Skip to main content
main-content
Erschienen in: Surgical Endoscopy 3/2007

01.03.2007

Pooled data analysis of laparoscopic vs. open ventral hernia repair: 14 years of patient data accrual

verfasst von: Richard A. Pierce, Jennifer A. Spitler, Margaret M. Frisella, Brent D. Matthews, L. Michael Brunt

Erschienen in: Surgical Endoscopy | Ausgabe 3/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

The purpose of this study was to analyze the published perioperative results and outcomes of laparoscopic (LVHR) and open (OVHR) ventral hernia repair focusing on complications and hernia recurrences.

Methods

Data were compiled from all English-language reports of LVHR published from 1996 through January 2006. Series with fewer than 20 cases of LVHR, insufficient details of complications, or those part of a larger series were excluded. Data were derived from 31 reports of LVHR alone (unpaired studies) and 14 that directly compared LVHR to OVHR (paired sudies). Chi-squared analysis, Fisher’s exact test, and two-tailed t-test analysis were used.

Results

Forty-five published series were included, representing 5340 patients (4582 LVHR, 758 OVHR). In the pooled analysis (combined paired and unpaired studies), LVHR was associated with significantly fewer wound complications (3.8% vs. 16.8%, p < 0.0001), total complications (22.7% vs. 41.7%, p < 0.0001), hernia recurrences (4.3% vs. 12.1%, p < 0.0001), and a shorter length of stay (2.4 vs. 4.3 days, p = 0.0004). These outcomes maintained statistical significance when only the paired studies were analyzed. In the pooled analysis, LVHR was associated with fewer gastrointestinal (2.6% vs. 5.9%, p < 0.0001), pulmonary (0.6% vs. 1.7%, p = 0.0013), and miscellaneous (0.7% vs. 1.9%, p = 0.0011) complications, but a higher incidence of prolonged procedure site pain (1.96% vs. 0.92%, p = 0.0469); none of these outcomes was significant in the paired study analysis. No differences in cardiac, neurologic, septic, genitourinary, or thromboembolic complications were found. The mortality rate was 0.13% with LVHR and 0.26% with OVHR (p = NS). Trends toward larger hernia defects and larger mesh sizes were observed for LVHR.

Conclusions

The published literature indicates fewer wound-related and overall complications and a lower rate of hernia recurrence for LVHR compared to OVHR. Further controlled trials are necessary to substantiate these findings and to assess the health care economic impact of this approach.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV, Turnage RH (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24: 95–100 PubMedCrossRef Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV, Turnage RH (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24: 95–100 PubMedCrossRef
2.
Zurück zum Zitat Beldi G, Ipaktchi R, Wagner M, Gloor B, Candinas D (2006) Laparoscopic ventral hernia repair is safe and cost effective. Surg Endosc 20: 92–95 PubMedCrossRef Beldi G, Ipaktchi R, Wagner M, Gloor B, Candinas D (2006) Laparoscopic ventral hernia repair is safe and cost effective. Surg Endosc 20: 92–95 PubMedCrossRef
3.
Zurück zum Zitat Ben-Haim M, Kuriansky J, Tal R, Zmora O, Mintz Y, Rosin D, Ayalon A, Shabtai M (2002) Pitfalls and complications with laparoscopic intraperitoneal expanded polytetrafluoroethylene patch repair of postoperative ventral hernia. Surg Endosc 16: 785–788 PubMedCrossRef Ben-Haim M, Kuriansky J, Tal R, Zmora O, Mintz Y, Rosin D, Ayalon A, Shabtai M (2002) Pitfalls and complications with laparoscopic intraperitoneal expanded polytetrafluoroethylene patch repair of postoperative ventral hernia. Surg Endosc 16: 785–788 PubMedCrossRef
4.
Zurück zum Zitat Bencini L, Sanchez LJ (2004) Learning curve for laparoscopic ventral hernia repair. Am J Surg 187: 378–382 PubMedCrossRef Bencini L, Sanchez LJ (2004) Learning curve for laparoscopic ventral hernia repair. Am J Surg 187: 378–382 PubMedCrossRef
5.
Zurück zum Zitat Bencini L, Sanchez LJ, Boffi B, Farsi M, Scatizzi M, Moretti R (2003) Incisional hernia: repair retrospective comparison of laparoscopic and open techniques. Surg Endosc 17: 1546–1551 PubMedCrossRef Bencini L, Sanchez LJ, Boffi B, Farsi M, Scatizzi M, Moretti R (2003) Incisional hernia: repair retrospective comparison of laparoscopic and open techniques. Surg Endosc 17: 1546–1551 PubMedCrossRef
6.
Zurück zum Zitat Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240: 578–583 PubMed Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240: 578–583 PubMed
7.
Zurück zum Zitat Carbajo MA, Martin del Olmo JC, Blanco JI, de la CC, Toledano M, Martin F, Vaquero C, Inglada L (1999) Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13: 250–252 PubMedCrossRef Carbajo MA, Martin del Olmo JC, Blanco JI, de la CC, Toledano M, Martin F, Vaquero C, Inglada L (1999) Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13: 250–252 PubMedCrossRef
8.
Zurück zum Zitat Carbajo MA, Martin del Olmo JC, Blanco JI, Toledano M, de la CC, Ferreras C, Vaquero C (2003) Laparoscopic approach to incisional hernia. Surg Endosc 17: 118–122 PubMedCrossRef Carbajo MA, Martin del Olmo JC, Blanco JI, Toledano M, de la CC, Ferreras C, Vaquero C (2003) Laparoscopic approach to incisional hernia. Surg Endosc 17: 118–122 PubMedCrossRef
9.
Zurück zum Zitat Cobb WS, Kercher KW, Heniford BT (2005) Laparoscopic repair of incisional hernias. Surg Clin North Am 85: 91–103, ix PubMedCrossRef Cobb WS, Kercher KW, Heniford BT (2005) Laparoscopic repair of incisional hernias. Surg Clin North Am 85: 91–103, ix PubMedCrossRef
10.
Zurück zum Zitat DeMaria EJ, Moss JM, Sugerman HJ (2000) Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Prospective comparison to open prefascial polypropylene mesh repair. Surg Endosc 14: 326–329 PubMedCrossRef DeMaria EJ, Moss JM, Sugerman HJ (2000) Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Prospective comparison to open prefascial polypropylene mesh repair. Surg Endosc 14: 326–329 PubMedCrossRef
11.
Zurück zum Zitat Earle D, Seymour N, Fellinger E, Perez A (2006) Laparoscopic versus open incisional hernia repair: a single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc 20: 71–75 PubMedCrossRef Earle D, Seymour N, Fellinger E, Perez A (2006) Laparoscopic versus open incisional hernia repair: a single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc 20: 71–75 PubMedCrossRef
12.
Zurück zum Zitat Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003) Laparoscopic versus open umbilical hernia repair. JSLS 7: 323–328 PubMed Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003) Laparoscopic versus open umbilical hernia repair. JSLS 7: 323–328 PubMed
13.
Zurück zum Zitat Goodney PP, Birkmeyer CM, Birkmeyer JD (2002) Short-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. Arch Surg 137: 1161–1165 PubMedCrossRef Goodney PP, Birkmeyer CM, Birkmeyer JD (2002) Short-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. Arch Surg 137: 1161–1165 PubMedCrossRef
14.
Zurück zum Zitat Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg 238: 391–399 PubMed Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg 238: 391–399 PubMed
15.
Zurück zum Zitat Holzman MD, Purut CM, Reintgen K, Eubanks S, Pappas TN (1997) Laparoscopic ventral and incisional hernioplasty. Surg Endosc 11: 32–35 PubMedCrossRef Holzman MD, Purut CM, Reintgen K, Eubanks S, Pappas TN (1997) Laparoscopic ventral and incisional hernioplasty. Surg Endosc 11: 32–35 PubMedCrossRef
16.
Zurück zum Zitat LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3: 39–41 PubMed LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3: 39–41 PubMed
17.
Zurück zum Zitat LeBlanc KA, Booth WV, Whitaker JM, Bellanger DE (2000) Laparoscopic incisional and ventral herniorrhaphy in 100 patients. Am J Surg 180: 193–197 PubMedCrossRef LeBlanc KA, Booth WV, Whitaker JM, Bellanger DE (2000) Laparoscopic incisional and ventral herniorrhaphy in 100 patients. Am J Surg 180: 193–197 PubMedCrossRef
18.
Zurück zum Zitat Luijendijk RW, Hop WC, van den Tol MP, de L, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343: 392–398 Luijendijk RW, Hop WC, van den Tol MP, de L, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343: 392–398
19.
Zurück zum Zitat Luijendijk RW, Lemmen MH, Hop WC, Wereldsma JC (1997) Incisional hernia recurrence following “vest-over-pants” or vertical Mayo repair of primary hernias of the midline. World J Surg 21: 62–65 PubMedCrossRef Luijendijk RW, Lemmen MH, Hop WC, Wereldsma JC (1997) Incisional hernia recurrence following “vest-over-pants” or vertical Mayo repair of primary hernias of the midline. World J Surg 21: 62–65 PubMedCrossRef
20.
Zurück zum Zitat McGreevy JM, Goodney PP, Birkmeyer CM, Finlayson SR, Laycock WS, Birkmeyer JD (2003) A prospective study comparing the complication rates between laparoscopic and open ventral hernia repairs. Surg Endosc 17: 1778–1780 PubMedCrossRef McGreevy JM, Goodney PP, Birkmeyer CM, Finlayson SR, Laycock WS, Birkmeyer JD (2003) A prospective study comparing the complication rates between laparoscopic and open ventral hernia repairs. Surg Endosc 17: 1778–1780 PubMedCrossRef
21.
Zurück zum Zitat Moreno-Egea A, Carrasco L, Girela E, Martin JG, Aguayo JL, Canteras M (2002) Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. Arch Surg 137: 1266–1268 PubMedCrossRef Moreno-Egea A, Carrasco L, Girela E, Martin JG, Aguayo JL, Canteras M (2002) Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. Arch Surg 137: 1266–1268 PubMedCrossRef
22.
Zurück zum Zitat Moreno-Egea A, Torralba JA, Girela E, Corral M, Bento M, Cartagena J, Vicente JP, Aguayo JL, Canteras M (2004) Immediate, early, and late morbidity with laparoscopic ventral hernia repair and tolerance to composite mesh. Surg Laparosc Endosc Percutan Tech 14: 130–135 PubMedCrossRef Moreno-Egea A, Torralba JA, Girela E, Corral M, Bento M, Cartagena J, Vicente JP, Aguayo JL, Canteras M (2004) Immediate, early, and late morbidity with laparoscopic ventral hernia repair and tolerance to composite mesh. Surg Laparosc Endosc Percutan Tech 14: 130–135 PubMedCrossRef
23.
Zurück zum Zitat Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72: 70–71 PubMed Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72: 70–71 PubMed
24.
Zurück zum Zitat Novitsky YW, Cobb WS, Kercher KW, Matthews BD, Sing RF, Heniford BT (2006) Laparoscopic ventral hernia repair in obese patients: a new standard of care. Arch Surg 141: 57–61 PubMedCrossRef Novitsky YW, Cobb WS, Kercher KW, Matthews BD, Sing RF, Heniford BT (2006) Laparoscopic ventral hernia repair in obese patients: a new standard of care. Arch Surg 141: 57–61 PubMedCrossRef
25.
Zurück zum Zitat Perrone JM, Soper NJ, Eagon JC, Klingensmith ME, Aft RL, Frisella MM, Brunt LM (2005) Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery 138: 708–715 PubMedCrossRef Perrone JM, Soper NJ, Eagon JC, Klingensmith ME, Aft RL, Frisella MM, Brunt LM (2005) Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery 138: 708–715 PubMedCrossRef
26.
Zurück zum Zitat Read RC, Yoder G (1989) Recent trends in the management of incisional herniation. Arch Surg 124: 485–488 PubMed Read RC, Yoder G (1989) Recent trends in the management of incisional herniation. Arch Surg 124: 485–488 PubMed
27.
Zurück zum Zitat Rosen M, Brody F, Ponsky J, Walsh RM, Rosenblatt S, Duperier F, Fanning A, Siperstein A (2003) Recurrence after laparoscopic ventral hernia repair. Surg Endosc 17: 123–128 PubMedCrossRef Rosen M, Brody F, Ponsky J, Walsh RM, Rosenblatt S, Duperier F, Fanning A, Siperstein A (2003) Recurrence after laparoscopic ventral hernia repair. Surg Endosc 17: 123–128 PubMedCrossRef
28.
Zurück zum Zitat Salameh JR, Sweeney JF, Graviss EA, Essien FA, Williams MD, Awad S, Itani KM, Fisher WE (2002) Laparoscopic ventral hernia repair during the learning curve. Hernia 6: 182–187 PubMedCrossRef Salameh JR, Sweeney JF, Graviss EA, Essien FA, Williams MD, Awad S, Itani KM, Fisher WE (2002) Laparoscopic ventral hernia repair during the learning curve. Hernia 6: 182–187 PubMedCrossRef
29.
Zurück zum Zitat Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jorgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140: 119–123 PubMedCrossRef Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jorgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140: 119–123 PubMedCrossRef
30.
Zurück zum Zitat Sugerman HJ (1998) Increased intra-abdominal pressure in obesity. Int J Obes Relat Metab Disord 22: 1138 PubMedCrossRef Sugerman HJ (1998) Increased intra-abdominal pressure in obesity. Int J Obes Relat Metab Disord 22: 1138 PubMedCrossRef
31.
Zurück zum Zitat Sugerman HJ (2001) Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am 81: 1063–1075, vi PubMedCrossRef Sugerman HJ (2001) Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am 81: 1063–1075, vi PubMedCrossRef
32.
Zurück zum Zitat Ujiki MB, Weinberger J, Varghese TK, Murayama KM, Joehl RJ (2004) One hundred consecutive laparoscopic ventral hernia repairs. Am J Surg 188: 593–597 PubMedCrossRef Ujiki MB, Weinberger J, Varghese TK, Murayama KM, Joehl RJ (2004) One hundred consecutive laparoscopic ventral hernia repairs. Am J Surg 188: 593–597 PubMedCrossRef
33.
Zurück zum Zitat Winslow ER, Fleshman JW, Birnbaum EH, Brunt LM (2002) Wound complications of laparoscopic vs open colectomy. Surg Endosc 16: 1420–1425 PubMedCrossRef Winslow ER, Fleshman JW, Birnbaum EH, Brunt LM (2002) Wound complications of laparoscopic vs open colectomy. Surg Endosc 16: 1420–1425 PubMedCrossRef
34.
Zurück zum Zitat Wright BE, Beckerman J, Cohen M, Cumming JK, Rodriguez JL (2002) Is laparoscopic umbilical hernia repair with mesh a reasonable alternative to conventional repair? Am J Surg 184: 505–508 PubMedCrossRef Wright BE, Beckerman J, Cohen M, Cumming JK, Rodriguez JL (2002) Is laparoscopic umbilical hernia repair with mesh a reasonable alternative to conventional repair? Am J Surg 184: 505–508 PubMedCrossRef
35.
Zurück zum Zitat Wright BE, Niskanen BD, Peterson DJ, Ney AL, Odland MD, VanCamp J, Zera RT, Rodriguez JL (2002) Laparoscopic ventral hernia repair: are there comparative advantages over traditional methods of repair? Am Surg 68: 291–295 PubMed Wright BE, Niskanen BD, Peterson DJ, Ney AL, Odland MD, VanCamp J, Zera RT, Rodriguez JL (2002) Laparoscopic ventral hernia repair: are there comparative advantages over traditional methods of repair? Am Surg 68: 291–295 PubMed
Metadaten
Titel
Pooled data analysis of laparoscopic vs. open ventral hernia repair: 14 years of patient data accrual
verfasst von
Richard A. Pierce
Jennifer A. Spitler
Margaret M. Frisella
Brent D. Matthews
L. Michael Brunt
Publikationsdatum
01.03.2007
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 3/2007
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9115-6