Open vs laparoscopic repair of secondary lumbar hernias: a prospective nonrandomized study.
BACKGROUND
Lumbar hernias are uncommon defects of the posterior abdominal wall. Surgical treatment is still controversial in these cases. The aim of this study was to compare outcome and costs of the laparoscopic approach vs the open method.


METHODS
We conducted a prospective nonrandomized study of 16 patients who underwent operation for secondary lumbar hernia between January 1997 and January 2003. Nine were treated via the laparoscopic approach and seven with an open technique. The following variables were analyzed: clinical data, hospital data (operating time and length of stay), patient comfort (consumption of analgesics and time to return to normal activities), and recurrences. Hospital costs were also analyzed.


RESULTS
There were no differences between the two groups in terms of age and history, although the defects of the patients in the laparoscopic group were smaller. Mean operating time, postoperative morbidity, mean hospital stay, consumption of analgesics, and time to return to normal activities were significantly lower in the laparoscopic group (p < 0. 01). No were there any statistical differences between the two types of surgical procedure in terms of hospital costs. However, the final cost did show differences when expenses for readmissions and recurrences were taken into account (p < 0.01).


CONCLUSIONS
The laparoscopic approach to secondary lumbar hernia repair is more efficient and more profitable than the traditional open technique.
Moreno-Egea
A
A
Department of General Surgery, J. M. Morales Meseguer Hospital, Murcia, 30008, Spain. moreno-egea@ono.com
Torralba-Martinez
J A
JA
Morales
G
G
Fernández
T
T
Girela
E
E
Aguayo-Albasini
J L
JL
D000368:Aged; D003365:Costs and Cost Analysis; D013505:Digestive System Surgical Procedures / Q000191:economics / Q000379:methods*; D005260:Female; D046449:Hernia, Abdominal / Q000191:economics / Q000601:surgery*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000191:economics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013030:Spain; D013526:Surgical Mesh; D016896:Treatment Outcome