Laparoscopic Treatment of Incisional and Ventral Hernia.
Abdominal Wall
/ surgery
Adult
Aged
Hernia, Ventral
/ surgery
Herniorrhaphy
/ adverse effects
Humans
Incisional Hernia
/ surgery
Laparoscopy
/ adverse effects
Length of Stay
Male
Middle Aged
Operative Time
Postoperative Complications
/ epidemiology
Postoperative Period
Recurrence
Retrospective Studies
Surgical Mesh
Fixing devices
Incisional Hernia
Laparoscopy
Mesh
Ventral hernia
Journal
JSLS : Journal of the Society of Laparoendoscopic Surgeons
ISSN: 1938-3797
Titre abrégé: JSLS
Pays: United States
ID NLM: 100884618
Informations de publication
Date de publication:
Historique:
entrez:
12
7
2021
pubmed:
13
7
2021
medline:
24
7
2021
Statut:
ppublish
Résumé
Although several large studies regarding patients undergoing minimally invasive repair of incisional hernia are currently available, the results are not particularly reliable as they are based on heterogeneous groups, different surgical techniques, different mesh types, or with a too short follow period. We conducted a retrospective observational trial, collecting data from patients who underwent laparoscopic repair of a primary abdominal wall or an incisional hernia using the laparoscopic Intraperitoneal Onlay Mesh technique and a single mesh type, i.e., a composite polyester mesh with a hydrophilic film (Parietex Composite One thousand seven hundred seventy-seven patients were enrolled. The median surgery time was 50 minutes and the median length of hospital stay was 2 days. Intraoperative complications occurred in 12 patients (0.7%), while early postoperative surgical complications occurred in 115 (6.5%); during follow-up, bulging mesh was diagnosed in 4.5% of cases and hernia recurred in 4.3% of patients. An overlap equal or greater than 4 cm resulted as a significant protective factor, while the use of absorbable fixing devices was a risk factor for recurrence (odds ration: 9.06, p < 0.001, 95% confidence interval: 4.19 - 19.57). Minimally invasive treatment of primary and postincisional abdominal wall hernias is a safe, effective, and reproducible procedure. An overlap equal or greater than 4 cm, the use of nonabsorbable fixing devices and a postoperative care and follow-up regime are crucial in order to obtain good results and low recurrence rates.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Although several large studies regarding patients undergoing minimally invasive repair of incisional hernia are currently available, the results are not particularly reliable as they are based on heterogeneous groups, different surgical techniques, different mesh types, or with a too short follow period.
METHODS
METHODS
We conducted a retrospective observational trial, collecting data from patients who underwent laparoscopic repair of a primary abdominal wall or an incisional hernia using the laparoscopic Intraperitoneal Onlay Mesh technique and a single mesh type, i.e., a composite polyester mesh with a hydrophilic film (Parietex Composite
RESULTS
RESULTS
One thousand seven hundred seventy-seven patients were enrolled. The median surgery time was 50 minutes and the median length of hospital stay was 2 days. Intraoperative complications occurred in 12 patients (0.7%), while early postoperative surgical complications occurred in 115 (6.5%); during follow-up, bulging mesh was diagnosed in 4.5% of cases and hernia recurred in 4.3% of patients. An overlap equal or greater than 4 cm resulted as a significant protective factor, while the use of absorbable fixing devices was a risk factor for recurrence (odds ration: 9.06, p < 0.001, 95% confidence interval: 4.19 - 19.57).
CONCLUSIONS
CONCLUSIONS
Minimally invasive treatment of primary and postincisional abdominal wall hernias is a safe, effective, and reproducible procedure. An overlap equal or greater than 4 cm, the use of nonabsorbable fixing devices and a postoperative care and follow-up regime are crucial in order to obtain good results and low recurrence rates.
Identifiants
pubmed: 34248345
doi: 10.4293/JSLS.2021.00007
pii: JSLS.2021.00007
pmc: PMC8249222
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2021 by SLS, Society of Laparoscopic & Robotic Surgeons.
Déclaration de conflit d'intérêts
Conflicts of Interest: none.
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