Authors: Julia B KösslerEbs Kathrin Grummich Katrin Jensen Felix J Hüttner Beat MüllerStich Christoph M Seiler Phillip Knebel Markus W Büchler Markus K Diener
Publish Date: 2016/05/04
Volume: 40, Issue: 10, Pages: 2319-2330
Abstract
Incisional hernias are one of the most common longterm complications associated with open abdominal surgery The aim of this review and metaanalysis was to systematically assess laparoscopic versus open abdominal surgery as a general surgical strategy in all available indications in terms of incisional hernia occurrenceA systematic literature search was performed to identify randomized controlled trials comparing incisional hernia rates after laparoscopic versus open abdominal surgery in all indications Random effects metaanalyses were calculated and presented as risk differences RD with their corresponding 95 confidence intervals CI24 trials 3490 patients were included Incisional hernias were significantly reduced in the laparoscopic group RD −006 95 CI −009 −003 p = 00002 I 2 = 75 The advantage of the laparoscopic procedure persisted in the subgroup of totallaparoscopic interventions RD −014 95 CI −022 −006 p = 0001 I 2 = 87 whereas laparoscopically assisted procedures did not show a significant reduction of incisional hernias compared to open surgery RD −001 95 CI −003 001 p = 031 I 2 = 35 Wound infections were significantly reduced in the laparoscopic group RD −006 95 CI −009 −003 p 00001 I 2 = 35 overall postoperative morbidity was comparable in both groups RD −006 95 CI −013 000 p = 006 I 2 = 64 Open abdominal surgery showed a significantly longer hospital stay compared to laparoscopy RD −192 95 CI −267 −117 p 000001 I 2 = 87 At shortterm followup quality of life was in favor of laparoscopy
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