Laparoscopic versus open incisional hernia repair: an open randomized controlled study.
BACKGROUND
Incisional hernia is a common complication of abdominal surgery, and it is often a source of morbidity and high costs for health care. This is a case-control study to compare laparoscopic versus anterior-open incisional hernia repair.


METHODS
170 patients with incisional hernia were enrolled in this study between September 2001 and December 2004. Of these, 85 underwent anterior-open repair (open group: OG), and 85 underwent laparoscopic repair (laparoscopic group: LG). The clinical outcome was determined by a median follow-up of 24.0 months for LG and OG.


RESULTS
No difference was noticed between the two groups in age, American Society of Anesthesiologists (ASA) score, body mass index (BMI), and incisional hernia diameter. Mean operative time was 61.0 min for LG patients and 150.9 min for OG patients (p < .05). Mean hospitalization was 2.7 days for LG patients and 9.9 days for OG patients (p < .05). Mean return to work was 13 days (range, 6-15 days) in LG patients and 25 days (range, 16-30 days) in OG patients. Complications occurred in 16.4 % of LG patients and 29.4 % of OG patients, with a relapse rate of 2.3% in LG and 1.1% in OG patients.


CONCLUSIONS
Short-term results indicate that laparoscopic incisional hernia repair is associated with a shorter operative time and hospitalization, a faster return to work, and a lower incidence of wound infections and major complications compared to the anterior-open procedure. Further studies and longer follow-up are required to confirm these findings.
Olmi
S
S
Department of Surgery, Center of Laparoscopic and Minimally Invasive Surgery, S. Gerardo Hospital, via Donizetti 106, 20052, Monza, Milan, Italy. stefanoolmi@tiscali.it
Scaini
A
A
Cesana
G C
GC
Erba
L
L
Croce
E
E
D000368:Aged; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D055502:Secondary Prevention; D016037:Single-Blind Method; D014945:Wound Healing / Q000502:physiology