Laparoscopy versus laparotomy in the repair of ventral hernias: systematic review and meta-analysis

Arq Gastroenterol. 2014 Jul-Sep;51(3):205-11. doi: 10.1590/s0004-2803201400030008.

Abstract

Objective: To compare the laparotomy and laparoscopy techniques for correction of ventral hernia when related to perioperative complications, length of hospitalization, surgical time, and recurrence of hernia.

Methods: This was a systematic review of randomized controlled trials, which included studies retrieved from four databases (MEDLINE, Embase, Cochrane and LILACS), using a combination of the terms (Hernia, Ventral) and (Laparoscopy) and (Laparotomy).

Results: Six randomized trials were included, totaling 566 patients, 283 in the Laparoscopy group and 283 in the Laparotomy group. Laparoscopy reduced the risk of infection of the surgical wound (NNT = 5) and seroma formation (NNT = 13) and less length hospitalization (P = 0.02) compared to laparotomy in the correction of ventral hernias. Furthermore, laparoscopy increased the incidence of enterotomy (NNH = 25) and post operative pain (NNH = 8) and longer surgical time (P = 0.0009) when compared with laparotomy. There was no difference related to abscess (P = 0.79), hematoma (P = 0.43) and recurrency of ventral hernias (P = 0.25).

Conclusions: In the correction of ventral hernias, the use of laparoscopic technique is effective to reduce infections of the surgical wound and seroma formation, as well as, decrease the length hospitalization.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Hernia, Ventral / surgery*
  • Humans
  • Laparoscopy* / adverse effects
  • Laparotomy* / adverse effects
  • Length of Stay
  • Operative Time
  • Randomized Controlled Trials as Topic
  • Recurrence