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Erschienen in: Surgical Endoscopy 8/2016

05.11.2015

Is laparoscopic repair of incarcerated abdominal hernias safe? Analysis of short-term outcomes

verfasst von: Ahmad Elnahas, Song Hon H. Kim, Allan Okrainec, Fayez Quereshy, Timothy D. Jackson

Erschienen in: Surgical Endoscopy | Ausgabe 8/2016

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Abstract

Background

There is a paucity of literature surrounding the safety and feasibility of laparoscopic repair for acutely incarcerated abdominal hernias. The objective of this study was to compare the 30-day morbidity and mortality between laparoscopic and open repairs of incarcerated abdominal hernias.

Methods

A retrospective cohort study was conducted using data from the National Surgery Quality Improvement Program from 2005 to 2012. The study population was selected using ICD-9 diagnostic codes describing abdominal hernias with obstruction, but without gangrene. Cases with documented bowel resection were excluded. Group classification was based on CPT coding. Study outcomes included the 30-day major complication, reoperation and mortality rates. Multivariable logistic regression models were used to adjust for confounding for all study outcomes.

Results

A total of 2688 and 15,562 patients were in the laparoscopic and open group, respectively. After adjustment for clinically relevant confounders, laparoscopic surgery was associated with a significantly lower 30-day infectious (OR 0.36, p < 0.001, 95 % CI 0.23–0.56) and serious complication rates (OR 0.66, p < 0.001, 95 % CI 0.55–0.80). However, there was no statistical difference with respect to the 30-day reoperation (OR 0.81, p = 0.28, 95 % CI 0.56–1.18) or mortality rates (OR 0.94, p = 0.80, 95 % CI 0.58–1.53).

Conclusions

Patients with incarcerated abdominal hernias who underwent laparoscopic repair had a significantly lower 30-day morbidity compared to patients with open repair. Although the 30-day reoperation and mortality rates were also lower, there was no statistically significant difference. Laparoscopic surgery appears to be safe in the management of select incarcerated abdominal hernias.
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Metadaten
Titel
Is laparoscopic repair of incarcerated abdominal hernias safe? Analysis of short-term outcomes
verfasst von
Ahmad Elnahas
Song Hon H. Kim
Allan Okrainec
Fayez Quereshy
Timothy D. Jackson
Publikationsdatum
05.11.2015
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 8/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4649-0

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