Hybrid operation technique for incisional hernia repair: a systematic review and meta-analysis of intra- and postoperative complications.

Autor: Van den Dop LM; Department of Surgery, Erasmus University Medical Center, Room Ee-173, Post box 2040, 3000, Rotterdam, CA, The Netherlands. l.vandendop@erasmusmc.nl., De Smet GHJ; Department of Surgery, Erasmus University Medical Center, Room Ee-173, Post box 2040, 3000, Rotterdam, CA, The Netherlands., Kleinrensink GJ; Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands., Hueting WE; Department of Surgery, Alrijne Ziekenhuis, Leiderdorp, Leiden, The Netherlands., Lange JF; Department of Surgery, Erasmus University Medical Center, Room Ee-173, Post box 2040, 3000, Rotterdam, CA, The Netherlands.; Department of Surgery, IJsselland Ziekenhuis, Capelle Aan Den IJssel, The Netherlands.
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2021 Dec; Vol. 25 (6), pp. 1459-1469. Date of Electronic Publication: 2021 Sep 18.
DOI: 10.1007/s10029-021-02497-3
Abstrakt: Background: Incisional hernia (IH) occurs approximately in 15% of patients after midline surgery. Surgical treatment for IHs include a solely open or solely laparoscopic approach with mesh placement. Recently, hybrid (combined laparoscopic and open) approaches have been introduced. This systematic review evaluates perioperative complications of hybrid incisional hernia repair (HIHR).
Methods: EMBASE, Medline via OvidSP, Web of Science, Cochrane and Google Scholar databases were searched. Studies providing data on intra- and postoperative complications in patients who underwent HIHR were included. Data on intra- and postoperative complications were extracted and meta-analyses were performed. Study quality was assessed with the Newcastle Ottowa Scale, ROBINS-I tool, and Cochrane risk of bias. PROSPERO registration: CRD42020175053.
Results: Eleven studies (n = 1681 patients) were included. Five studies compared intra-operative complications between HIHR and laparoscopic incisional hernia repair (LIHR) with a pooled incidence of 1.8% in HIHR group and 2.8% in LIHR group (p = 0.13). Comparison of postoperative prevalence of surgical site occurrences (SSOs) (23% versus 26%, p = 0.02) and surgical site occurrences requiring interventions (SSOPIs) (1.5% versus 4.1%, p < 0.01) were in favour of the HIHR group. Overall postoperative complications seemed to occur less frequent in the HIHR group, though no hard statements could be made due to the vast heterogeneity in reporting between studies.
Conclusion: Although the majority of studies were retrospective and included a small number of patients, HIHR seemingly led to less SSOs and SSOPIs. This systematic review forms a strong invitation for more randomized controlled trials to confirm the benefits of this approach.
(© 2021. The Author(s).)
Databáze: MEDLINE