Division of Surgery, Federal University of the Southern Border (Universidade Federal da Fronteira Sul), 20 Capitão Araujo St., Passo, Fundo, 99010-121, Brazil.
Division of Surgery, Federal University of Health Sciences of Porto Alegre (Universidade Federal de Ciências da Saúde de), 245 Sarmento Leite St., Porto Alegre, 90050-170, Brazil.
Hernia. 2024 Dec;28(6):2055-2067. doi: 10.1007/s10029-024-03105-w. Epub 2024 Jul 11.
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).
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.
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.
Hybrid IPOM is a safe and effective method for incisional hernia repair. Moreover, it facilitates fascial defect closure and decreases postoperative seromas.
腹腔镜 IPOM 技术难度大，尤其是在筋膜闭合方面。已经提出了混合修复作为一种更简单的方法。我们旨在比较接受腹疝修复 (VHR) 的患者中混合修复与腹腔镜腹膜内补片修补术 (IPOM) 的效果。
我们对 Cochrane、Scopus 和 MEDLINE 数据库进行了系统评价，以确定比较混合与腹腔镜 IPOM VHR 报告复发、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的研究。使用 RStudio 4.1.2 使用随机效应模型进行统计分析。
我们筛选了 2896 篇文章，并对其中 22 篇进行了全面审查。共有五项研究，包括 664 名患者被纳入。其中，337 名（50.8%）患者接受了腹腔镜 IPOM。所有患者均患有切口疝，平均直径为 3 至 12.7cm，60%为女性，平均 BMI 为 29.5 至 38。与腹腔镜组相比，混合组血清肿发生率较低（OR 0.22；95%CI 0.05 至 0.92；p=0.038；I²=78%）。我们没有发现两组在复发、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存在差异。
混合 IPOM 是一种安全有效的切口疝修复方法。此外，它有助于筋膜缺损闭合并减少术后血清肿。
