Stipa Francesco, Giaccaglia Valentina, Burza Antonio, Santini Ettore, Bascone Bruno, Picchio Marcello
Department of Surgery, San Giovanni Hospital, Roma, Italy.
Surg Laparosc Endosc Percutan Tech. 2013 Aug;23(4):419-22. doi: 10.1097/SLE.0b013e31828e3c33.
To compare laparoscopic and open repair of incisional hernia in terms of complications and failure rates.
Between June 2005 and April 2012, 252 patients underwent incisional hernia repair. Of these, 126 underwent laparoscopic and 126 open repair. The median follow-up was 38.7 months.
Baseline characteristics [age, body mass index, American Society of Anesthesiologists (ASA) score, comorbidities, hernia size, and follow-up] did not differ significantly. Mean operative time was similar (72 vs. 83 min). Laparoscopic repair was associated with less postoperative pain, less postoperative complications (3.9% vs. 13.4%, P=0.012), and shorter hospital stay (3.5 vs. 4.3, P=0.002). Recurrence occurred in 6 patients of group 1 and in 7 patients of group 2 (4.7% vs. 5.5%, P=not significant).
In this study, the trend in favor of laparoscopic treatment for incisional hernias is remarkable. Fewer postoperative complications and shorter hospital stay with similar operative time may balance the higher costs associated with the technique.
比较腹腔镜修补术和开放修补术治疗切口疝的并发症及失败率。
2005年6月至2012年4月期间，252例患者接受了切口疝修补术。其中，126例行腹腔镜修补术，126例行开放修补术。中位随访时间为38.7个月。
基线特征[年龄、体重指数、美国麻醉医师协会（ASA）评分、合并症、疝大小及随访情况]差异无统计学意义。平均手术时间相似（72分钟对83分钟）。腹腔镜修补术术后疼痛较轻，术后并发症较少（3.9%对13.4%，P = 0.012），住院时间较短（3.5天对4.3天，P = 0.002）。第1组6例患者和第2组7例患者出现复发（4.7%对5.5%，P无统计学意义）。
在本研究中，腹腔镜治疗切口疝的优势趋势显著。手术时间相似的情况下，术后并发症较少且住院时间较短，可能会抵消该技术较高的成本。
