoscopic surgery. The prevalence of laparoscopic surgery is constantly increasing in modern surgical practice, therefore, it is important to study specific complications after such surgical interventions.
The aim – to develop a mathematical model to predict the risk of trocar hernia after laparoscopic cholecystectomy.
Material and Methods. A retrospective study of medical records of 50 patients who were operated on for the diagnosis of trocar hernia. In general, anatomical local and systemic determinants of the occurrence of this disease were assessed. Multivariate regression analysis was used, to assess the quality of the regression model, the histogram of residual deviations and their normal probability plot were analyzed, and to assess the goodness of fit of the model as a whole, ANOVA analysis was performed.
Results. Significant factors that influence the risk of developing trocar hernia were identified: age, gender, postoperative complications after cholecystectomy, body mass index (BMI), cardiovascular disease, diabetes mellitus, gastrointestinal disease, connective tissue dysplasia, planned/urgent laparoscopic cholecystectomy, morphological form of cholecystitis catarrhal/destructive, repeated surgical interventions in the anamnesis, access used for cholecystectomy. According to the results of the analysis, it was found that the mathematical model for determining the risk factor for developing trocar hernias included 6 most significant factors: postoperative complications after cholecystectomy, body mass index (BMI), connective tissue dysplasia, planned/urgent laparoscopic cholecystectomy, repeated surgical interventions in the anamnesis, access used for cholecystectomy. Using ANOVA analysis, it can be concluded that the model for predicting the risk of trocar hernias in general has a high level of acceptability, since the significance level is p<0.001, and the model itself will work better than a simple prediction using average values.
Conclusions. This mathematical model should be used to assess the risk of trocar hernias.
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