Estudio comparativo de casos y controles concurrentes entre hernioplastia intraperitoneal laparoscópica y hernioplastia intraperitoneal abierta

Abstract

IntroductionLaparoscopic incisional hernioplasty has demonstrated advantages in selected cases in terms of postoperative recuperation and complications, and it is comparable in recurrence to open incisional hernioplasty; however, this technique does not constitute the gold standard for incisional hernia repair. We recommend that laparoscopic incisional hernioplasty should be considered the gold standard technique to repair upper midline incisional hernias with rings of less than 10cm and without loss of domain. Patients and methodsProspective case-control study of patients operated for incisional hernia with laparoscopic and open techniques that were followed-up with previously validated instruments for the measurement of incisional hernia outcomes and postoperative complications, without direct intervention over the study population. ResultsOne-hundred twelve patients with M2 incisional hernia were included, of them 28 were submitted to laparoscopic surgery and 84 to open surgery. Both groups of patients were comparable in their general and hernia characteristics. Complications were more common in patients submitted to open surgery, being skin-related complications the most frequent. All patients complied with the two-year follow-up. During this period, outcomes were measured with the available instrument, evidencing the better outcomes of the laparoscopic technique. ConclusionsThe outcomes of laparoscopic incisional hernioplasty in selected upper midline hernias showed the superiority of this technique compared with the open technique.