Evidenzbasierte laparoskopische Chirurgie - Narbenhernie

 

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Zusammenfassung

Trotz der hohen Inzidenz an Narbenhernien im chirurgischen Patientenkollektiv ist das Evidenzniveau der meisten Publikationen zur Narbenhernienreparation erschreckend niedrig, liegen kaum kontrollierte Studien zu technischen Fragestellungen vor. Immerhin sind innerhalb der letzten Jahre die Nahtverfahren weitestgehend durch vornehmlich offene Netzreparationen abgelöst worden. Dabei wird die Sublay-Position gegenüber der Onlay-Position bevorzugt, und scheint in der Tat eine geringere Rezidivrate aufzuweisen. Durch den Einsatz von laparoskopischen Techniken bei der Reparation von Narbenhernien stellt die IPOM-Position eine weitere Alternative dar. Erste Analysen zeigen Vorteile in der Rate lokaler Wundkomplikationen und einer schnelleren Rekonvaleszenz. Unklar ist jedoch weiterhin die zumindest mittelfristig zu verzeichnende Rezidivrate, die optimale Fixationstechnik, das geeignetste Material bzw. die Anzahl adhäsions-bedingter Komplikationen im Langzeitverlauf. Anhand einer Medline Recherche wird eine Einschätzung der laparoskopischen Technik im Vergleich mit den offenen Netzverfahren, unter Berücksichtigung der jeweiligen Vor- und Nachteile, versucht.

Abstract

Beside the high incidence of incisional hernias in visceral surgery the evidence level of most publication on incisional hernia repair is noticeable low, almost no controlled studies concerning technical aspects available. At least a replacement of suture repair by primarily open mesh repair has taken place. Thereby the sublay position seems to have a lower recurrence rate than the onlay position. The possibility of laparoscopic techniques for the repair of incisional hernias the intraabdominal position (IPOM) is another alternative. First analyses show advantages for the rate of wound complications and a faster convalescence. What remains unclear are at least the middle-term recurrence rate, the ideal fixation technique, the most appropriate mesh material respectively the number of adhesion-related long-term complications. On the basis of a Medline research we try an evaluation of the laparoscopic technique in comparison with the open mesh repairs for incisional hernia under consideration of advantages and disadvantages of each technique.

Literatur

• 1 Hoer J, Lawong G, Klinge U, Schumpelick V. [Factors influencing the development of incisional hernia. A retrospective study of 2 983 laparotomy patients over a period of 10 years].  Chirurg. 2002;  73 474-480
  CrossrefPubMedGoogle Scholar
• 2 Schumpelick V, Klinge U, Welty G, Klosterhalfen B. [Meshes within the abdominal wall].  Chirurg. 1999;  70 876-887
  CrossrefPubMedGoogle Scholar
• 3 Carbajo M A. Laparoscopic treatment of the massive periumbilical hernia with expanded PTFE patch. In: Topuzlu CTY (ed). Joint Euro-Asian Congress of Endoscopic Surgery. Monduzzi Editore, Bologna (Italy) 1994; 351-354
  Google Scholar
• 4 LeBlanc K A, Booth W V. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings.  Surg Laparosc Endosc. 1993;  3 39-41
  PubMedGoogle Scholar
• 5 Cobb W S, Kercher K W, Heniford B T. Laparoscopic repair of incisional hernias.  Surg Clin North Am. 2005;  85 91-103 , ix
  CrossrefPubMedGoogle Scholar
• 6 Ramshaw B J, Esartia P, Schwab J, Mason E M, Wilson R A, Duncan T D, Miller J, Lucas G W, Promes J. Comparison of laparoscopic and open ventral herniorrhaphy.  Am Surg. 1999;  65 827-831
  PubMedGoogle Scholar
• 7 Weber G, Horvath O P. [Results of ventral hernia repair: comparison of suture repair with mesh implantation (onlay vs sublay) using open and laparoscopic approach - prospective, randomized, multicenter study].  Magy Seb. 2002;  55 285-289
  PubMedGoogle Scholar
• 8 Rudmik L R, Schieman C, Dixon E, Debru E. Laparoscopic incisional hernia repair: a review of the literature.  Hernia. 2006;  10 110-119
  CrossrefPubMedGoogle Scholar
• 9 Berger D, Bientzle M, Muller A. [Laparoscopic repair of incisional hernias].  Chirurg. 2002;  73 905-908
  PubMedGoogle Scholar
• 10 LeBlanc K A. Laparoscopic incisional and ventral hernia repair: Complications-how to avoid and handle.  Hernia. 2004;  8 323-331
  CrossrefPubMedGoogle Scholar
• 11 Koehler R H, Voeller G. Recurrences in laparoscopic incisional hernia repairs: a personal series and review of the literature.  JSLS. 1999;  3 293-304
  PubMedGoogle Scholar
• 12 Heniford B T, Park A, Ramshaw B J, Voeller G. Laparoscopic repair of ventral hernias: nine years' experience with 850 consecutive hernias.  Ann Surg. 2003;  238 391-399
  PubMedGoogle Scholar
• 13 Park A, Birch D W, Lovrics P. Laparoscopic and open incisional hernia repair: a comparison study.  Surgery. 1998;  124 816-821
  CrossrefPubMedGoogle Scholar
• 14 Rosen M, Brody F, Ponsky J, Walsh R M, Rosenblatt S, Duperier F, Fanning A, Siperstein A. Recurrence after laparoscopic ventral hernia repair.  Surg Endosc. 2003;  17 123-128
  CrossrefPubMedGoogle Scholar
• 15 Toy F K, Bailey R W, Carey S, Chappuis C W, Gagner M, Josephs L G, Mangiante E C, Park A E, Pomp A, Smoot Jr  R T, Uddo Jr  J F, Voeller G R. Prospective, multicenter study of laparoscopic ventral hernioplasty. Preliminary results.  Surg Endosc. 1998;  12 955-959
  CrossrefPubMedGoogle Scholar
• 16 Roth J C, Park A E, Witzke D, Mastrangelo M J. Laparoscopic incisional/ventral herniorrhaphy: a five year experience.  Hernia. 1999;  4 209-214
  PubMedGoogle Scholar
• 17 Bärlehner E, Schwetling R. [Laparoscopic Repair of incisional hernias].  Zentralbl Chir. 1996;  121 307-312
  PubMedGoogle Scholar
• 18 Ben Haim M, Kuriansky J, Tal R, Zmora O, Mintz Y, Rosin D, Ayalon A, Shabtai M. Pitfalls and complications with laparoscopic intraperitoneal expanded polytetrafluoroethylene patch repair of postoperative ventral hernia.  Surg Endosc. 2002;  16 785-788
  CrossrefPubMedGoogle Scholar
• 19 McGreevy J M, Goodney P P, Birkmeyer C M, Finlayson S R, Laycock W S, Birkmeyer J D. A prospective study comparing the complication rates between laparoscopic and open ventral hernia repairs.  Surg Endosc. 2003;  17 1778-1780
  CrossrefPubMedGoogle Scholar
• 20 Bageacu S, Blanc P, Breton C, Gonzales M, Porcheron J, Chabert M, Balique J G. Laparoscopic repair of incisional hernia: a retrospective study of 159 patients.  Surg Endosc. 2002;  16 345-348
  CrossrefPubMedGoogle Scholar
• 21 Bencini L, Sanchez L J, Scatizzi M, Farsi M, Boffi B, Moretti R. Laparoscopic treatment of ventral hernias: prospective evaluation.  Surg Laparosc Endosc Percutan Tech. 2003;  13 16-19
  CrossrefPubMedGoogle Scholar
• 22 Chari R, Chari V, Eisenstat M, Chung R. A case controlled study of laparoscopic incisional hernia repair.  Surg Endosc. 2000;  14 117-119
  PubMedGoogle Scholar
• 23 Bencini L, Sanchez L J. Learning curve for laparoscopic ventral hernia repair.  Am J Surg. 2004;  187 378-382
  CrossrefPubMedGoogle Scholar
• 24 Klinge U, Zheng H, Si Z Y, Schumpelick V, Bhardwaj R, Klosterhalfen B. Synthesis of type I and III collagen, expression of fibronectin and matrix metalloproteinases-1 and -13 in hernial sac of patients with inguinal hernia.  Int J Surg Investig. 1999;  1 219-227
  PubMedGoogle Scholar
• 25 Klinge U, Si Z Y, Zheng H, Schumpelick V, Bhardwaj R S, Klosterhalfen B. Abnormal collagen I to III distribution in the skin of patients with incisional hernia.  Eur Surg Res. 2000;  32 43-48
  CrossrefPubMedGoogle Scholar
• 26 Klinge U, Si Z Y, Zheng H, Schumpelick V, Bhardwaj R S, Klosterhalfen B. Collagen I/III and matrix metalloproteinases (MMP) 1 and 13 in the fascia of patients with incisional hernias.  J Invest Surg. 2001;  14 47-54
  CrossrefPubMedGoogle Scholar
• 27 Burger J W, Luijendijk R W, Hop W C, Halm J A, Verdaasdonk E G, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia.  Ann Surg. 2004;  240 578-583
  PubMedGoogle Scholar
• 28 Flum D R, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis.  Ann Surg. 2003;  237 129-135
  CrossrefPubMedGoogle Scholar
• 29 Conze J, Kingsnorth A N, Flament J B, Simmermacher R, Arlt G, Langer C, Schippers E, Hartley M, Schumpelick V. Randomized clinical trial comparing lightweight composite mesh with polyester or polypropylene mesh for incisional hernia repair.  Br J Surg. 2005;  92 1488-1493
  CrossrefPubMedGoogle Scholar
• 30 Korenkov M, Sauerland S, Arndt M, Bograd L, Neugebauer E A, Troidl H. Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia.  Br J Surg. 2002;  89 50-56
  CrossrefPubMedGoogle Scholar
• 31 Luijendijk R W, Hop W C, van den Tol M P, de Lange D C, Braaksma M M, IJzermans J N, Boelhouwer R U, de Vries B C, Salu M K, Wereldsma J C, Bruijninckx C M, Jeekel J. A comparison of suture repair with mesh repair for incisional hernia.  N Engl J Med. 2000;  343 392-398
  CrossrefPubMedGoogle Scholar
• 32 Duce A M, Noguerales F, Villeta R, Hernandez P, Lozano O, Keller J, Granell J. Modifications to Rives technique for midline incisional hernia repair.  Hernia. 2001;  5 70-72
  CrossrefPubMedGoogle Scholar
• 33 DeMaria E J, Moss J M, Sugerman H J. Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Prospective comparison to open prefascial polypropylene mesh repair.  Surg Endosc. 2000;  14 326-329
  CrossrefPubMedGoogle Scholar
• 34 Perrone J M, Soper N J, Eagon J C, Klingensmith M E, Aft R L, Frisella M M, Brunt L M. Perioperative outcomes and complications of laparoscopic ventral hernia repair.  Surgery. 2005;  138 708-715
  CrossrefPubMedGoogle Scholar
• 35 Wright B E, Niskanen B D, Peterson D J, Ney A L, Odland M D, Van Camp J, Zera R T, Rodriguez J L. Laparoscopic ventral hernia repair: are there comparative advantages over traditional methods of repair?.  Am Surg. 2002;  68 291-295
  PubMedGoogle Scholar
• 36 Leber G E, Garb J L, Alexander A I, Reed W P. Long-term complications associated with prosthetic repair of incisional hernias.  Arch Surg. 1998;  133 378-382
  CrossrefPubMedGoogle Scholar
• 37 Rios A, Rodriguez J M, Munitiz V, Alcaraz P, Perez D, Parrilla P. Factors that affect recurrence after incisional herniorrhaphy with prosthetic material.  Eur J Surg. 2001;  167 855-859
  CrossrefPubMedGoogle Scholar
• 38 Machairas A, Misiakos E P, Liakakos T, Karatzas G. Incisional hernioplasty with extraperitoneal onlay polyester mesh.  Am Surg. 2004;  70 726-729
  PubMedGoogle Scholar
• 39 Langer C, Liersch T, Kley C, Flosman M, Suss M, Siemer A, Becker H. [Twenty-five years of experience in incisional hernia surgery. A comparative retrospective study of 432 incisional hernia repairs].  Chirurg. 2003;  74 638-645
  CrossrefPubMedGoogle Scholar
• 40 Schumpelick V, Conze J, Klinge U. [Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias].  Chirurg. 1996;  67 1028-1035
  CrossrefPubMedGoogle Scholar
• 41 McLanahan D, King L T, Weems C, Novotney M, Gibson K. Retrorectus prosthetic mesh repair of midline abdominal hernia.  Am J Surg. 1997;  173 445-449
  CrossrefPubMedGoogle Scholar
• 42 Ladurner R, Trupka A, Schmidbauer S, Hallfeldt K. [The use of an underlay polypropylene mesh in complicated incisional hernias: sucessful French surgical technique].  Minerva Chir. 2001;  56 111-117
  PubMedGoogle Scholar
• 43 Marchal F, Brunaud L, Sebbag H, Bresler L, Tortuyaux J M, Boissel P. Treatment of incisional hernias by placement of an intraperitoneal prosthesis: a series of 128 patients.  Hernia. 1999;  3 141-147
  CrossrefPubMedGoogle Scholar
• 44 Millikan K W, Baptista M, Amin B, Deziel D J, Doolas A. Intraperitoneal underlay ventral hernia repair utilizing bilayer expanded polytetrafluoroethylene and polypropylene mesh.  Am Surg. 2003;  69 287-291
  PubMedGoogle Scholar
• 45 Heartsill L, Richards M L, Arfai N, Lee A, Bingener-Casey J, Schwesinger W H, Sirinek K R. Open Rives-Stoppa ventral hernia repair made simple and successful but not for everyone.  Hernia. 2005;  9 162-166
  CrossrefPubMedGoogle Scholar
• 46 Carbajo M A, Martp del Olmo J C, Blanco J I, Toledano M, de la C C, Ferreras C, Vaquero C. Laparoscopic approach to incisional hernia.  Surg Endosc. 2003;  17 118-122
  CrossrefPubMedGoogle Scholar
• 47 LeBlanc K A, Whitaker J M, Bellanger D E, Rhynes V K. Laparoscopic incisional and ventral hernioplasty: lessons learned from 200 patients.  Hernia. 2003;  7 118-124
  CrossrefPubMedGoogle Scholar
• 48 Franklin Jr  M E, Gonzalez Jr  J J, Glass J L, Manjarrez A. Laparoscopic ventral and incisional hernia repair: an 11-year experience.  Hernia. 2004;  8 23-27
  CrossrefPubMedGoogle Scholar

Dr. med. Joachim Conze

Chirurgische Klinik und Poliklinik · Universitätsklinikum der RWTH Aachen

Pauwelsstr. 30

52074 Aachen

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Fax: ++49/2 41/8 08 24 17

Email: jconze@ukaachen.de