Hybrid intraperitoneal onlay mesh repair for incisional hernias: a systematic review and meta-analysis.

IF 2.6 2区医学 Q1 SURGERY Hernia Pub Date : 2024-12-01 Epub Date: 2024-07-11 DOI:10.1007/s10029-024-03105-w

Patrícia Marcolin, Sarah Bueno Motter, Gabriela R Brandão, Diego L Lima, Bruna Oliveira Trindade, Sérgio Mazzola Poli de Figueiredo

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Abstract

Introduction: Laparoscopic IPOM is technically challenging, especially regarding fascial closure. Hybrid repair has been proposed as a simpler approach. We aimed to compare hybrid and laparoscopic intraperitoneal onlay mesh repair (IPOM) in patients undergoing ventral hernia repair (VHR).

Methods: We performed a systematic review of Cochrane, Scopus, and MEDLINE databases to identify studies comparing hybrid versus laparoscopic IPOM VHR reporting the outcomes of recurrence, mortality, seroma, postoperative complications, reoperation, surgical site infection, and operative time. Statistical analysis was performed using RStudio 4.1.2 using a random-effects model.

Results: We screened 2,896 articles and fully reviewed 22 of them. A total of five studies, encompassing 664 patients were included. Among them, 337 (50.8%) underwent laparoscopic IPOM. All patients had incisional hernias, with a mean diameter varying from 3 to 12.7 cm, 60% were women, with a mean BMI varying from 29.5 to 38. The hybrid approach had a lower rate of seroma when compared to the laparoscopic (OR 0.22; 95% CI 0.05 to 0.92; p = 0.038; I²=78%). We found no difference in recurrence, mortality, postoperative complications, reoperation, surgical site infection, and operative time between groups.

Conclusion: Hybrid IPOM is a safe and effective method for incisional hernia repair. Moreover, it facilitates fascial defect closure and decreases postoperative seromas.

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针对切口疝的混合腹膜内镶嵌网片修复术：系统综述和荟萃分析。

简介腹腔镜 IPOM 在技术上具有挑战性，尤其是在筋膜闭合方面。混合修补术被认为是一种更简单的方法。我们的目的是对腹股沟疝修补术（VHR）患者进行混合腹腔镜和腹腔镜腹膜内网片修补术（IPOM）的比较：我们对 Cochrane、Scopus 和 MEDLINE 数据库进行了系统回顾，以确定比较杂交与腹腔镜 IPOM VHR 的研究，这些研究报告了复发、死亡率、血清肿、术后并发症、再次手术、手术部位感染和手术时间等结果。统计分析使用 RStudio 4.1.2，采用随机效应模型：我们筛选了 2,896 篇文章，并对其中的 22 篇进行了全面审查。共纳入了 5 项研究，涉及 664 名患者。其中，337人（50.8%）接受了腹腔镜IPOM手术。所有患者都患有切口疝，平均直径从3厘米到12.7厘米不等，60%为女性，平均体重指数从29.5到38不等。与腹腔镜方法相比，混合方法的血清肿发生率较低（OR 0.22；95% CI 0.05 至 0.92；P = 0.038；I²=78%）。我们发现不同组别在复发率、死亡率、术后并发症、再次手术、手术部位感染和手术时间方面没有差异：结论：混合 IPOM 是一种安全有效的切口疝修补方法。结论：混合型 IPOM 是一种安全有效的切口疝修补方法，而且有利于筋膜缺损的闭合，减少术后血清肿。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.