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Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery-A Systematic Review and Meta-Analysis.

Julia B Kössler-Ebs1,2, Kathrin Grummich2, Katrin Jensen3

  • 1Department of General-, Visceral- and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.

World Journal of Surgery
|May 6, 2016
PubMed
Summary
This summary is machine-generated.

Laparoscopic surgery significantly reduces incisional hernia rates compared to open abdominal surgery. The total-laparoscopic approach offers the greatest benefit, suggesting less traumatic access should be prioritized.

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Incisional hernias are a frequent complication following open abdominal surgery.
  • Evaluating surgical approaches for incisional hernia prevention is crucial for patient outcomes.
  • Systematic review and meta-analysis to compare laparoscopic versus open abdominal surgery for incisional hernia occurrence.

Purpose of the Study:

  • To systematically assess the incidence of incisional hernias after laparoscopic versus open abdominal surgery.
  • To compare the efficacy of different laparoscopic techniques in preventing incisional hernias.
  • To evaluate secondary outcomes including wound infections, postoperative morbidity, hospital stay, and quality of life.

Main Methods:

  • Systematic literature search for randomized controlled trials comparing laparoscopic and open abdominal surgery.
  • Inclusion of trials across all surgical indications to assess incisional hernia rates.
  • Random effects meta-analyses used to calculate risk differences (RD) and 95% confidence intervals (CI).

Main Results:

  • Incisional hernias were significantly reduced in the laparoscopic group (RD -0.06, 95% CI [-0.09, -0.03]).
  • Total-laparoscopic interventions showed a significant reduction (RD -0.14, 95% CI [-0.22, -0.06]), unlike laparoscopically assisted procedures.
  • Laparoscopic surgery led to reduced wound infections and shorter hospital stays, with comparable postoperative morbidity and improved short-term quality of life.

Conclusions:

  • The total-laparoscopic approach significantly decreases incisional hernia occurrence compared to open abdominal surgery.
  • Minimally invasive, less traumatic surgical access should be preferred when feasible.
  • Laparoscopic surgery demonstrates advantages in reducing complications and improving patient recovery.