International Journal of Abdominal Wall and Hernia Surgery (Jan 2018)
Outcome assessment of primary ventral versus incisional hernia repair by laparoscopic approach
Abstract
INTRODUCTION: The superiority of laparoscopic approach for a ventral and incisional hernia has been well documented over the traditional open repair. However, there is a paucity of literature comparing the outcomes of laparoscopic repair of primary ventral hernias versus incisional hernias. The objective of our study was to compare the operative variables and short-term outcomes of laparoscopic repair of primary ventral hernia as compared to incisional hernia in our setup. MATERIALS AND METHODS: We reviewed the clinical data of 159 patients who underwent laparoscopic ventral and incisional hernia repair from January 2014 to December 2015. Demographics, operative variables, and short-term outcomes were compared between the two groups. Comparison of outcome variables was done using independent sample t- test for continuous variables and Chi-square test for categorical variables. RESULTS: Of 159 patients, 90 (57%) had primary ventral hernia repair and 69 (43%) underwent incisional hernia repair. Both groups were similar in terms of age, body mass index, comorbid conditions, and high preponderance of females. The number (P < 0.006) and size (P < 0.000) of the hernia defect were significantly higher in the incisional hernia group. The operating time (P < 0.000) and extent of adhesiolysis (P < 0.011) were significantly higher in patients with incisional hernia. There was no statistically significant difference in intraoperative and postoperative complications in the two groups. The duration of postoperative hospital stay was longer in the incisional hernia group (P < 0.001). CONCLUSIONS: The patients in the incisional hernia group had higher frequency of complex and large hernias. Laparoscopic repair of incisional hernia was associated with extensive adhesiolysis, longer operating time, and longer hospital stay as compared to primary ventral hernias.
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