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World Journal of Surgery

, Volume 38, Issue 9, pp 2233–2240 | Cite as

Laparoscopic Versus Open Incisional and Ventral Hernia Repair: A Systematic Review and Meta-analysis

  • Yanyan Zhang
  • Haiyang ZhouEmail author
  • Yunsheng Chai
  • Can Cao
  • Kaizhou Jin
  • Zhiqian HuEmail author
Article

Abstract

Background

Laparoscopic incisional and ventral hernia repair (LIVHR) is an alternative approach to conventional open incisional and ventral hernia repair (OIVHR). A consensus on outcomes of LIVHR when compared with OIVHR has not been reached.

Methods

As the basis for the present study, we performed a systematic review and meta-analysis of all randomized controlled trials comparing LIVHR and OIVHR.

Results

Eleven studies involving 1,003 patients were enrolled. The incidences of wound infection were significantly lower in the laparoscopic group than that in the open group (laparoscopic group 2.8 %, open group 16.2 %; RR = 0.19, 95 % CI 0.11–0.32; P < 0.00001). The rates of wound drainage were significantly lower in the laparoscopic group than that in the open group (laparoscopic group 2.6 %, open group 67.0 %; RR = 0.06, 95 % CI 0.03–0.09; P < 0.00001). However, the rates of bowel injury were significantly higher in the laparoscopic group than in the open group (laparoscopic group 4.3 %, open group 0.81 %; RR = 3.68, 95 % CI 1.56–8.67; P = 0.003). There were no significant differences between the two groups in the incidences of hernia recurrence, postoperative seroma, hematoma, bowel obstruction, bleeding, and reoperation. Descriptive analyses showed a shorter length of hospital stay in the laparoscopic group.

Conclusions

Laparoscopic incisional and ventral hernia repair is a feasible and effective alternative to the open technique. It is associated with lower incidences of wound infection and shorter length of hospital stay. However, caution is required because it is associated with an increased risk of bowel injury compared with the open technique. Given the relatively short follow-up duration of trials included in the systematic review, trials with long-term follow-up are needed to compare the durability of laparoscopic and open repair.

Keywords

Risk Ratio Open Group Ventral Hernia Laparoscopic Group Open Repair 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This work was supported by the National Natural Science Foundation of China (No. 31100681), Shanghai Nanotechnology Program (No. 11nm0504800), Shanghai Basic Research Program (No. 12JC1411402), and Shanghai Rising Star Program (No. 11CG42).

Conflict of interest

Yanyan Zhang, Haiyang Zhou, Yunsheng Chai, Can Cao, Kaizhou Jin, and Zhiqian Hu have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71PubMedCrossRefGoogle Scholar
  2. 2.
    Manninen MJ, Lavonius M, Perhoniemi VJ et al (1991) Results of incisional hernia repair: a retrospective study of 172 unselected hernioplasties. Eur J Surg 157:29–31PubMedGoogle Scholar
  3. 3.
    Anthony T, Bergen PC, Kim LT (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24:95–101PubMedCrossRefGoogle Scholar
  4. 4.
    Luijendijk RW, Hop WC, van den Tol MP (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398PubMedCrossRefGoogle Scholar
  5. 5.
    van der Linden FT, van Vroonhoven TJ (1988) Long term results after surgical correction of incisional hernia. Neth J Surg 40:127–129PubMedGoogle Scholar
  6. 6.
    Liakakos T, Karanikas I, Panagiotidis H (1994) Use of Marlex mesh in the repair of recurrent incisional hernia. Br J Surg 81:248–249PubMedCrossRefGoogle Scholar
  7. 7.
    Toniato A, Pagetta C, Bernante P (2002) Incisional hernia treatment with progressive pneumoperitoneum and retromuscular prosthetic hernioplasty. Lagenbecks Arch Surg 387:246–248CrossRefGoogle Scholar
  8. 8.
    LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMedGoogle Scholar
  9. 9.
    Moreau PE, Helmy N, Vons C (2012) Laparoscopic treatment of incisional hernia. State of the art in 2012. J Visc Surg 149(5 Suppl):e40–e48PubMedCrossRefGoogle Scholar
  10. 10.
    Turner PL, Park AE (2008) Laparoscopic repair of ventral incisional hernias: pros and cons. Surg Clin North Am 88:85–100PubMedCrossRefGoogle Scholar
  11. 11.
    Moher D, Jadad AR, Tugwell P (1996) Assessing the quality of randomized controlled trials. Current issues and future directions. Int J Technol Assess Health Care 12:195–208PubMedCrossRefGoogle Scholar
  12. 12.
    Egger M, Davey Smith G, Schneider M et al (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Rogmark P, Petersson U, Bringman S et al (2013) Short-term outcomes for open and laparoscopic midline incisional hernia repair: a randomized multicenter controlled trial: the ProLOVE (prospective randomized trial on open versus laparoscopic operation of ventral eventrations) trial. Ann Surg 258:37–45PubMedCrossRefGoogle Scholar
  14. 14.
    Asencio F, Aguilo J, Peiro S et al (2009) Open randomized clinical trial of laparoscopic versus open incisional hernia repair. Surg Endosc 23:1441–1448PubMedCrossRefGoogle Scholar
  15. 15.
    Eker HH, Hansson BM, Buunen M et al (2013) Laparoscopic vs. open incisional hernia repair: a randomized clinical trial. JAMA Surg 148:259–263PubMedCrossRefGoogle Scholar
  16. 16.
    Itani KM, Hur K, Kim LT et al (2010) Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg 145:322–328PubMedCrossRefGoogle Scholar
  17. 17.
    Barbaros U, Asoglu O, Seven R et al (2007) The comparison of laparoscopic and open ventral hernia repairs: a prospective randomized study. Hernia 11:51–56PubMedCrossRefGoogle Scholar
  18. 18.
    Olmi S, Scaini A, Cesana GC et al (2007) Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc 21:555–559PubMedCrossRefGoogle Scholar
  19. 19.
    Carbajo MA, Martin del Olmo JC, Blanco JI et al (1999) Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13:250–252PubMedCrossRefGoogle Scholar
  20. 20.
    Moreno-Egea A, Carrasco L, Girela E et al (2002) Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. Arch Surg 137:1266–1268PubMedCrossRefGoogle Scholar
  21. 21.
    Navarra G, Musolino C, De Marco ML et al (2007) Retromuscular sutured incisional hernia repair: a randomized controlled trial to compare open and laparoscopic approach. Surg Laparosc Endosc Percutan Tech 17:86–90PubMedCrossRefGoogle Scholar
  22. 22.
    Misra MC, Bansal VK, Kulkarni MP et al (2006) Comparison of laparoscopic and open repair of incisional and primary ventral hernia: results of a prospective randomized study. Surg Endosc 20:1839–1845PubMedCrossRefGoogle Scholar
  23. 23.
    Pring CM, Tran V, O’Rourke N et al (2008) Laparoscopic versus open ventral hernia repair: a randomized controlled trial. ANZ J Surg 78:903–906PubMedCrossRefGoogle Scholar
  24. 24.
    Perrone JM, Soper NJ, Eagon JC et al (2005) Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery 138:708–715PubMedCrossRefGoogle Scholar
  25. 25.
    Rudmik LR, Schieman C, Dixon E et al (2006) Laparoscopic incisional hernia repair: a review of the literature. Hernia 10:110–119PubMedCrossRefGoogle Scholar
  26. 26.
    Gurusamy KS, Allen VB, Samraj K (2012) Wound drains after incisional hernia repair. Cochrane Database Syst Rev 2:CD005570PubMedGoogle Scholar
  27. 27.
    Pierce RA, Spitler JA, Frisella MM et al (2007) Pooled data analysis of laparoscopic vs. open ventral hernia repair: 14 years of patient data accrual. Surg Endosc 21:378–386PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  1. 1.Department of General Surgery, Changzheng HospitalSecond Military Medical UniversityShanghaiPeople’s Republic of China
  2. 2.State Key Laboratory of Molecular Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological SciencesChinese Academy of SciencesShanghaiPeople’s Republic of China

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