BJS-06 Laparoscopic Intracorporeal Rectus Aponeuroplasty (Lira) Technique Versus Intraperitoneal Onlay Mesh Closing the Defect (Ipom Plus) for Ventral Hernia Repair: Comparative Results at Medium Follow-Up

Abstract

Background The primary aim of this prospective study is to compare the postoperative outcomes between LIRA technique and IPOM plus, in terms of recurrence and bulging rates at one-year follow-up; the secondary aim is to compare the postoperative complications, seroma and pain at 30 days and one-year after surgery. Methods Patients with midline ventral hernia of 4–10 cm in width were included. Seromaand recurrence was evaluated by Computed tomography scan 1 month and 1 year after surgery. Pain was evaluated using the visual analogue scale score. Results Forty-five and forty-seven patients underwent LIRA and IPOM plus, respectively. Preoperatively, smoke habitus rate was statistically significantly higher in LIRA group (20 patients, 44.4%) in comparison to IPOM group (5 patients, 10.6%) (p=0.0001). Statistically significant differences were not considering the intraoperative variables. Two bulgings (4.4%) occurred in the LIRA group, while in the IPOM group occurred 10 bulgings (21.3%) and three recurrences (6.4%) (p=0.017 and p=0.085, respectively). Postoperatively, seven (15.6%, Clavien-Dindo I) and four complications (8.5%, two Clavien-Dindo I and two Clavien-Dindo III-b) occurred in the LIRA and in the IPOM group, respectively (p=0.298). One month after surgery, clinical seroma, occurred in five (11.1%) and eight patients (17%) in the LIRA and in the IPOM group, respectively (p=0.416). During follow-up, pain reduction occurred, without statistically significant differences. Conclusions LIRA showed lower bulging and recurrence rates in comparison to IPOM plus at one-year follow-up. Further prospective studies, with a large sample of patients and longer follow-up are required to draw definitive conclusions.