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Outcomes Following Laparoscopic Versus Open Repair of Incisional Hernia

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Abstract

Aim

The purpose of this study was to compare short- and long-term outcomes for patients undergoing laparoscopic or open surgery for incisional hernia repair using meta-analytical techniques.

Methods

A literature search was performed to identify comparative studies reporting outcomes on laparoscopic versus open surgery for incisional hernia repair. A random-effect meta-analytical model was used and subgroup analysis performed on high-quality studies, those reporting on more than 30 patients, and those published since 2000.

Results

Five studies, with a total of 351 patients, satisfied the inclusion criteria. Laparoscopic surgery was attempted in 148 (42.2%) patients. Overall, in the laparoscopic group, operative time was significantly longer—by 12.0 minutes (P = 0.03) and length of stay reduced by 3.3 days (P < 0.003) although this finding was associated with significant heterogeneity between studies (P < 0.001). There was no difference in the short-term adverse events between the groups, but there were fewer wound infections for laparoscopic patients in high-quality studies [odds ratio (OR) = 0.22, 95% confidence interval (CI): 0.05, 0.85, P = 0.03] and those reporting on more than 30 patients (OR = 0.19, 95% CI: 0.04, 0.84, P = 0.03). No difference in hernia recurrence was shown in the overall or subgroup analysis.

Conclusions

Laparoscopic incisional hernia repair was associated with a reduced length of stay and lower wound infection rate. The impact on post-operative quality of life and financial implications needs further prospective, validated evaluation.

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Authors and Affiliations

  1. Department of Biosurgery and Surgical Technology, Imperial College London, St. Mary’s Hospital, London, UK

    Parvinder S. Sains MRCS, Henry S. Tilney MRCS, Sanjay Purkayastha MRCS, Ara W. Darzi KBE, FRCS, Thanos Athanasiou PhD, FECTS, Paris P. Tekkis MD, FRCS & Alexander G. Heriot MD, FRCS

  2. Department of Surgical Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, Melbourne, Australia

    Alexander G. Heriot MD, FRCS

Authors
  1. Parvinder S. Sains MRCS
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  2. Henry S. Tilney MRCS
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  3. Sanjay Purkayastha MRCS
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  4. Ara W. Darzi KBE, FRCS
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  5. Thanos Athanasiou PhD, FECTS
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  6. Paris P. Tekkis MD, FRCS
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  7. Alexander G. Heriot MD, FRCS
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Correspondence to Alexander G. Heriot MD, FRCS.

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Sains, P.S., Tilney, H.S., Purkayastha, S. et al. Outcomes Following Laparoscopic Versus Open Repair of Incisional Hernia. World J. Surg. 30, 2056–2064 (2006). https://doi.org/10.1007/s00268-006-0026-4

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  • DOI: https://doi.org/10.1007/s00268-006-0026-4

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