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Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study.
Hernia 2019H

Abstract

BACKGROUND

Single-incision laparoscopic cholecystectomy (SILC) is a feasible technique that provides comparable results to standard laparoscopic cholecystectomy (LC). However, despite the theoretical advantages of minor wound complications and cosmetic results, SILC usually requires a larger incision, which may increase the incidence of incisional hernias. This study evaluated SILC and standard multiport cholecystectomy with respect to perioperative outcomes, hospital stay, cosmetic results, and postoperative complications, including the 5-year incisional hernia rate.

METHODS

A cohort study was performed with patients who underwent elective laparoscopic surgery for noncomplicated cholelithiasis at our hospital between July 2009 and June 2011. During the study period, there were 45 nonselected patients who underwent SILC, and these patients were compared with a control group of 140 patients who underwent LC using the standard three-trocar technique during the same period. Both patient groups were comparable in age, gender, BMI and ASA classification.

RESULTS

The mean follow-up was 58.7 ± 10.9 (range 3-80) months. There were no differences between groups in terms of hospital stay, rate and severity of complications, wound infection, and patient cosmetic satisfaction. However, the operating time (57.8 versus 35.2 min) and long-term incisional hernia rate (13.3% versus 4.7%) were significantly higher in the SILC group.

CONCLUSION

SILC is associated with a statistically significantly higher long-term incisional hernia rate at the umbilical port site than the standard multiport laparoscopic cholecystectomy. Our data show there was no relevant advantage regarding the postoperative course, hospital stay or cosmetic satisfaction. To date, widespread use of SILC cannot be recommended. Registration number: NCT03768661 (https://www.clinicaltrials.gov).

TRIAL REGISTRATION

This study has been registered at www.clinicaltrials.gov . The clinicaltrials.gov ID number is: NCT03768661.

Authors+Show Affiliations

Department of General and Digestive Surgery, Hospital Platón, Universitat Internacional de Catalunya, Platón 21, 08006, Barcelona, Spain. drhoyuela@gmail.com.Department of General and Digestive Surgery, Hospital Platón, Universitat Internacional de Catalunya, Platón 21, 08006, Barcelona, Spain.Department of General and Digestive Surgery, Hospital Platón, Universitat Internacional de Catalunya, Platón 21, 08006, Barcelona, Spain.Department of General and Digestive Surgery, Hospital Platón, Universitat Internacional de Catalunya, Platón 21, 08006, Barcelona, Spain.Department of General and Digestive Surgery, Hospital Platón, Universitat Internacional de Catalunya, Platón 21, 08006, Barcelona, Spain.Department of General and Digestive Surgery, Hospital Platón, Universitat Internacional de Catalunya, Platón 21, 08006, Barcelona, Spain.Department of General and Digestive Surgery, Hospital Platón, Universitat Internacional de Catalunya, Platón 21, 08006, Barcelona, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31073959

Citation

Hoyuela, C, et al. "Long-term Incisional Hernia Rate After Single-incision Laparoscopic Cholecystectomy Is Significantly Higher Than That After Standard Three-port Laparoscopy: a Cohort Study." Hernia : the Journal of Hernias and Abdominal Wall Surgery, 2019.
Hoyuela C, Juvany M, Guillaumes S, et al. Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study. Hernia. 2019.
Hoyuela, C., Juvany, M., Guillaumes, S., Ardid, J., Trias, M., Bachero, I., & Martrat, A. (2019). Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study. Hernia : the Journal of Hernias and Abdominal Wall Surgery, doi:10.1007/s10029-019-01969-x.
Hoyuela C, et al. Long-term Incisional Hernia Rate After Single-incision Laparoscopic Cholecystectomy Is Significantly Higher Than That After Standard Three-port Laparoscopy: a Cohort Study. Hernia. 2019 May 9; PubMed PMID: 31073959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study. AU - Hoyuela,C, AU - Juvany,M, AU - Guillaumes,S, AU - Ardid,J, AU - Trias,M, AU - Bachero,I, AU - Martrat,A, Y1 - 2019/05/09/ PY - 2019/01/27/received PY - 2019/04/28/accepted PY - 2019/5/11/entrez KW - Cholecystectomy KW - Incisional hernia KW - Laparoscopy KW - SILS KW - Single-incision laparoscopic surgery KW - Trocar-site hernia JF - Hernia : the journal of hernias and abdominal wall surgery JO - Hernia N2 - BACKGROUND: Single-incision laparoscopic cholecystectomy (SILC) is a feasible technique that provides comparable results to standard laparoscopic cholecystectomy (LC). However, despite the theoretical advantages of minor wound complications and cosmetic results, SILC usually requires a larger incision, which may increase the incidence of incisional hernias. This study evaluated SILC and standard multiport cholecystectomy with respect to perioperative outcomes, hospital stay, cosmetic results, and postoperative complications, including the 5-year incisional hernia rate. METHODS: A cohort study was performed with patients who underwent elective laparoscopic surgery for noncomplicated cholelithiasis at our hospital between July 2009 and June 2011. During the study period, there were 45 nonselected patients who underwent SILC, and these patients were compared with a control group of 140 patients who underwent LC using the standard three-trocar technique during the same period. Both patient groups were comparable in age, gender, BMI and ASA classification. RESULTS: The mean follow-up was 58.7 ± 10.9 (range 3-80) months. There were no differences between groups in terms of hospital stay, rate and severity of complications, wound infection, and patient cosmetic satisfaction. However, the operating time (57.8 versus 35.2 min) and long-term incisional hernia rate (13.3% versus 4.7%) were significantly higher in the SILC group. CONCLUSION: SILC is associated with a statistically significantly higher long-term incisional hernia rate at the umbilical port site than the standard multiport laparoscopic cholecystectomy. Our data show there was no relevant advantage regarding the postoperative course, hospital stay or cosmetic satisfaction. To date, widespread use of SILC cannot be recommended. Registration number: NCT03768661 (https://www.clinicaltrials.gov). TRIAL REGISTRATION: This study has been registered at www.clinicaltrials.gov . The clinicaltrials.gov ID number is: NCT03768661. SN - 1248-9204 UR - https://www.unboundmedicine.com/medline/citation/31073959/Long-term_incisional_hernia_rate_after_single-incision_laparoscopic_cholecystectomy_is_significantly_higher_than_that_after_standard_three-port_laparoscopy:_a_cohort_study L2 - https://dx.doi.org/10.1007/s10029-019-01969-x DB - PRIME DP - Unbound Medicine ER -