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01-12-2018 | Original Article

A comparison of laparoscopic and open repair of subxiphoid incisional hernias

Authors: J. Raakow, J. Schulte-Mäter, Y. Callister, M. Aydin, C. Denecke, J. Pratschke, M. Kilian

Published in: Hernia | Issue 6/2018

Abstract

Introduction

Incisional hernias to the subxiphoid region are rare and anatomically challenging, with bony and cartilaginous structures attaching, as well as conflating abdominal fascia. The repair of hernias in this region is, therefore, difficult and prone to recurrence. The surgical treatment can be done by open or laparoscopic repair but very little is known about which method is superior. We, therefore, reviewed our data of patients undergoing repair of subxiphoid hernias.

Methods

Between January 2010 and June 2015 twenty-eight patients were treated by laparoscopic (n = 8) or open (n = 20) hernia repair due to an incisional hernia in the subxiphoid region. Patients with ventral hernias with an origin more distal than the M1-area only extending into the subxiphoid region and those undergoing suture hernia repair were excluded.

Results

The hernia sizes, in terms of length, width and EHS classification, did not vary between open and laparoscopic repair. The duration of laparoscopic surgery was significantly shorter than the mean operative time for an open subxiphoid hernia repair (168.1 min vs. 96.1 min, respectively; p = 0.012). The groups did not differ significantly in terms of overall postoperative complications (p = 0.568) but the grade (Clavien–Dindo) of complications was higher following open repair leading to three reoperations. Within the follow-up time, we diagnosed significantly (p = 0.031) more subxiphoid hernia recurrences after laparoscopic repair (37.5%, n = 3) than after open repair (0%).

Conclusion

Laparoscopic and open repair of subxiphoid incisional hernias are both technically challenging compared to other midline hernias. Referring to our results laparoscopic repair has shorter operative times, lower postoperative morbidity with a higher recurrence rate compared to open repair but the sample size is too small for an overall conclusion.

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Title: A comparison of laparoscopic and open repair of subxiphoid incisional hernias
Authors: J. Raakow
J. Schulte-Mäter
Y. Callister
M. Aydin
C. Denecke
J. Pratschke
M. Kilian
Publication date: 01-12-2018
Publisher: Springer Paris
Published in: Hernia / Issue 6/2018
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-018-1815-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A comparison of laparoscopic and open repair of subxiphoid incisional hernias

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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