Laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair: A retrospective study
Background : Umbilical defects may cause technical problems for general surgeons in patients during laparoscopic cholecystectomy (LC) operations and may increase the incidence of incisional hernia. Aim : The objectives of this study were to determine the optimal repair method for umbilical hernias t...
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Veröffentlicht in: | Journal of postgraduate medicine (Bombay) 2007-07, Vol.53 (3), p.176-180 |
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Zusammenfassung: | Background : Umbilical defects may cause technical problems for general
surgeons in patients during laparoscopic cholecystectomy (LC)
operations and may increase the incidence of incisional hernia. Aim :
The objectives of this study were to determine the optimal repair
method for umbilical hernias that already exist or are encountered
incidentally and to present data regarding potential problems that may
occur during LC. Settings and Design : Medical records of patients who
had received simultaneous umbilical hernia repair (UHR) with LC were
investigated retrospectively. Materials and Methods : Cholelithiasis
was accompanied by umbilical hernia in 64 (8.6%) out of 745 patients
who underwent LC and UHR simultaneously in our hospital between 2000
and 2004. Statistical Analysis Used : The Mann-Whitney U, Chi-square,
One-Way Anova, Kaplan-Meier survival analysis, the log-rank test and t
test were used for statistical analyses. Results : LC was followed by
UHR using primary suture (Group 1), Mayo repair (Group 2) and flat
mesh-based repair (Group 3) in 32 (50%), 18 (28.1%) and 14 (21.9%)
patients, respectively. Mean body mass indexes (BMI) of patients were
26.6 kg/m 2 , 29.2 kg/m 2 and 39.9 kg/m 2 in Groups 1, 2 and 3,
respectively. Recurrence rates were 9.4%, 5.6% and none (0%) in Groups
1, 2 and 3, respectively. Recurrence was observed in three (7.0%) out
of 43(67.2%) patients with BMI≥30 kg/m 2 while umbilical hernia
recurred in one (4.8%) out of 21 (32.8%) patients with BMI< 30 kg/m
2 . Overall morbidity and mortality rates were 14.1% and 0%,
respectively. Conclusions : The outcomes of the UHR with mesh after
laparoscopic surgeries appear to be better for either obese or
non-obese patients than primary suture techniques in recurrence rates. |
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ISSN: | 0022-3859 0972-2823 |
DOI: | 10.4103/0022-3859.33859 |