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Open versus laparoscopic umbilical and epigastric hernia repair: nationwide data on short- and long-term outcomes

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Abstract

Background

It is unclear whether an open or laparoscopic approach results in the best outcomes for repair of umbilical and epigastric hernias. The aim of the study was to evaluate the rates of 90-day readmission and reoperation for complication, together with rate of operation for recurrence after either open or laparoscopic mesh repair for primary umbilical or epigastric hernias with defect widths above 1 cm.

Methods

A merge of data between the Danish Hernia Database and the National Patient Registry provided data from 2007 to 2018 on perioperative information, 90-day readmission, 90-day reoperation for complication, and long-term operation for hernia recurrence.

Results

A total of 6855 patients were included, of whom 4106 (59.9%) and 2749 (40.1%) patients had an open or laparoscopic repair, respectively. There were significantly more patients readmitted with a superficial surgical site infection 2.5% (102/4106) after open repair compared with laparoscopic repair (0.5% (15/2749), P < 0.001. The 90-day reoperation rate for complications was significantly higher for open repairs 5.0% (205/4106) compared with laparoscopic repairs 2.7% (75/2749), P < 0.001. The incidence of a reoperation for a severe condition was significantly increased after laparoscopic repair 1.5% (41/2749) compared with open repair 0.8% (34/4106), P = 0.010. The 4-year cumulative incidence of operation for hernia recurrence was 3.5% after open and 4.2% after laparoscopic repairs, P = 0.302.

Conclusions

Recurrence rates were comparable between open and laparoscopic repair of umbilical and epigastric hernias. Open repair was associated with a significantly higher rate of readmission and reoperation due to surgical site infection, whereas the rate of reoperation due to a severe complication was significantly higher after laparoscopic repair.

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Funding

The study was funded by the Danish Hernia Database.

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Authors and Affiliations

  1. Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark

    N. A. Henriksen & F. Helgstrand

  2. Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark

    L. N. Jorgensen

  3. Department of Surgery, Horsens Regional Hospital, University of Aarhus, Horsens, Denmark

    H. Friis-Andersen

Authors
  1. N. A. Henriksen
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  2. L. N. Jorgensen
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  3. H. Friis-Andersen
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  4. F. Helgstrand
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the Danish Hernia Database

Corresponding author

Correspondence to N. A. Henriksen.

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Disclosures

Drs. N.A. Henriksen, L.N. Jorgensen, H. Friis-Andersen and F. Helgstrand are all members of the Danish Hernia Database Steering Committee. Dr. L.N. Jorgensen has conducted educational activities for BARD/BD and Medtronic. Dr. H. Friis-Andersen has received financial research support from Medtronic (Sofradim, Trevoux, France). Dr. F. Helgstrand has received funding for Copenhagen Hernia Day Symposium from BARD/BD, Medtronic, Intuitive Surgical, Olympus, Baxter, Ethicon, Stryker, B Braun, Vicare Medical, Gore, Cook Biotech, Kebomed, Sarcomed, Applied Medicine. Dr. N.A. Henriksen has no conflicts of interest or financial ties to disclose.

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Henriksen, N.A., Jorgensen, L.N., Friis-Andersen, H. et al. Open versus laparoscopic umbilical and epigastric hernia repair: nationwide data on short- and long-term outcomes. Surg Endosc 36, 526–532 (2022). https://doi.org/10.1007/s00464-021-08312-5

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  • DOI: https://doi.org/10.1007/s00464-021-08312-5

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