Hernioplastía Ventral Laparoscópica

Abstract

Laparoscopic repair of ventral herniasBackground: Ventral hernias are defects of the anterior abdominal wall, the laparoscopic repair has shown some advantages compared to open repair. Aim: To evaluate perioperative outcomes of the laparoscopic ventral hernia repair and to describe risk factors associated to recurrence. Methods: Non-concurrent prospective cohort study, clinical data of all patients who underwent laparoscopic ventral hernia repair between June 2006 and May 2013 were reviewed. Univariate analyses were performed using chi-square for categorical variables and U Mann-Whitney test for continuous variables. Multivariate analysis was performed using a logistic regression model. Results: 127 patients underwent laparoscopic ventral hernia, 52% female, age of 58.1 ± 1.2 years old. Mean Body Mass Index (BMI) was 31 ± 0.5 kg/m 2 and 67.7% were incisional hernias. Median operative time was 80 minutes (ranging from 30-350) and the median defect size was 6 cm (ranging from 2-20). Conversion to open surgery was necessary in 4 cases (3.9%). Median of hospital stay was 2 days (ranging from 1-15). Recurrence rate was 14.2% and the median to recurrence was 9 months. Recurrence rate was associated positively to defect size > 10 cm (p = 0.002), previous recurrence (p = 0.029) and operative time > 90 minutes (p = 0.017) in the univariate analyses. However, it was only associated to the first two in the multivariate analysis (OR 3.906; respectively). Conclusions: Laparoscopic repair of ventral hernia is a safe procedure with acceptable perioperative complication rates. Defect size and previous recurrence are associated to a higher recurrence rate.