Abstract：
BACKGROUND: Laparoscopic IPOM is technically challenging, especially regarding fascial closure. Hybrid repair has been proposed as a simpler approach. We aimed to compare hybrid and laparoscopic intraperitoneal onlay mesh repair (IPOM) in patients undergoing ventral hernia repair (VHR).
METHODS: We performed a systematic review of Cochrane, Scopus, and MEDLINE databases to identify studies comparing hybrid versus laparoscopic IPOM VHR reporting the outcomes of recurrence, mortality, seroma, postoperative complications, reoperation, surgical site infection, and operative time. Statistical analysis was performed using RStudio 4.1.2 using a random-effects model.
RESULTS: We screened 2,896 articles and fully reviewed 22 of them. A total of five studies, encompassing 664 patients were included. Among them, 337 (50.8%) underwent laparoscopic IPOM. All patients had incisional hernias, with a mean diameter varying from 3 to 12.7 cm, 60% were women, with a mean BMI varying from 29.5 to 38. The hybrid approach had a lower rate of seroma when compared to the laparoscopic (OR 0.22; 95% CI 0.05 to 0.92; p = 0.038; I²=78%). We found no difference in recurrence, mortality, postoperative complications, reoperation, surgical site infection, and operative time between groups.
CONCLUSIONS: Hybrid IPOM is a safe and effective method for incisional hernia repair. Moreover, it facilitates fascial defect closure and decreases postoperative seromas.
METHODS: We performed a systematic review of Cochrane, Scopus, and MEDLINE databases to identify studies comparing hybrid versus laparoscopic IPOM VHR reporting the outcomes of recurrence, mortality, seroma, postoperative complications, reoperation, surgical site infection, and operative time. Statistical analysis was performed using RStudio 4.1.2 using a random-effects model.
RESULTS: We screened 2,896 articles and fully reviewed 22 of them. A total of five studies, encompassing 664 patients were included. Among them, 337 (50.8%) underwent laparoscopic IPOM. All patients had incisional hernias, with a mean diameter varying from 3 to 12.7 cm, 60% were women, with a mean BMI varying from 29.5 to 38. The hybrid approach had a lower rate of seroma when compared to the laparoscopic (OR 0.22; 95% CI 0.05 to 0.92; p = 0.038; I²=78%). We found no difference in recurrence, mortality, postoperative complications, reoperation, surgical site infection, and operative time between groups.
CONCLUSIONS: Hybrid IPOM is a safe and effective method for incisional hernia repair. Moreover, it facilitates fascial defect closure and decreases postoperative seromas.
摘要：
背景：腹腔镜IPOM在技术上具有挑战性，特别是关于筋膜闭合。混合修复已被提出作为一种更简单的方法。我们旨在比较接受腹侧疝修补术（VHR）的患者的混合和腹腔镜腹膜内嵌式网片修补术（IPOM）。
方法：我们对Cochrane，Scopus,和MEDLINE数据库，以确定比较混合与腹腔镜IPOMVHR报告复发结果的研究，死亡率,血清肿,术后并发症,再操作,手术部位感染,和手术时间。使用RStudio4.1.2使用随机效应模型进行统计分析。
结果：我们筛选了2,896篇文章，并对其中22篇进行了全面审查。总共有五项研究，纳入664例患者.其中,337例（50.8%）行腹腔镜IPOM。所有病人都有切口疝,平均直径从3到12.7厘米不等，60%是女性,平均BMI从29.5到38不等。与腹腔镜相比，混合方法的血清肿发生率较低（OR0.22；95％CI0.05至0.92；p=0.038；I²=78％）。我们发现复发没有差异，死亡率,术后并发症,再操作,手术部位感染,和组间手术时间。
结论：混合IPOM是一种安全有效的切口疝修补方法。此外，它有助于筋膜缺损闭合并减少术后血清瘤。
方法：我们对Cochrane，Scopus,和MEDLINE数据库，以确定比较混合与腹腔镜IPOMVHR报告复发结果的研究，死亡率,血清肿,术后并发症,再操作,手术部位感染,和手术时间。使用RStudio4.1.2使用随机效应模型进行统计分析。
结果：我们筛选了2,896篇文章，并对其中22篇进行了全面审查。总共有五项研究，纳入664例患者.其中,337例（50.8%）行腹腔镜IPOM。所有病人都有切口疝,平均直径从3到12.7厘米不等，60%是女性,平均BMI从29.5到38不等。与腹腔镜相比，混合方法的血清肿发生率较低（OR0.22；95％CI0.05至0.92；p=0.038；I²=78％）。我们发现复发没有差异，死亡率,术后并发症,再操作,手术部位感染,和组间手术时间。
结论：混合IPOM是一种安全有效的切口疝修补方法。此外，它有助于筋膜缺损闭合并减少术后血清瘤。
