To Compare the Short-Term Outcome of Open Repair versus Laparoscopic Repair in Abdominal Incisional Hernia Repair
Article Sidebar
Main Article Content
Abstract
Background: Incisional hernia is a common complication post abdominal surgery. Its effective management is crucial for patient outcomes and healthcare efficiency. This study aims to evaluate and compare the short-term outcomes of open and laparoscopic incisional hernia repair techniques.
Objective: The study's objectives are twofold: 1) To ascertain the short-term outcomes, specifically focusing on the length of hospital stay, operative time, wound infections, and recurrence rate in patients undergoing open and laparoscopic incisional hernia repair, and 2) To compare these outcomes between open and laparoscopic repair methods.
Methods: A randomized design was employed, with patients assigned to either Group A (open repair) or Group B (laparoscopic repair) using computer software. The duration of surgery, from the first incision to skin closure, was timed with a digital stopwatch. Patients were followed up for one month with specific attention to any redness, persistent pain, or fever. The key outcome parameters assessed were operative time, hospital stay duration, incidence of wound infection, and hernia recurrence.
Results: Group A exhibited a 9.9% wound infection rate and 51.1% recurrence rate, with 39.0% of patients achieving satisfactory outcomes. In contrast, Group B demonstrated a 13.5% wound infection rate, a notably lower recurrence rate of 11.3%, and 75.2% of patients reported satisfactory outcomes.
Conclusion: Laparoscopic repair shows superior outcomes compared to open repair regarding wound infection, recurrence rate, patient satisfaction, operative time, and length of hospital stay.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Itatsu K, Yokoyama Y, Sugawara G, Kubota H, Tojima Y, Kurumiya Y, et al. Incidence of and risk factors for incisional hernia after abdominal surgery. Br J Surg. 2014;101(11):1439-47.
Smith CT, Katz MG, Foley D, Welch B, Leverson GE, Funk LM, et al. Incidence and risk factors of incisional hernia formation following abdominal organ transplantation. Surg Endosc. 2015;29(2):398-404.
Ooms LS, Verhelst J, Jeekel J, Ijzermans JN, Lange JF, Terkivatan T. Incidence, risk factors, and treatment of incisional hernia after kidney transplantation: An analysis of 1,564 consecutive patients. Surgery. 2016;159(5):1407-11.
Julliard O, Hauters P, Possoz J, Malvaux P, Landenne J, Gherardi DJSe. Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors. Surg Endosc. 2016;30(10):4539-43.
Kaoutzanis C, Leichtle S, Mouawad N, Welch K, Lampman R, Wahl W, et al. Risk factors for postoperative wound infections and prolonged hospitalization after ventral/incisional hernia repair. Hernia. 2015;19(1):113-23.
Tastaldi L, Petro CC, Krpata DM, Alkhatib H, Fafaj A, Tu C, et al. History of surgical site infection increases the odds for a new infection after open incisional hernia repair. Surgery. 2019;166(1):88-93.
Park A, Birch DW, Lovrics P. Laparoscopic and open incisional hernia repair: A comparison study. Surgery. 1998;124(4):816-22.
Ahonen-Siirtola M, Rautio T, Ward J, Kössi J, Ohtonen P, Mäkelä JJWjos. Complications in laparoscopic versus open incisional ventral hernia repair. A retrospective comparative study. World J Surg. 2015;39(12):2872-7.
Basheer M, Negm A, El-Ghadban H, Samir M, Hadidy A, Dawoud IJTEJoS. Laparoscopic versus open ventral hernia repair: a comparative study. Egypt J Surg. 2018;37(4):465.
Awaiz A, Rahman F, Hossain M, Yunus R, Khan S, Memon B, et al. Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Anz J Surg 2015;19(3):449-63.
Asti MT, Manthey DE. Abdominal hernia reduction. In: Roberts JR, Custalow CB, Thomsen TW, et al, editors. Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia: Elsevier Saunders; 2014. p. 873-9.
Eker ML. Pediatric hernias. Surg Clin North Am. 2008 Feb;88(1):27-43, vii-viii.
Walter IM, Robbins AW. Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States. Surg Clin North Am. 1993 Jun;73(3):413-26.
Scherer LR 3rd, Grosfeld JL. Inguinal hernia and umbilical anomalies. Pediatr Clin North Am. 1993 Dec;40(6):1121-31.
Barakaat DA. Evaluation and management of inguinal and umbilical hernias. Pediatr Ann. 2001 Dec;30(12):729-35.
Levine BJ, Nabha S, Bouzoukis JK. Chronic inguinal hernia. J Emerg Med. 1999 May-Jun;17(3):515-6.
Itani RD, Neumayer L. Inguinal hernia in the 21st century: an evidence-based review. Curr Probl Surg. 2008 Apr;45(4):261-312.
Bobrow RS. The hernia. J Am Board Fam Pract. 1999 Jan-Feb;12(1):95-6.
Qadri J, Lv Y, Shen Y, Liu S, Wang M. A prospective comparison of preperitoneal tension-free open herniorrhaphy with mesh plug herniorrhaphy for the treatment of femoral hernias. Surgery. 2010 Nov;148(5):976-81.
Mandarry MT, Zeng SB, Wei ZQ, Zhang C, Wang ZW. Obturator hernia--a condition seldom thought of and hence seldom sought. Int J Colorectal Dis. 2012 Feb;27(2):133-41.
Kingsnorth A, Banerjea A, Bhargava A. Incisional hernia repair - laparoscopic or open surgery? Annals of the Royal College of Surgeons of England. 2009;91(8):631-6.
Den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical procedures for incisional hernias. Cochrane Database Syst Rev. 2008, 3:CD006438.
Medscape. [Internet]. [cited 2023 Dec 20]. Available from: https://www.medscape.com/viewarticle/809132_4
Eker HH, Hansson BME, Buunen M, et al. Laparoscopic vs Open Incisional Hernia Repair: A Randomized Clinical Trial. JAMA Surg. 2013;148(3):259–263. doi:10.1001/jamasurg.2013.1466