Laparoscopic incisional and ventral hernia repair in a district general hospital
| Autor: | Colin Hart, JG Finch, CD Mann, Alison Luther |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Incisional hernia medicine.medical_treatment Morbidly obese Hospitals General Body Mass Index Conversion to open surgery Young Adult Postoperative Complications Recurrence Risk Factors Medicine Humans Defect size General hospital Herniorrhaphy Aged Aged 80 and over business.industry Ventral hernia repair General surgery General Medicine Middle Aged Hernia repair medicine.disease Hernia Ventral United Kingdom Surgery Cross-Sectional Studies General Surgery Female Laparoscopy business Body mass index |
| Popis: | Introduction The laparoscopic approach to repairing ventral and incisional hernias has gained increasing popularity worldwide. We reviewed the experience of laparoscopic ventral hernia repair at a district general hospital in the UK with particular reference to patients with massive defects (diameter ≥15cm) and the morbidly obese. Methods A total of 144 patients underwent laparoscopic ventral (incisional or umbilical/paraumbilical) hernia repair between April 2007 and September 2012. Results The prevalence of conversion to open surgery was 2.8%. The prevalence of postoperative complications was 3.5%. Median postoperative follow-up was 30.2 months. A total of 5.6% cases suffered late complications and 2.8% developed recurrence. Thirty-four patients underwent repair of defects ≥10cm in diameter with a prevalence of recurrence of 5.6%. Sixteen patients underwent repair of ‘massive’ incisional hernia (diameter ≥15cm) with a prevalence of recurrence of 12.5%. Sixteen patients with a body mass index (BMI) ≥40kg/m2 (range, 40–61kg/m2) underwent laparoscopic repair with a prevalence of recurrence of 6.3% (p>0.05 vs BMI 2). Conclusions Laparoscopic ventral hernia repair can be carried out safely with a low prevalence of recurrence. It may have advantages in morbidly obese patients in whom open repair would represent a significant undertaking. Laparoscopic ventral hernia repair may be used in cases of large and massive hernias, in which the risk of recurrence increases but is comparable with open repair and associated with low morbidity. |
| Databáze: | OpenAIRE |
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