School of Medicine, Queen's University, Kingston, ON, Canada.
General Surgery, Kingston Health Sciences Centre, 76 Stuart Street, Burr 2, Kingston, ON, K7L 2V7, Canada.
Hernia. 2019 Feb;23(1):91-100. doi: 10.1007/s10029-018-1853-6. Epub 2018 Nov 23.
To compare, using a meta-analysis of randomized controlled trials, the risk of incisional hernia in patients undergoing single-incision laparoscopic surgery to those undergoing traditional laparoscopic surgery.
MEDLINE and EMBASE databases were searched. Randomized controlled trials comparing single-incision laparoscopic surgery to traditional laparoscopic surgery and which reported incisional hernias over a minimum 6-month follow-up period were eligible. Risk of bias was assessed as outlined in the Cochrane Handbook. Pooled odds ratios were calculated using RevMan.
Of 309 identified studies, 22 were included in this meta-analysis. Pooled results showed higher odds of incisional hernia following single-incision laparoscopic surgery relative to traditional laparoscopic surgery (odds ratio 2.83, 95% CI 1.34-5.98, p = 0.006, I = 0%). There was no difference in the odds of incisional hernias requiring surgical repair (p = 0.10). Subgroup analysis found no difference in the odds of incisional hernias based on procedure type (p = 0.69) or method of follow-up (p = 0.85). The quality of evidence was determined to be moderate.
Single-incision laparoscopic surgery is associated with a threefold increase in the odds of incisional hernia compared with traditional laparoscopic surgery.
通过对随机对照试验的荟萃分析，比较单切口腹腔镜手术与传统腹腔镜手术患者切口疝的风险。
检索 MEDLINE 和 EMBASE 数据库。纳入比较单切口腹腔镜手术与传统腹腔镜手术且随访时间至少 6 个月的随机对照试验。使用 Cochrane 手册评估偏倚风险。使用 RevMan 计算合并优势比。
在 309 项已识别的研究中，有 22 项研究纳入本荟萃分析。汇总结果显示，与传统腹腔镜手术相比，单切口腹腔镜手术后切口疝的发生风险更高（优势比 2.83，95%置信区间 1.34-5.98，p=0.006，I=0%）。两种手术方式发生需要手术修复的切口疝的风险无差异（p=0.10）。亚组分析发现，基于手术类型（p=0.69）或随访方法（p=0.85），切口疝的发生风险无差异。证据质量被确定为中等。
与传统腹腔镜手术相比，单切口腹腔镜手术导致切口疝的风险增加了三倍。
