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01-10-2016 | Original Scientific Report

Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery—A Systematic Review and Meta-Analysis

Authors: Julia B. Kössler-Ebs, Kathrin Grummich, Katrin Jensen, Felix J. Hüttner, Beat Müller-Stich, Christoph M. Seiler, Phillip Knebel, Markus W. Büchler, Markus K. Diener

Published in: World Journal of Surgery | Issue 10/2016

Abstract

Background

Incisional hernias are one of the most common long-term complications associated with open abdominal surgery. The aim of this review and meta-analysis was to systematically assess laparoscopic versus open abdominal surgery as a general surgical strategy in all available indications in terms of incisional hernia occurrence.

Methods

A systematic literature search was performed to identify randomized controlled trials comparing incisional hernia rates after laparoscopic versus open abdominal surgery in all indications. Random effects meta-analyses were calculated and presented as risk differences (RD) with their corresponding 95 % confidence intervals (CI).

Results

24 trials (3490 patients) were included. Incisional hernias were significantly reduced in the laparoscopic group (RD −0.06, 95 % CI [−0.09, −0.03], p = 0.0002, I ² = 75). The advantage of the laparoscopic procedure persisted in the subgroup of total-laparoscopic interventions (RD −0.14, 95 % CI [−0.22, −0.06], p = 0.001, I ² = 87 %), whereas laparoscopically assisted procedures did not show a significant reduction of incisional hernias compared to open surgery (RD −0.01, 95 % CI [−0.03, 0.01], p = 0.31, I ² = 35 %). Wound infections were significantly reduced in the laparoscopic group (RD −0.06, 95 % CI [−0.09, −0.03], p < 0.0001, I ² = 35 %); overall postoperative morbidity was comparable in both groups (RD −0.06, 95 % CI [−0.13, 0.00], p = 0.06; I ² = 64 %). Open abdominal surgery showed a significantly longer hospital stay compared to laparoscopy (RD −1.92, 95 % CI [−2.67, −1.17], p < 0.00001, I ² = 87 %). At short-term follow-up, quality of life was in favor of laparoscopy.

Conclusions

Incisional hernias are less frequent using the total-laparoscopic approach instead of open abdominal surgery. Whenever possible, the less traumatic access should be chosen.

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Title: Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery—A Systematic Review and Meta-Analysis
Authors: Julia B. Kössler-Ebs
Kathrin Grummich
Katrin Jensen
Felix J. Hüttner
Beat Müller-Stich
Christoph M. Seiler
Phillip Knebel
Markus W. Büchler
Markus K. Diener
Publication date: 01-10-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 10/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3520-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery—A Systematic Review and Meta-Analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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