Laparoscopy versus laparotomy in the repair of ventral hernias: systematic review and meta-analysis.

Autor:	Castro PM; Faculdade de Medicina, Centro Universitário Lusíada, Santos, SP, Brasil., Rabelato JT; Faculdade de Medicina, Centro Universitário Lusíada, Santos, SP, Brasil., Monteiro GG; Faculdade de Medicina, Centro Universitário Lusíada, Santos, SP, Brasil., del Guerra GC; Faculdade de Medicina, Centro Universitário Lusíada, Santos, SP, Brasil., Mazzurana M; Departamento de Clínica Cirúrgica, Centro Universitário Lusíada, Santos, SP, Brasil., Alvarez GA; Departamento de Clínica Cirúrgica, Centro Universitário Lusíada, Santos, SP, Brasil.
Jazyk:	angličtina
Zdroj:	Arquivos de gastroenterologia [Arq Gastroenterol] 2014 Jul-Sep; Vol. 51 (3), pp. 205-11.
DOI:	10.1590/s0004-2803201400030008
Abstrakt:	Objective: To compare the laparotomy and laparoscopy techniques for correction of ventral hernia when related to perioperative complications, length of hospitalization, surgical time, and recurrence of hernia. Methods: This was a systematic review of randomized controlled trials, which included studies retrieved from four databases (MEDLINE, Embase, Cochrane and LILACS), using a combination of the terms (Hernia, Ventral) and (Laparoscopy) and (Laparotomy). Results: Six randomized trials were included, totaling 566 patients, 283 in the Laparoscopy group and 283 in the Laparotomy group. Laparoscopy reduced the risk of infection of the surgical wound (NNT = 5) and seroma formation (NNT = 13) and less length hospitalization (P = 0.02) compared to laparotomy in the correction of ventral hernias. Furthermore, laparoscopy increased the incidence of enterotomy (NNH = 25) and post operative pain (NNH = 8) and longer surgical time (P = 0.0009) when compared with laparotomy. There was no difference related to abscess (P = 0.79), hematoma (P = 0.43) and recurrency of ventral hernias (P = 0.25). Conclusions: In the correction of ventral hernias, the use of laparoscopic technique is effective to reduce infections of the surgical wound and seroma formation, as well as, decrease the length hospitalization.
Databáze:	MEDLINE
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