A new three-step hybrid approach is a safe procedure for incisional hernia: early experiences with a single centre retrospective cohort.

Autor: van den Dop LM; Department of Surgery, Erasmus University Medical Centre, Room Ee-173, Dr. Molewaterplein 40, 3000 CA, PO BOX 2040, 3015 GD, Rotterdam, The Netherlands. Matthijs.vandendop@gmail.com., de Smet GHJ; Department of Surgery, Erasmus University Medical Centre, Room Ee-173, Dr. Molewaterplein 40, 3000 CA, PO BOX 2040, 3015 GD, Rotterdam, The Netherlands., Bus MPA; Department of Surgery, Alrijne Ziekenhuis, Leiderdop, The Netherlands., Lange JF; Department of Surgery, Erasmus University Medical Centre, Room Ee-173, Dr. Molewaterplein 40, 3000 CA, PO BOX 2040, 3015 GD, Rotterdam, The Netherlands.; Department of Surgery, IJsselland Ziekenhuis, Capelle Aan Den IJssel, The Netherlands., Koch SMP; Department of Surgery, Alrijne Ziekenhuis, Leiderdop, The Netherlands., Hueting WE; Department of Surgery, Alrijne Ziekenhuis, Leiderdop, The Netherlands.
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2021 Dec; Vol. 25 (6), pp. 1693-1701. Date of Electronic Publication: 2020 Sep 12.
DOI: 10.1007/s10029-020-02300-9
Abstrakt: Purpose: In this study, a three-step novel surgical technique was developed for incisional hernia, in which a laparoscopic procedure with a mini-laparotomy is combined: so-called 'three-step incisional hybrid repair'. The aim of this study was to reduce the risk of intestinal lacerations during adhesiolysis and recurrence rate by better symmetrical overlap placement of the mesh.
Objectives: To evaluate first perioperative outcomes with this technique.
Methods: From 2016 to 2020, 70 patients (65.7% females) with an incisional hernia of > 2 and ≤ 10 cm underwent a elective three-step incisional hybrid repair in two non-academic hospitals performed by two surgeons specialised in abdominal wall surgery. Intra- and postoperative complications, operation time, hospitalisation time and hernia recurrence were assessed.
Results: Mean operation time was 100 min. Mean hernia size was 4.8 cm; 45 patients (64.3%) had a hernia of 1-5 cm, 25 patients (35.7%) of 6-10 cm. Eight patients had a grade 1 complication (11.4%), five patients a grade 2 (7.1%), two patients (2.8%) a grade 4 complication and one patient (1.4%) a grade 5 complication. Five patients had an intraoperative complication (7.0%), two enterotomies, one serosa injury, one omentum bleeding and one laceration of an epigastric vessel. Mean length of stay was 3.3 days. Four patients (5.6%) developed a hernia recurrence during a mean follow-up of 19.5 weeks.
Conclusion: A three-step hybrid incisional hernia repair is a safe alternative for incisional hernia repair. Intraoperative complications rate was low.
(© 2020. The Author(s).)
Databáze: MEDLINE
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