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Published on: September 11, 2021
Short-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis
Philip P Goodney1, Christian M Birkmeyer, John D Birkmeyer
1VA Outcomes Group, Department of Veteran Affairs Medical Center, White River Junction, VT 05009, USA. philip.goodney@hitchcock.org
Background:
Although laparoscopic repair of ventral hernia has become increasingly popular, its outcomes relative to open repair have not been well characterized. For this reason, we performed a meta-analysis of studies comparing open and laparoscopic ventral (including incisional) hernia repair.
Hypothesis:
Laparoscopic ventral hernia repair results in better short-term outcomes than open ventral hernia repair.
Data Sources:
Structured MEDLINE search for published studies. One unpublished study was also identified.
Study Selection:
Studies were selected on the basis of study design (comparison of laparoscopic and open ventral hernia repair). The 3 main outcome measures were perioperative complications, operative time, and length of hospital stay. Of 83 potential studies identified by abstract review, 8 (10%) met the inclusion criteria.
Data Extraction:
Two reviewers assessed each article to determine eligibility for inclusion and, where appropriate, abstracted information on patient characteristics and main outcome measures.
Data Synthesis:
Across 8 studies, 390 patients underwent open repair and 322 underwent laparoscopic repair. Perioperative complications were less than half as likely to occur in patients undergoing laparoscopic repair (14% vs 27%; P =.03; odds ratio, 0.42; 95% confidence interval, 0.29-0.68). Average length of stay was shorter in the laparoscopic group (2.0 vs 4.0 days; P =.02). No statistically significant difference in operative times was noted between laparoscopic and open repair (99 vs 96 minutes; P =.38).
Conclusions:
Laparoscopic ventral hernia repair offers lower complication rates and shorter length of stay than open repair. However, randomized controlled trials and studies with long-term follow-up are needed to confirm these findings and to assess long-term rates of hernia recurrence.
