Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 7, 2022; 10(1): 51-61
Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.51
Outcomes and complications of open, laparoscopic, and hybrid giant ventral hernia repair
Shuo Yang, Ming-Gang Wang, Yu-Sheng Nie, Xue-Fei Zhao, Jing Liu
Shuo Yang, Ming-Gang Wang, Yu-Sheng Nie, Xue-Fei Zhao, Jing Liu, Department of Hernia and Abdominal Wall, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100043, China
Author contributions: Wang MG designed the study, wrote the protocol, and undertook the statistical analysis; Yang S performed research; Wang MG and Yang S wrote the first draft of the manuscript; Nie YS, Zhao XF and Liu J assisted in the searches and analyses.
Institutional review board statement: The study protocol was approved by the local Ethical Review Boards of Chao-Yang Hospital. All procedures were performed following established European and American guidelines for the repair of hernias.
Conflict-of-interest statement: All the authors declare no conflict of interest.
Data sharing statement: The data of this research could be obtained upon reasonable request from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Gang Wang, MD, Chief Doctor, Department of Hernia and Abdominal Wall, Beijing Chao-Yang Hospital, Capital Medical University, No. 5 Jingyuan Road, Shijingshan District, Beijing 100043, China. womi93781345585@163.com
Received: January 28, 2021
Peer-review started: January 28, 2021
First decision: June 15, 2021
Revised: July 11, 2021
Accepted: November 22, 2021
Article in press: November 22, 2021
Published online: January 7, 2022
Processing time: 335 Days and 22.7 Hours
ARTICLE HIGHLIGHTS
Research background

Incisional hernia is a common complication of abdominal surgery. The traditional method, including open or laparoscopic surgery, still has many limitations.

Research motivation

This study motivated us to investigate the potential advantages of a hybrid application of open and laparoscopic approaches in giant ventral hernia repair.

Research objectives

This study tried to determine if a hybrid application of open and laparoscopic approaches is more effective and safer in the repair of giant ventral hernias than a single open or laparoscopic procedure.

Research methods

Patients were retrospectively reviewed and divided into open (n = 82), laparoscopic (n = 73), and hybrid group (n = 153), respectively. The hernia recurrence rate, intraoperative and postoperative complications, operative time, blood loss, length of hospital stay, and mortality in the three groups were also recorded and analyzed.

Research results

Patients in the three groups were comparable in demographic and baseline characteristics (all, P > 0.05). The mean operation times of the hybrid group were significantly longer than the open and laparoscopic groups (76.7 ± 23.7 vs 63.6 ± 12.1 and 113.6 ± 21.8, P < 0.001). However, the incidence of postoperative complications was significantly lower in the hybrid group (7.23%) than in the open (17.1%; P = 0.019) or laparoscopic (26.0%; P < 0.05) groups. Besides, the hybrid group had a significantly lower intraoperative intestinal injury rate, reoperation rate, and seroma formation than the open and laparoscopic groups (1.5% vs 6.1% and 4.1%, P < 0.05; 3.9% vs 12.2% and 24.78%, P < 0.001; 2.6% vs 6.1% and 32.8%, P < 0.001).

Research conclusions

The hybrid approach of laparoscopic and open procedures is associated with lower complication and hernia recurrence rates. It combines the advantages of laparoscopic and open repair and minimizes the disadvantages of the two approaches.

Research perspectives

The hybrid approach of the laparoscopic and open procedures, which is worthy of clinical application, is an effective method for giant ventral hernia repair.