Comparison Of Endoscopic Versus Open Component Separ-ation Technique For Abdominal Hernia: A Meta-analysis

Objective: To evaluate the efficacy and safety of endoscopic versus open componentseparation technique (CST) for abdominal hernia．Methods: A comprehensive search of PubMed, Medline, Embase, the CochraneLibrary, VIP Chinese Scientific Journals database, CNKI and Wanfang data wasperformed for studies published until March2014. Systematic review was carried outto identify the controlled clinical studies comparing endoscopic CST with open CSTfor abdominal hernia. Outcomes evaluated were recurrence rate, postoperative woundcomplications, operative time, intraoperative blood loss and postoperative hospitalstay. The Meta-analysis was performed with RevMan5.2software.Results: Five studies matched the selection criteria. A total of185patients withabdominal hernia were included in this Meta-analysis of whom79underwentendoscopic CST and106underwent open CST. Analysis of the data suggested thatthere was no significant differences in recurrence rate between endoscopic CST andopen CST(P=0.84, risk difference=-0.01,95%CI-0.12to0.10). However，endoscopicCST compared with open CST was associated with a significant reduction ofpostope rative wound complications (P<0.0001, odds ratio=0.19,95%CI0.09to0.41). And there was no significant differences in operative time, intraoperative bloodloss and postoperative hospital stay (all P>0.05).Conclusion: As compared to open CST, endoscopic CST show equivalent clinicaleffects with similar recurrence rate. However, endoscopic CST was associated with asignificant reduction of postoperative wound complications, and there was nosignifi cant differences in in operative time, intraoperative blood loss andpostoperative hospital stay. And therefore, endoscopic CST may be a safe and feasibleoption for abdominal hernia.