Laparoscopic intraperitoneal onlay mesh (IPOM) with fascial repair (IPOM-plus) for ventral and incisional hernia: a systematic review and meta-analysis

被引：9

作者：

Huang, X. ^{[1
]}

Shao, X. ^{[2
]}

Cheng, T. ^{[2
]}

Li, J. ^{[2
]}

机构：

[1] Southeast Univ, Sch Med, Nanjing 210009, Peoples R China

[2] Southeast Univ, Affiliated Zhongda Hosp, Dept Gen Surg, Nanjing 210009, Peoples R China

来源：

HERNIA | 2024年 / 28卷 / 02期

关键词：

IPOM; IPOM-plus; Fascia closure; Ventral; Incisional hernia; (INTERNATIONAL ENDOHERNIA SOCIETY; NON-CLOSURE; FOLLOW-UP; OUTCOMES; DEFECT; GUIDELINES;

D O I：

10.1007/s10029-024-02983-4

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Purpose Despite advancements in laparoscopic ventral hernia repair (LVHR) using the intraperitoneal onlay mesh technique (sIPOM), recurrence remains a common postoperative complication. The objective of this systematic review and meta-analysis is to compare the efficacy of defect closure (IPOM-plus) versus non-closure in ventral and incisional hernia repair. The aim is to determine which technique yields better outcomes in terms of reducing recurrence and complication rates. Methods A comprehensive literature review was conducted in the PubMed, Web of Science, Cochrane Library, Embase, and ClinicalTrials.gov databases from their inception until October 1, 2022, to identify all online English publications that compared the outcomes of laparoscopic ventral hernia repair with and without fascia closure. Results Three randomized controlled trials (RCTs) and eleven cohort studies involving 1585 patients met the inclusion criteria. The IPOM-plus technique was found to reduce the recurrence of hernias (OR = 0.51, 95% CI [0.35, 0.76], p < 0.01), seroma (OR = 0.48, 95% CI [0.32, 0.71], p < 0.01), and mesh bulging (OR = 0.08, 95% CI [0.01, 0.42], p < 0.01). Subgroup analysis revealed that body mass index (BMI) (OR = 0.43, 95% CI [0.29, 0.65], p < 0.0001), type of article (OR = 0.51, 95% CI [0.35, 0.76], p = 0.0008 < 0.01), geographical location (OR = 0.54, 95% CI [0.36, 0.82], p = 0.004 < 0.01), follow-up time (OR = 0.50, 95% CI [0.34, 0.73], p = 0.0004 < 0.01) had a significant influence on the postoperative recurrence of the IPOM-plus technique. Conclusion The IPOM-plus technique has been shown to greatly reduce the occurrence of recurrence, seroma, and mesh bulging. Overall, the IPOM-plus technique is considered a safe and effective procedure. However, additional randomized controlled studies with extended follow-up periods are necessary to further evaluate the IPOM-plus technique.

引用

页码：385 / 400

页数：16

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