Outcomes and Complications of Open, Laparoscopic, and Hybrid Giant Ventral Hernia Repair

Abstract

Background This study aimed to compare outcomes and complications between open, laparoscopic, and hybrid (laparoscopic and open combined) approaches in giant ventral hernia repair. Methods Records of patients with giant ventral hernias who received operations from 2006 to 2013 were retrospectively reviewed. Open, laparoscopic, or a hybrid procedure was performed in every case. The primary outcome was hernia recurrence rate, and secondary outcomes included intraoperative and postoperative complications. Results A total of 82 patients received open repair, 94 laparoscopic repair, and 132 hybrid repair. The median hernia diameter was 13.11 ± 3.4 cm. With a mean follow-up of 41 months, the incidence of hernia recurrence in the hybrid procedure group was 1.3%, which was significantly lower than that in the laparoscopic (20.5%) or open procedure group (8.5%) (P < 0.001). The incidence of intraoperative intestinal injury was 6.1% in open, 4.1% in laparoscopic, and only 1.5% in the hybrid procedure (hybrid vs. open and laparoscopic procedures; P < 0.05). Rates of postoperative intestinal fistula formation in the open, laparoscopic, and hybrid groups were 2.4%, 6.8%, and 3.3%, respectively (P > 0.05). Conclusions Compared with an open and a simple laparoscopic procedure, a hybrid procedure is more effective and safer in the repair of giant ventral hernias.