EARLY OUTCOMES OF LAPAROSCOPIC VS OPEN IPOM REPAIRS FOR SMALL VENTRAL HERNIAS
Abstract
The postoperative ileus and wound hematoma are frequent complications after ventral abdominal hernia repair. My objective is to compare laparoscopic versus open ventral hernia repair in terms of frequency of postoperative ileus and wound hematoma formation. Main outcome. The prolonged ileus and hematoma formation were outcomes Study design. Randomized controlled trial Setting. Department of General Surgery, Jinnah Hospital, Lahore Duration of study. January 2020 to January 2022
Total of 70 patients were admitted through outpatient department of Jinnah Hospital Surgery Department after undergoing ventral abdominal hernia repair. The diagnosis was confirmed by history, relevant examination and investigations. I divided the patients randomly into two equal groups via computer generated random numbers i.e. A and B. In group A the laparoscopic approach was used while in group B, open repair of hernia was done. All surgical procedures were done under standard general anesthesia with cuffed endotracheal tube. All cases were operated by same surgical team. Standard postoperative care was provided to all the patients. All the patients were assessed for return of bowel sounds every hour until return of bowel activity. Hematoma formation was assessed daily up to 72 hours. Data was analyzed using SPSS version 24. Quantitative variables like age was expressed via mean and standard deviation. Frequencies and percentages were calculated for qualitative
data like gender, prolonged ileus and hematoma formation. Both groups were compared among each other in terms of hematoma formation and prolonged ileus by Chi square test. Effect modifiers like age, gender and BMI were controlled by stratification. Post stratification Chi square test was applied. P value ≤ 0.05 was considered as statistically significant. The mean age and BMI were 41.29 ± 12.755 years and 26.80 ± 3.278 kg/m2 respectively. The female gender was dominant as 70% cases were females. The prolonged ileus and hematoma formation were evident in 51.4%. There was no difference between groups in terms of age, gender and BMI distribution as p values were 0.382, 0.794 and 0.942 respectively. The prolonged ileus and hematoma formation were statistically significant among groups. The group B has more frequency of prolonged ileus and hematoma formation as compared to group A (p values 0.004 and 0.017 respectively). The data was stratified according to age, gender and BMI. The results showed that difference in frequency of prolonged ileus remained significant among groups for age >40, female gender and BMI >27 kg/m2 (p values 0.005 and 0.007 respectively). The frequency of hematoma formation was
significant among groups for age >40 and male gender (p values 0.031 and 0.049 respectively). The laparoscopic approach for ventral abdominal hernias is associated with reduced frequency of hematoma formation and prolonged ileus.
Total of 70 patients were admitted through outpatient department of Jinnah Hospital Surgery Department after undergoing ventral abdominal hernia repair. The diagnosis was confirmed by history, relevant examination and investigations. I divided the patients randomly into two equal groups via computer generated random numbers i.e. A and B. In group A the laparoscopic approach was used while in group B, open repair of hernia was done. All surgical procedures were done under standard general anesthesia with cuffed endotracheal tube. All cases were operated by same surgical team. Standard postoperative care was provided to all the patients. All the patients were assessed for return of bowel sounds every hour until return of bowel activity. Hematoma formation was assessed daily up to 72 hours. Data was analyzed using SPSS version 24. Quantitative variables like age was expressed via mean and standard deviation. Frequencies and percentages were calculated for qualitative
data like gender, prolonged ileus and hematoma formation. Both groups were compared among each other in terms of hematoma formation and prolonged ileus by Chi square test. Effect modifiers like age, gender and BMI were controlled by stratification. Post stratification Chi square test was applied. P value ≤ 0.05 was considered as statistically significant. The mean age and BMI were 41.29 ± 12.755 years and 26.80 ± 3.278 kg/m2 respectively. The female gender was dominant as 70% cases were females. The prolonged ileus and hematoma formation were evident in 51.4%. There was no difference between groups in terms of age, gender and BMI distribution as p values were 0.382, 0.794 and 0.942 respectively. The prolonged ileus and hematoma formation were statistically significant among groups. The group B has more frequency of prolonged ileus and hematoma formation as compared to group A (p values 0.004 and 0.017 respectively). The data was stratified according to age, gender and BMI. The results showed that difference in frequency of prolonged ileus remained significant among groups for age >40, female gender and BMI >27 kg/m2 (p values 0.005 and 0.007 respectively). The frequency of hematoma formation was
significant among groups for age >40 and male gender (p values 0.031 and 0.049 respectively). The laparoscopic approach for ventral abdominal hernias is associated with reduced frequency of hematoma formation and prolonged ileus.