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Hernia. 2013 Oct;17(5):589-96. doi: 10.1007/s10029-013-1115-6. Epub 2013 Jun 20.

Closure versus non-closure of hernia defect during laparoscopic ventral hernia repair with mesh.

Author information

1
Miami International Surgical Services at Jackson South Community Hospital, 9195 SW 72nd St # 230, Miami, FL, 33173, USA, mzeichen@hotmail.com.

Abstract

PURPOSE:

Laparoscopic ventral hernia repair with mesh versus laparoscopic ventral hernia defect closure with mesh reinforcement. The primary end-point was recurrence.

METHODS:

Retrospective review of patients who underwent laparoscopic ventral hernia repair for small- and medium-sized hernias between July 2000 and September 2011. These patients were divided: (1) repair with mesh alone (non-closure group) and (2) those with hernia defect closure and mesh reinforcement (closure group). The closure group was further divided by technique: percutaneous versus intracorporeal closure of the defect.

RESULTS:

128 patients were studied: 93 patients (72.66 %) in the non-closure group and 35 patients (27.34 %) in the closure group. Follow-up was available in 105 patients (82.03 %) at a mean of 797.2 days (range 7-3,286 days). In the non-closure group there were 14 patients (15.05 %) with postoperative complications and 8 patients (22.86 %) in the closure group, four of which were seromas. Fourteen patients (19.18 %) developed recurrent hernias in the non-closure group with an average time to presentation of 23.17 months (range 5.3-75.3). Two patients (6.25 %) developed recurrent hernias in the percutaneous group with an average time to presentation of 12.95 months (range 9.57-16.33). There have been no recurrences in patients whose defect was closed intracorporeally.

CONCLUSION:

Although our study demonstrated a difference in recurrence rates of 19.18 % in the non-closure group versus 6.25 % in the closure group, the difference did not reach statistical significance. A larger series with longer follow-up may demonstrate clinical significance.

PMID:
23784711
DOI:
10.1007/s10029-013-1115-6
[Indexed for MEDLINE]

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