Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh

被引:231
|
作者
Forbes, S. S. [2 ,3 ,4 ]
Eskicioglu, C. [2 ,3 ,4 ]
McLeod, R. S. [2 ,3 ,4 ,5 ]
Okrainec, A. [1 ,2 ]
机构
[1] Univ Hlth Network, Toronto Western Hosp, Toronto, ON M8Y 1E8, Canada
[2] Univ Toronto, Dept Surg, Toronto, ON, Canada
[3] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada
[4] Dr Zane Digest Dis Clin Res Ctr, Toronto, ON, Canada
[5] Mt Sinai Hosp, Samuel Lunenfeld Res Inst, Toronto, ON M5G 1X5, Canada
关键词
D O I
10.1002/bjs.6668
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Laparoscopic ventral and incisional hernia repair has been reported in a number of small trials to have equivalent or superior outcomes to open repair. Methods: Randomized controlled trials comparing laparoscopic and open incisional or ventral hernia repair with mesh that included data oil effectiveness and safety were included in a meta-analysis. Results: Eight studies met the inclusion criteria. There was no difference between groups in hernia recurrence rates (relative risk 1.02 (95 per cent confidence interval (c.i.) 0.41 to 2.54)). Duration of Surgery varied. Mean length of hospital stay was shorter after laparoscopic repair in six Of the included studies; the longest mean stay was 5.7 days for laparoscopic and 10 (lays for open surgery. Laparoscopic hernia repair was associated with fewer wound infections (relative risk 0.22 (95 per cent c.i. 0.09 to 0.54)), and a trend to-ward fewer haemorrhagic complications and infections requiring mesh removal. Conclusion: Laparoscopic repair of ventral and incisional hernia is at least as effective, if not superior to, the open approach in a number of outcomes.
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页码:851 / 858
页数:8
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