Comparison Between Laparoscopic IPOM And Open Sublay In Abdominal Incisional Hernia Repair

ObjectiveAbdominal incisional hernia is one of the common complications after abdominal surgery.At present,Sublay is the most effective treatment in open surgery.With the development of technology,IPOM has become more mature and accepted by more people.In this study,the clinical effects of laparoscopic IPOM repair and open Sublay repair were compared to explore the therapeutic advantages of laparoscopic incisional hernia repair.MethodsRetrospective analysis was performed on the clinical data of 76 patients with abdominal incisional hernia admitted to The First Affiliated Hospital of Zhengzhou University from January 2016 to January 2019.Among whom 36 patients underwent laparoscopic IPOM repair and 40 patients underwent open Sublay repair.Statistical analysis was conducted on the operation time,intraoperative blood loss,VAS scores on day 3 after surgery,recovery time of intestinal peristalsis,total hospital expenses,recurrence rates and the occurrence of postoperative complications including seroma,incision infection,chronic pain,and intestinal canal injury.ResultsThere was no statistically significant difference between the two groups in general information such as gender,age,BMI,hernia location and size(P>0.05).The mean intraoperative blood loss(34.4±14.6 ml),VAS scores on day 3 after surgery(2.5±0.6),postoperative anal exhaust time(1.9±0.6d)and postoperative hospitalization time(6.2±1.4 d)in the LIHR group were all lower than those in the Sublay group(42.5±18.2 ml),(3.3±0.6),(2.9±1.0 d)and(9.1±2.4d),with statistically significant differences(P<0.05).The mean operation time in the LIHR group was(134.4±39.7 min)longer than that in the Sublay group(119.2±31.1 min),but the difference was not statistically significant(P>0.05).The total hospital expenses in the LIHR group(38052.0±2987.5 yuan)were higher than that in the Sublay group(19729.2±2716.7 yuan),and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the LIHR group was lower than that in the Sublay group(11.1%vs 30%;P<0.05).Postoperative follow-up was 1 to 3 years,1(2.28%)patient in the Sublay group had recurrence,and the LIHR group had no recurrence,with no statistically significant difference(P>0.05).Conclusion1.Laparoscopic IPOM is as safe and effective as open Sublay repair.But the laparoscopic surgery has the advantages of less trauma,faster recovery,less bleeding,less pain and fewer complications.Therefore,LIHR is a more ideal surgical method for repairing abdominal incisional hernia.2.The cost of LIHR is relatively high,and there are some limitations to LIHR on the treatment of complex incisional hernia,so a reasonable surgical plan should be selected according to the patient's condition.