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Açık ve laparoskopik insizyonel herni onarımının ağrı skorları ve hasta memnuniyeti açısından karşılaştırılması

Year 2018, Volume: 57 Issue: 4, 195 - 200, 03.12.2018
https://doi.org/10.19161/etd.417270

Abstract

Amaç: İnsizyonel herni karın cerrahisi sonrası görülen en sık komplikasyonlardandır. Son zamanlarda laparoskopik onarım gündeme gelmiştir. Bu çalışmanın amacı, açık ve laparoskopik insizyonel herni onarımı yapılan hastalarda ağrı skorları ve memnuniyet oranlarını karşılaştırmaktır.
Gereç ve Yöntem: Yüz altmış dört hasta çalışmaya dahil edildi. Grup 1 (n=47) laparoskopik onarım ve Grup 2 (n=117) açık onarım yapılan hastalardan oluşmaktaydı. Hastalar, demografik özellikler, ameliyat bulguları, ameliyat sonrası komplikasyon ve nüks açısından incelendi. Grup 1’deki 32 (%68.08) ve Grup 2’deki 88 (%75.21) hastaya telefon anketi uygulandı. Ağrı skorları ve memnuniyet oranları karşılaştırıldı.
Bulgular: Hastaların 51’i (%31.1) erkek, 113’ü (%68.9) kadındı. Ortalama yaş 55.35±11.73 idi. Ameliyat sonrası komplikasyon oranları Grup 1 için %2.1 ve Grup 2 için %23.9 olarak saptandı (p<0.05). Grup 1 ve 2 için nüks oranları sırasıyla %25.7 ve %20 olarak saptandı (p>0.05). Gruplar arasında ağrı skorları ve memnuniyet oranları açısından anlamlı fark saptanmadı (p>0.05).
Sonuç: Laparoskopik onarımın avantajları olmasına rağmen ağrı ve memnuniyet açısından açık onarıma üstünlüğü olmamaktadır.

References

  • Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 1985;72(1):70-1.
  • Hoer J, Lawong G, Klinge U, Schumpelick V. Factors influencing the development of incisional hernia. A retrospective study of 2,983 laparotomy patients over a period of 10 years. Chirurg 2002;73(5):474-80.
  • Bevis PM, Windhaber RA, Lear PA, Poskitt KR, Earnshaw JJ, Mitchell DC. Randomized clinical trial of mesh versus sutured wound closure after open abdominal aortic aneurysm surgery. Br J Surg 2010;97(10):1497-502.
  • Pham CT, Perera CL, Watkin DS, Maddern GJ. Laparoscopic ventral hernia repair: A systematic review. Surg Endosc 2009;23(1):4-15.
  • Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed) 1982;284(6320):931-3.
  • Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg 2002;89(5):534-45.
  • The Society for Surgery of the Alimentary Tract. Available from: http://www.ssat.com/cgi-bin/incisionalhernia.cgi (accessed 20.04.2014).
  • Chevrel JP. The treatment of large midline incisional hernias by "overcoat" plasty and prothesis (author's transl). Nouv Presse Med 1979;8(9):695-96.
  • Rives J, Lardennois B, Pire JC, Hibon J. Large incisional hernias. The importance of flail abdomen and of subsequent respiratory disorders. Chirurgie 1973;99(8):547-63.
  • Flament JB. Retro rectus approach to ventral hernia repair. Operative Techniques in General Surgery 2004;6(3):165-78.
  • Le Blanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: Preliminary findings. Surg Laparosc Endosc 1993;3(1):39-41.
  • Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK. Laparoscopic versus open repair of incisional/ventral hernia: A meta-analysis. Am J Surg 2009;197(1):64-72.
  • Le Blanc KA, Booth WV, Whitaker JM, Bellanger DE. Laparoscopic incisional and ventral herniorrhaphy: Our initial 100 patients. Hernia 2001;5(1):41-5.
  • Eker HH, Hansson BM, Buunen M, et al. Laparoscopic vs. open incisional hernia repair: A randomized clinical trial. JAMA Surg 2013;148(3):259-63.
  • Ahonen-Siirtola M, Rautio T, Ward J, Kössi J, Ohtonen P, Mäkelä J. Complications in laparoscopic versus open incisional ventral hernia repair. A retrospective comparative study. World J Surg 2015;39(12):2872-7.
  • Al Chalabi H, Larkin J, Mehigan B, McCormick P. A systematic review of laparoscopic versus open abdominal incisional hernia repair, with meta-analysis of randomized controlled trials. Int J Surg 2015;20(8):65-74.
  • Earle D, Seymour N, Fellinger E, Perez A. Laparoscopic versus open incisional hernia repair: A single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc 2006;20(1):71-5.
  • Salvilla SA, Thusu S, Panesar SS. Analysing the benefits of laparoscopic hernia repair compared to open repair: A meta-analysis of observational studies. J Minim Access Surg 2012;8(4):111-7.
  • Awaiz A, Rahman F, Hossain MB, et al. Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Hernia 2015;19(3):449-63.
  • Asencio F, Aguiló J, Peiró S, et al. Open randomized clinical trial of laparoscopic versus open incisional hernia repair. Surg Endosc 2009;23(7):1441-8.
  • Olmi S, Scaini A, Cesana GC, Erba L, Croce E. Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc 2007;21(4):555-9.
  • Tsuruta A, Hirai T, Nakamura M. Retrospective comparison of open versus laparoscopic ventral and incisional hernia repair. Asian J Endosc Surg 2014;7(3):246-50.
  • Stipa F, Giaccaglia V, Burza A, Santini E, Bascone B, Picchio M. Incisional hernia: Laparoscopic or open repair? Surg Laparosc Endosc Percutan Tech 2013;23(4):419-22.
  • Zhang Y, Zhou H, Chai Y, Cao C, Jin K, Hu Z. Laparoscopic versus open incisional and ventral hernia repair: A systematic review and meta-analysis. World J Surg 2014;38(9):2233-40.
  • Froylich D, Segal M, Weinstein A, Hatib K, Shiloni E, Hazzan D. Laparoscopic versus open ventral hernia repair in obese patients: a long-term follow-up. Surg Endosc 2016; 30(2): 670-5.
  • Wolter A, Rudroff C, Sauerland S, Heiss MM. Laparoscopic incisional hernia repair: Evaluation of effectiveness and experiences. Hernia 2009;13(5):469-74.
  • Lomanto D, Iyer SG, Shabbir A, Cheah WK. Laparoscopic versus open ventral hernia mesh repair: A prospective study. Surg Endosc 2006;20(7):1030-5.

Comparison of pain score and patient satisfaction between laparoscopic and open abdominal incisional hernia repair

Year 2018, Volume: 57 Issue: 4, 195 - 200, 03.12.2018
https://doi.org/10.19161/etd.417270

Abstract

Aim: Incisional hernia is one of the most common postoperative complications of abdominal surgery. Recently laparoscopic repair was introduced. The aim of this study is to compare pain scores and satisfaction rates of patients performed open and laparoscopic incisional hernia repair.

Materials and Methods: A total of 164 patients were included. Group 1 (n=47) consists of patients performed laparoscopic repair and Group 2 (n=117) consists of open repair. Patients were analyzed according to demographic data, operative findings, postoperative complications and recurrence. 32 (68.08%) patients in Group 1 and 88 (75.21%) patients in Group 2 were applied to telephone survey. Pain scores and satisfaction rates of patients were compared.

Results: 51 (31.1%) patients were male and 113 (68.9%) patients were female. Mean age of patients was 55.35±11.73 years. Postoperative complications were found in only 2.1% of patients in Group 1 and 23.9% of patients in Group 2 (p<0.05). Recurrence rates for Group 1 and 2 was 25.7% and 20%, respectively (p>0.05). No statistical difference was observed between groups regarding to pain scores and satisfaction rates (p>0.05).

Conclusion: Although laparoscopic repair seems to have advantages, it has no superiority to the open repair regarding pain and satisfaction.

References

  • Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 1985;72(1):70-1.
  • Hoer J, Lawong G, Klinge U, Schumpelick V. Factors influencing the development of incisional hernia. A retrospective study of 2,983 laparotomy patients over a period of 10 years. Chirurg 2002;73(5):474-80.
  • Bevis PM, Windhaber RA, Lear PA, Poskitt KR, Earnshaw JJ, Mitchell DC. Randomized clinical trial of mesh versus sutured wound closure after open abdominal aortic aneurysm surgery. Br J Surg 2010;97(10):1497-502.
  • Pham CT, Perera CL, Watkin DS, Maddern GJ. Laparoscopic ventral hernia repair: A systematic review. Surg Endosc 2009;23(1):4-15.
  • Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed) 1982;284(6320):931-3.
  • Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg 2002;89(5):534-45.
  • The Society for Surgery of the Alimentary Tract. Available from: http://www.ssat.com/cgi-bin/incisionalhernia.cgi (accessed 20.04.2014).
  • Chevrel JP. The treatment of large midline incisional hernias by "overcoat" plasty and prothesis (author's transl). Nouv Presse Med 1979;8(9):695-96.
  • Rives J, Lardennois B, Pire JC, Hibon J. Large incisional hernias. The importance of flail abdomen and of subsequent respiratory disorders. Chirurgie 1973;99(8):547-63.
  • Flament JB. Retro rectus approach to ventral hernia repair. Operative Techniques in General Surgery 2004;6(3):165-78.
  • Le Blanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: Preliminary findings. Surg Laparosc Endosc 1993;3(1):39-41.
  • Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK. Laparoscopic versus open repair of incisional/ventral hernia: A meta-analysis. Am J Surg 2009;197(1):64-72.
  • Le Blanc KA, Booth WV, Whitaker JM, Bellanger DE. Laparoscopic incisional and ventral herniorrhaphy: Our initial 100 patients. Hernia 2001;5(1):41-5.
  • Eker HH, Hansson BM, Buunen M, et al. Laparoscopic vs. open incisional hernia repair: A randomized clinical trial. JAMA Surg 2013;148(3):259-63.
  • Ahonen-Siirtola M, Rautio T, Ward J, Kössi J, Ohtonen P, Mäkelä J. Complications in laparoscopic versus open incisional ventral hernia repair. A retrospective comparative study. World J Surg 2015;39(12):2872-7.
  • Al Chalabi H, Larkin J, Mehigan B, McCormick P. A systematic review of laparoscopic versus open abdominal incisional hernia repair, with meta-analysis of randomized controlled trials. Int J Surg 2015;20(8):65-74.
  • Earle D, Seymour N, Fellinger E, Perez A. Laparoscopic versus open incisional hernia repair: A single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc 2006;20(1):71-5.
  • Salvilla SA, Thusu S, Panesar SS. Analysing the benefits of laparoscopic hernia repair compared to open repair: A meta-analysis of observational studies. J Minim Access Surg 2012;8(4):111-7.
  • Awaiz A, Rahman F, Hossain MB, et al. Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Hernia 2015;19(3):449-63.
  • Asencio F, Aguiló J, Peiró S, et al. Open randomized clinical trial of laparoscopic versus open incisional hernia repair. Surg Endosc 2009;23(7):1441-8.
  • Olmi S, Scaini A, Cesana GC, Erba L, Croce E. Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc 2007;21(4):555-9.
  • Tsuruta A, Hirai T, Nakamura M. Retrospective comparison of open versus laparoscopic ventral and incisional hernia repair. Asian J Endosc Surg 2014;7(3):246-50.
  • Stipa F, Giaccaglia V, Burza A, Santini E, Bascone B, Picchio M. Incisional hernia: Laparoscopic or open repair? Surg Laparosc Endosc Percutan Tech 2013;23(4):419-22.
  • Zhang Y, Zhou H, Chai Y, Cao C, Jin K, Hu Z. Laparoscopic versus open incisional and ventral hernia repair: A systematic review and meta-analysis. World J Surg 2014;38(9):2233-40.
  • Froylich D, Segal M, Weinstein A, Hatib K, Shiloni E, Hazzan D. Laparoscopic versus open ventral hernia repair in obese patients: a long-term follow-up. Surg Endosc 2016; 30(2): 670-5.
  • Wolter A, Rudroff C, Sauerland S, Heiss MM. Laparoscopic incisional hernia repair: Evaluation of effectiveness and experiences. Hernia 2009;13(5):469-74.
  • Lomanto D, Iyer SG, Shabbir A, Cheah WK. Laparoscopic versus open ventral hernia mesh repair: A prospective study. Surg Endosc 2006;20(7):1030-5.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

İlker Murat Arer 0000-0001-9880-3570

Murat Kuş 0000-0001-6529-7579

Nezih Akkapulu 0000-0001-7392-961X

Hakan Yabanoğlu 0000-0002-1161-3369

Hüseyin Özgür Aytac 0000-0002-3583-9282

Nurkan Törer 0000-0002-2749-3787

Publication Date December 3, 2018
Submission Date August 7, 2017
Published in Issue Year 2018Volume: 57 Issue: 4

Cite

Vancouver Arer İM, Kuş M, Akkapulu N, Yabanoğlu H, Aytac HÖ, Törer N. Comparison of pain score and patient satisfaction between laparoscopic and open abdominal incisional hernia repair. EJM. 2018;57(4):195-200.