{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:32:55Z","timestamp":1760059975852,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Postoperative ventral hernia (POVH) remains a significant complication following laparoscopic colectomy despite minimally invasive approaches. Extraction site selection may influence POVH incidence, yet optimal location remains controversial. Methods: This retrospective cohort study analyzed 550 patients undergoing elective laparoscopic right colectomy (2009\u20132024) at a single center. After exclusions for anastomotic leak and loss to follow-up, 266 patients were propensity-matched 1:1 comparing paramedian (n = 133) versus midline (n = 133) extraction sites. The primary outcome was POVH incidence at 36 months. Secondary outcomes included risk factor identification using multivariate logistic regression and Firth penalized methods. Results: POVH occurred in 3\/133 (2.3%) paramedian versus 15\/133 (11.3%) midline patients (p = 0.007). Multivariate analysis identified midline extraction (aOR 30.3, 95% CI: 3.34\u2013969, p &lt; 0.001), chronic cough (aOR 25.6, 95% CI: 3.56\u2013287, p = 0.001), and constipation (aOR 10.1, 95% CI: 1.60\u201370.7, p = 0.015) as independent POVH predictors. Patient comorbidities showed stronger associations than surgical factors in univariate analysis. The number needed to treat with paramedian extraction to prevent one POVH was 11.1. Conclusions: Paramedian extraction sites significantly reduce POVH incidence compared to midline approaches in laparoscopic right colectomy. The identification of modifiable physiological risk factors, particularly conditions causing increased intra-abdominal pressure (chronic cough, constipation), suggests that comprehensive perioperative optimization targeting these specific factors may further reduce POVH risk.<\/jats:p>","DOI":"10.3390\/jcm14155198","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T15:00:42Z","timestamp":1753196442000},"page":"5198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Paramedian Versus Midline Extraction Sites in Elective Laparoscopic Right Colectomy: A Propensity-Matched Study of Postoperative Ventral Hernia Development"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9754-5028","authenticated-orcid":false,"given":"Fahim","family":"Kanani","sequence":"first","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naheel","family":"Mahajna","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wasim","family":"Shaqqur","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasiia","family":"Iserlis","sequence":"additional","affiliation":[{"name":"Hospital Management, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaled","family":"Alnakib","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mordechai","family":"Shimonov","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1599-2618","authenticated-orcid":false,"given":"Amir","family":"Nutman","sequence":"additional","affiliation":[{"name":"Hospital Management, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Zahalka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-9583","authenticated-orcid":false,"given":"Nir","family":"Messer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arkadiy","family":"Iskhakov","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moshe","family":"Kamar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8550-9695","authenticated-orcid":false,"given":"Katia","family":"Dayan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wolfson Medical Center, Holon 58100, Israel, affiliated with the Gray Faculty of Medicine and Science, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.ctrv.2008.03.011","article-title":"Long-term outcome of laparoscopic surgery for 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