Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study
Abstract Background This study was performed to determine if defect size after laparoscopic incisional hernia repair is predictive of recurrence during the long-term follow-up evaluation. Methods We performed a prospective clinical study on 310 patients who underwent laparoscopic incisional hernia r...
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| Veröffentlicht in: | The American journal of surgery 2012, Vol.203 (1), p.87-94 |
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| creator | Moreno-Egea, Alfredo, M.D Carrillo-Alcaraz, Andres, M.D Aguayo-Albasini, J.L., M.D |
| description | Abstract Background This study was performed to determine if defect size after laparoscopic incisional hernia repair is predictive of recurrence during the long-term follow-up evaluation. Methods We performed a prospective clinical study on 310 patients who underwent laparoscopic incisional hernia repair to identify predictable risk factors for hernia recurrence. Univariate and multivariate Cox regression analysis were used. The defect size was analyzed with curve receiver operating characteristic curve. Results The overall recurrence rate was 6% after an average follow-up period of 60 months. On univariate analysis of the defect size (categories: 15 cm), obesity, previous repairs, hernia location, surgical time, hospital stay, morbidity, and recurrences were significantly different ( P < .001). By multivariate analysis, only obesity and defect size were independent prognostic factors ( P < .001). Conclusions The predictive value of defect size is shown. Patients with large defects have a higher risk of recurrence. Our study recommends reserving the laparoscopic technique for hernias not exceeding 10 cm in size, where it can be put to better use. |
| doi_str_mv | 10.1016/j.amjsurg.2010.11.017 |
| format | Article |
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A prospective study</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>ProQuest Central UK/Ireland</source><creator>Moreno-Egea, Alfredo, M.D ; Carrillo-Alcaraz, Andres, M.D ; Aguayo-Albasini, J.L., M.D</creator><creatorcontrib>Moreno-Egea, Alfredo, M.D ; Carrillo-Alcaraz, Andres, M.D ; Aguayo-Albasini, J.L., M.D</creatorcontrib><description>Abstract Background This study was performed to determine if defect size after laparoscopic incisional hernia repair is predictive of recurrence during the long-term follow-up evaluation. Methods We performed a prospective clinical study on 310 patients who underwent laparoscopic incisional hernia repair to identify predictable risk factors for hernia recurrence. Univariate and multivariate Cox regression analysis were used. The defect size was analyzed with curve receiver operating characteristic curve. Results The overall recurrence rate was 6% after an average follow-up period of 60 months. On univariate analysis of the defect size (categories: <10 cm, 10–12 cm, and >15 cm), obesity, previous repairs, hernia location, surgical time, hospital stay, morbidity, and recurrences were significantly different ( P < .001). By multivariate analysis, only obesity and defect size were independent prognostic factors ( P < .001). Conclusions The predictive value of defect size is shown. Patients with large defects have a higher risk of recurrence. Our study recommends reserving the laparoscopic technique for hernias not exceeding 10 cm in size, where it can be put to better use.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2010.11.017</identifier><identifier>PMID: 21788002</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Categories ; Chi-Square Distribution ; Defect size ; Defects ; Digestive system. Abdomen ; Endoscopy ; Female ; General aspects ; Hernia ; Hernia, Abdominal - surgery ; Hernias ; Herniorrhaphy - methods ; Humans ; Incisional hernia ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopic repair ; Laparoscopy ; Maintenance ; Male ; Medical sciences ; Middle Aged ; Morbidity ; Multivariate analysis ; Obesity ; Patients ; Prognostic factors ; Proportional Hazards Models ; Prospective Studies ; Recurrence ; Regression analysis ; Risk analysis ; Risk Factors ; ROC Curve ; Sensitivity and Specificity ; Studies ; Surgery ; Treatment Outcome</subject><ispartof>The American journal of surgery, 2012, Vol.203 (1), p.87-94</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jan 1, 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-7aa71c3aa108f6507fa08dd34651da1bd0f59d2dcca2af0eeb30204b32b88c643</citedby><cites>FETCH-LOGICAL-c477t-7aa71c3aa108f6507fa08dd34651da1bd0f59d2dcca2af0eeb30204b32b88c643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1925190939?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25785122$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21788002$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moreno-Egea, Alfredo, M.D</creatorcontrib><creatorcontrib>Carrillo-Alcaraz, Andres, M.D</creatorcontrib><creatorcontrib>Aguayo-Albasini, J.L., M.D</creatorcontrib><title>Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background This study was performed to determine if defect size after laparoscopic incisional hernia repair is predictive of recurrence during the long-term follow-up evaluation. Methods We performed a prospective clinical study on 310 patients who underwent laparoscopic incisional hernia repair to identify predictable risk factors for hernia recurrence. Univariate and multivariate Cox regression analysis were used. The defect size was analyzed with curve receiver operating characteristic curve. Results The overall recurrence rate was 6% after an average follow-up period of 60 months. On univariate analysis of the defect size (categories: <10 cm, 10–12 cm, and >15 cm), obesity, previous repairs, hernia location, surgical time, hospital stay, morbidity, and recurrences were significantly different ( P < .001). By multivariate analysis, only obesity and defect size were independent prognostic factors ( P < .001). Conclusions The predictive value of defect size is shown. Patients with large defects have a higher risk of recurrence. Our study recommends reserving the laparoscopic technique for hernias not exceeding 10 cm in size, where it can be put to better use.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Categories</subject><subject>Chi-Square Distribution</subject><subject>Defect size</subject><subject>Defects</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Female</subject><subject>General aspects</subject><subject>Hernia</subject><subject>Hernia, Abdominal - surgery</subject><subject>Hernias</subject><subject>Herniorrhaphy - methods</subject><subject>Humans</subject><subject>Incisional hernia</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopic repair</subject><subject>Laparoscopy</subject><subject>Maintenance</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Multivariate analysis</subject><subject>Obesity</subject><subject>Patients</subject><subject>Prognostic factors</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkktvFDEMx0cIRJfCRwBFQojTLHbmfaGqKh6VKnEAzpEncWiGeZHMVFo-PRntQqVeODlxfnZs_50kLxH2CFi-6_Y0dGH1P_YSNh_uAatHyQ7rqkmxrrPHyQ4AZNqUCGfJsxC6eEXMs6fJmcSqruPjLjHXQSy3LKZ10dMQrRU9zeSnoKfZaeFG7YKbRurFLfvRkfA8k_OCrGW9sBHtQRjeziK433whLsUco-focHcswrKaw_PkiaU-8IuTPU--f_zw7epzevPl0_XV5U2q86pa0oqoQp0RIdS2LKCyBLUxWV4WaAhbA7ZojDRakyQLzG0GEvI2k21d6zLPzpO3x7yxgl8rh0UNLmjuexp5WoNqEJsCSpCRfP2A7KbVxy6DwkYW2ECTNZEqjpSOHQXPVs3eDeQPCkFtKqhOnVRQmwoKUUUVYtyrU_a1Hdj8i_o79gi8OQEUNPXW0zbme66o6gLlxl0cOY5Tu3PsVdCOR83G-ThgZSb331LeP8igeze6-OlPPnC471oFqUB93VZm2xhEgExCkf0B0D69RA</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Moreno-Egea, Alfredo, M.D</creator><creator>Carrillo-Alcaraz, Andres, M.D</creator><creator>Aguayo-Albasini, J.L., M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>2012</creationdate><title>Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study</title><author>Moreno-Egea, Alfredo, M.D ; Carrillo-Alcaraz, Andres, M.D ; Aguayo-Albasini, J.L., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-7aa71c3aa108f6507fa08dd34651da1bd0f59d2dcca2af0eeb30204b32b88c643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Categories</topic><topic>Chi-Square Distribution</topic><topic>Defect size</topic><topic>Defects</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Female</topic><topic>General aspects</topic><topic>Hernia</topic><topic>Hernia, Abdominal - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - methods</topic><topic>Humans</topic><topic>Incisional hernia</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopic repair</topic><topic>Laparoscopy</topic><topic>Maintenance</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Multivariate analysis</topic><topic>Obesity</topic><topic>Patients</topic><topic>Prognostic factors</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Regression analysis</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moreno-Egea, Alfredo, M.D</creatorcontrib><creatorcontrib>Carrillo-Alcaraz, Andres, M.D</creatorcontrib><creatorcontrib>Aguayo-Albasini, J.L., M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moreno-Egea, Alfredo, M.D</au><au>Carrillo-Alcaraz, Andres, M.D</au><au>Aguayo-Albasini, J.L., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2012</date><risdate>2012</risdate><volume>203</volume><issue>1</issue><spage>87</spage><epage>94</epage><pages>87-94</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background This study was performed to determine if defect size after laparoscopic incisional hernia repair is predictive of recurrence during the long-term follow-up evaluation. Methods We performed a prospective clinical study on 310 patients who underwent laparoscopic incisional hernia repair to identify predictable risk factors for hernia recurrence. Univariate and multivariate Cox regression analysis were used. The defect size was analyzed with curve receiver operating characteristic curve. Results The overall recurrence rate was 6% after an average follow-up period of 60 months. On univariate analysis of the defect size (categories: <10 cm, 10–12 cm, and >15 cm), obesity, previous repairs, hernia location, surgical time, hospital stay, morbidity, and recurrences were significantly different ( P < .001). By multivariate analysis, only obesity and defect size were independent prognostic factors ( P < .001). Conclusions The predictive value of defect size is shown. Patients with large defects have a higher risk of recurrence. Our study recommends reserving the laparoscopic technique for hernias not exceeding 10 cm in size, where it can be put to better use.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21788002</pmid><doi>10.1016/j.amjsurg.2010.11.017</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Categories Chi-Square Distribution Defect size Defects Digestive system. Abdomen Endoscopy Female General aspects Hernia Hernia, Abdominal - surgery Hernias Herniorrhaphy - methods Humans Incisional hernia Investigative techniques, diagnostic techniques (general aspects) Laparoscopic repair Laparoscopy Maintenance Male Medical sciences Middle Aged Morbidity Multivariate analysis Obesity Patients Prognostic factors Proportional Hazards Models Prospective Studies Recurrence Regression analysis Risk analysis Risk Factors ROC Curve Sensitivity and Specificity Studies Surgery Treatment Outcome |
| title | Is the outcome of laparoscopic incisional hernia repair affected by defect size? A prospective study |
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