Laparoscopic Treatment of Incisional and Ventral Hernia
| Autor: | Basilio Pirrera, Mario Junior Nardi, Paolo Millo, Alberto Oldani, Francesca Pecchini, Stefano Olmi, Gianluca Garulli, Micaela Piccoli |
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| Přispěvatelé: | Olmi, S., Millo, P., Piccoli, M., Garulli, G., Nardi, M. J., Pecchini, F., Oldani, A., Pirrera, B. |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Incisional hernia Operative Time Abdominal wall Postoperative Complications Recurrence Incisional Hernia Humans Medicine Hernia Postoperative Period Risk factor Laparoscopy Herniorrhaphy Aged Retrospective Studies Mesh medicine.diagnostic_test business.industry Abdominal Wall Odds ratio Length of Stay Middle Aged Surgical Mesh medicine.disease Fixing devices Hernia Ventral Confidence interval Surgery Ventral hernia medicine.anatomical_structure business Research Article |
| Zdroj: | JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons |
| ISSN: | 1938-3797 1086-8089 |
| Popis: | Background and Objectives: Although several large studies regarding patients undergoing minimally invasive repair of incisional hernia are currently available, the results are not particularly reliable as they are based on heterogeneous groups, different surgical techniques, different mesh types, or with a too short follow period. Methods: We conducted a retrospective observational trial, collecting data from patients who underwent laparoscopic repair of a primary abdominal wall or an incisional hernia using the laparoscopic Intraperitoneal Onlay Mesh technique and a single mesh type, i.e., a composite poly-ester mesh with a hydrophilic film (Parietex Composite™ mesh – Medtronic, Minneapolis, MN-USA). All patients signed an informed consent. Results: One thousand seven hundred seventy-seven patients were enrolled. The median surgery time was 50 minutes and the median length of hospital stay was 2 days. Intraoperative complications occurred in 12 patients (0.7%), while early postoperative surgical complications occurred in 115 (6.5%); during follow-up, bulg-ing mesh was diagnosed in 4.5% of cases and hernia recurred in 4.3% of patients. An overlap equal or greater than 4 cm resulted as a significant protective factor, while the use of absorbable fixing devices was a risk factor for recurrence (odds ration: 9.06, p < 0.001, 95% confidence interval: 4.19 – 19.57). Conclusions: Minimally invasive treatment of primary and postincisional abdominal wall hernias is a safe, effec-tive, and reproducible procedure. An overlap equal or greater than 4 cm, the use of nonabsorbable fixing devices and a postoperative care and follow-up regime are crucial in order to obtain good results and low recurrence rates. |
| Databáze: | OpenAIRE |
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