Subxiphoid incisional hernias post median sternotomy: A literature review.

BACKGROUND Subxiphoid incisional hernias are one of the complications following a median sternotomy, a surgical procedure to provide access to the mediastinum. Incidence has been reported between 1% and 4%, although the true incidence is not well known due to its asymptomatic nature. METHOD A comprehensive search was performed on multiple sites. Keywords included "incisional hernia OR Subxiphoid hernia" AND "Median sternotomy OR Cardiac Surgery OR Coronary artery bypass graft OR Transplant OR Valve replacement". Articles up to August 1, 2020, were included in this study. RESULTS Eight articles were included in the study, with a total number of 132 patients identified. The incidence ranged from 0.81% to 3.44%. There was a mixture of repair methods and follow-up period reported. Recurrence post repair ranged from 10% to 43%. CONCLUSION Subxiphoid incisional hernias remain challenging to manage. We have discussed the incidence, risk factors, preventions, and management of subxiphoid incisional hernias including both the open and laparoscopic techniques.