Closure versus non-closure of hernia defect during laparoscopic ventral hernia repair with mesh
| Autor: | Victor Maciel, Eddie Gomez, Marianna Zeichen, A M Hernandez, Irving Jorge, Gustavo Plasencia, Henry J. Lujan, Wilmer Mata, D Lee |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Comparative Effectiveness Research Closure (topology) Severity of Illness Index Defect closure Postoperative Complications medicine Secondary Prevention Humans Hernia Mesh reinforcement Herniorrhaphy Secondary prevention Ventral hernia repair business.industry Abdominal Wound Closure Techniques Middle Aged Surgical Mesh medicine.disease digestive system diseases Hernia Ventral Surgery stomatognathic diseases surgical procedures operative Treatment Outcome Ventral hernia Female Laparoscopy business Abdominal surgery |
| Zdroj: | Hernia : the journal of hernias and abdominal wall surgery. 17(5) |
| ISSN: | 1248-9204 |
| Popis: | Laparoscopic ventral hernia repair with mesh versus laparoscopic ventral hernia defect closure with mesh reinforcement. The primary end-point was recurrence.Retrospective review of patients who underwent laparoscopic ventral hernia repair for small- and medium-sized hernias between July 2000 and September 2011. These patients were divided: (1) repair with mesh alone (non-closure group) and (2) those with hernia defect closure and mesh reinforcement (closure group). The closure group was further divided by technique: percutaneous versus intracorporeal closure of the defect.128 patients were studied: 93 patients (72.66 %) in the non-closure group and 35 patients (27.34 %) in the closure group. Follow-up was available in 105 patients (82.03 %) at a mean of 797.2 days (range 7-3,286 days). In the non-closure group there were 14 patients (15.05 %) with postoperative complications and 8 patients (22.86 %) in the closure group, four of which were seromas. Fourteen patients (19.18 %) developed recurrent hernias in the non-closure group with an average time to presentation of 23.17 months (range 5.3-75.3). Two patients (6.25 %) developed recurrent hernias in the percutaneous group with an average time to presentation of 12.95 months (range 9.57-16.33). There have been no recurrences in patients whose defect was closed intracorporeally.Although our study demonstrated a difference in recurrence rates of 19.18 % in the non-closure group versus 6.25 % in the closure group, the difference did not reach statistical significance. A larger series with longer follow-up may demonstrate clinical significance. |
| Databáze: | OpenAIRE |
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