Comparing the Efficacy of Laparoscopic and Open Umbilical or Paraumbilical Hernia Repair: An Updated Systematic Review and Meta-Analysis.

Abstract

BackgroundUmbilical or paraumbilical hernia repair is relatively common in general surgical procedures, including laparoscopic and open repair. However, there is currently insufficient evidence to prove which surgical approach is related to better postoperative outcomes.MethodsThe meta-analysis was based on the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The related studies were searched and retrieved from major databases (PubMed, Cochrane, and Web of Science). Both random and fixed-effects models were used to calculate the pooled effect size.ResultsNine observation studies and four randomized controlled trials (RCTs) involving 5458 patients were finally analyzed. The open group shows a longer duration of hospital stays (MD = -71.01; 95% CI: -108.52, -33.51; <i>P</i> = 0.0002), a higher incidence rate early complications (OR = 0.46; 95% CI: 0.27, 0.77; <i>P</i> = 0.003), and recurrence (OR = 0.14; 95% CI: 0.08, 0.26; <i>P</i> < 0.00001) compared with the laparoscopic group. The subgroup analysis of open repair types showed a higher incidence of recurrence rate (<i>P</i> = 0.008) in the open suture group compared to the open mesh group. Notably, in comparison with the laparoscopic group, early complications (<i>P</i> = 0.01 and <i>P</i> = 0.0003) and recurrence (<i>P</i> = 0.04 and <i>P</i> < 0.00001) were more common in the open repair with and without mesh groups separately.ConclusionIn umbilical or paraumbilical hernia patients, compared to the laparoscopic repair, hospital stays, early complications, and recurrence were more common in the open repair. Moreover, a higher incidence rate of recurrence was observed in the open suture repair compared with the open mesh repair.