Comparative Study On The Curative Effect Of Three Surgical Methods In The Treatment Of Incisional Hernia

Objective Compare and analyze the clinical efficacy of three surgical methods（laparoscopic IPOM repair,open IPOM repair and open Sublay repair）in the treatment of incisional hernia,and discuss their advantages and disadvantages,in order to provide reference for clinical work.Methods Reviewed the clinical data of incisional hernia patients who underwent surgical treatment at the First Hospital of Lanzhou University from January 2014 to June 2021 by the electronic case query system.According to the inclusion and exclusion criteria,a total of 86 eligible patients were included.According to different surgical methods,the patients were divided into laparoscopic IPOM repair group（Group A）,open IPOM repair（Group B）and open Sublay repair（Group C）.Basic data,surgical data,hospitalization data and follow-up data obtained at regular intervals were recorded for the included patients.The SPSS 25.0 tool was used for statistical analysis of the data collected.Results In this study,incisional hernia repair was successfully completed in all86 patients.The differences were not statistically significant（P> 0.05）in the comparison of the basic data（gender,age,BMI,smoking history,combined hypertension,combined diabetes mellitus,combined COPD）and incisional hernia data（transverse diameter of hernia ring,hernia classification,hernia location）among the three groups.The differences were not statistically significant（P> 0.05）in terms of bleeding,intraoperative bowel injury,postoperative feeding time,acute pain,incisional infection,bowel obstruction,seroma,recurrence,mesh infection,chronic pain,and foreign body sensation.In terms of operative time,the difference was statistically significant（P=0.001）.In a 2-by-2 comparison,the mean operative time of patients in the A group was significantly more than that in the B group（P=0.001）and the C group（P=0.001）,and the difference between the groups was statistically significant.The mean operative time of patients in the B group was more than that in the C group（P=0.196）,but the difference between the groups was not statistically significant.In terms of post-operative hospital stay,the difference was statistically significant（P=0.046）.In a 2-by-2 comparison,the mean post-operative hospital stay for patients in the A group significantly less than that in the B group（P=0.043）and the C group（P=0.029）,the difference between the groups was statistically significant.The mean post-operative hospital stay of patients in the B group less than that in the C group（P=0.756）,the difference between the groups was not statistically significant.In terms of hospitalisation costs,the difference was statistically significant（P=0.034）.In a 2-by-2 comparison,the mean hospitalisation cost of patients in Group C was significantly less than that in Group A（P=0.013）and Group B（P=0.039）,the difference between the groups was statistically significant.The mean hospitalisation cost of patients in Group B was slightly less than that in Group A（P=0.667）,the difference between the groups was not statistically significant.In terms of the total complication rate,the difference was statistically significant（P=0.001）.In a 2-by-2comparison,the total complication rate of patients in groups A was significantly less than that in group C（P=0.002）,the difference between the groups was statistically significant.The total complication rate of patients in groups B was significantly less than that in group C（P=0.008）,the difference between the groups was statistically significant.The total complication rate of patients in group A was less than that in group B（P=0.725）,the difference between the groups was not statistically significant.Conclusions All the three types of incisional hernia repair in this study are safe and effective,but each has its own advantages and disadvantages.Laparoscopic IPOM repair has a low complication rate,rapid postoperative recovery and short hospital stay.It is worthy of clinical promotion and application.