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Comparison of outcomes of laparoscopic hernioplasty with and without fascial repair (IPOM-Plus vs IPOM) for ventral hernia: A retrospective cohort study

BACKGROUND: Intra-peritoneal onlay mesh (IPOM) repair, a type of Laparoscopic Ventral Hernia Repair (LVHR), comprises bridging the defect from the peritoneal side with a composite mesh. Recently, IPOM-Plus has become the recommended type of LVHR in which the defect in the fascia is sutured before pl...

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Detalles Bibliográficos
Autores principales: Basukala, Sunil, Tamang, Ayush, Rawal, Sushil Bahadur, Malla, Srijan, Bhusal, Ujwal, Dhakal, Subodh, Sharma, Shriya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422290/
https://www.ncbi.nlm.nih.gov/pubmed/36045856
http://dx.doi.org/10.1016/j.amsu.2022.104297
Descripción
Sumario:BACKGROUND: Intra-peritoneal onlay mesh (IPOM) repair, a type of Laparoscopic Ventral Hernia Repair (LVHR), comprises bridging the defect from the peritoneal side with a composite mesh. Recently, IPOM-Plus has become the recommended type of LVHR in which the defect in the fascia is sutured before placing the mesh. MATERIALS AND METHODS: This study is a retrospective cohort study conducted at Shree Birendra Hospital (SBH), Nepal. Patients who had undergone IPOM-Plus or IPOM during the past five years (Aug 2016 to Aug 2021) were selected. Data regarding demographics, intraoperative and post-operative outcomes were collected from individual case sheets. Recurrence of hernia was checked at six-month follow-up. Data analysis was performed using SPSS version 25 taking a p-value of <0.05 as statistically significant. RESULTS: A total of 130 patients were included in this study, out of which 73 patients had undergone IPOM (Group I) and 57 patients underwent IPOM-Plus (Group II). In both the groups, there were no statistical difference in age, sex and Body Mass Index (BMI) of the patients. Hernia defect size among Group I and II varied significantly (p-value < 0.001). The mean operative time for Group II (111.05 ± 28.14 min) was significantly higher than Group I (80.00 ± 27.96 min) (p-value < 0.001). Hernia recurrence within six months was higher in Group I (15.1%) than Group II (3.5%) (p-value = 0.029). The adjusted odds ratio (AOR) for six-month recurrence after IPOM repair was 14.86 (95% CI: 2.51–87.85, p-value = 0.003) times higher than that after IPOM-Plus repair. CONCLUSIONS: Although the operative time and length of hospital stay is longer, IPOM-Plus repair has shown better outcomes regarding six-month recurrence compared to IPOM repair.