Page 38 - World Journal of Laparoscopic Surgery

Open Mesh Repair vs Laparoscopic Mesh Repair of Umbilical Hernia

objectIves of the study results
• To study the clinical profile of patients opting for open mesh Among the 40 (100%) subjects in LAP group, 18 (45%) were aged
repair or laparoscopic mesh repair of umbilical hernia. between 36 and 45 years, whereas in open group, 15 (37.5%)
• To study the outcomes of open mesh repair and laparoscopic subjects were aged between 36 and 45 years. Chi-square test
repair of umbilical hernia. was used to check the association and showed nonsignificant
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association with respect to age (χ = 1.349; p = 0.717) (Table 1).
MAterIAls Mean age was higher for open group (42.37 years) as compared
Study was prospective interventional study, and study population to LAP group (45.0 years). Independent sample t-test was used
were all the patients admitted with umbilical hernia to the surgical to compare the age between the two groups and showed
wards of hospitals associated with Bangalore Medical College and nonsignificant difference between the groups (p = 0.2309) with
Research Institute. The study was conducted from November 2018 respect to age (Table 2).
to May 2020. Institutional ethical committee approval was taken. Females were higher in both the groups, 36 (90%) in LAP group
Sample size selected was 80. Study sample was selected based on and 32 (80%) in open group. Chi-square test was used to check the
inclusion and exclusion criteria. association and showed nonsignificant association with respect to
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gender (χ = 1.56; p = 0.21) (Table 3).
Inclusion Criteria Out of 40 subjects in LAP group, majority 36 (90.0%) subjects
• Patients with age more than 18 years, admitted with umbilical had only swelling, whereas in open group, 35 (87.5%) had only
hernia without complications and willing for informed written swelling. Remaining subjects had mild pain with swelling.
consent. Chi-square test was used to check the association and showed
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nonsignificant association with respect to symptoms (χ = 0.1252;
Exclusion Criteria p = 0.7234) (Table 4).
• All patients with defect size more than 3 cm. Diabetes mellitus with hypertension was present in five (12.5%)
• Patients with obstructed/strangulated/complicated umbilical subjects in LAP group, whereas in open group, there were seven
hernia. (17.5%) subjects who had diabetes mellitus with hypertension.
• Patients having abdominal malignancies. Chi-square test was used to check the association and showed
2
• Patients having coagulopathy, severe cardiopulmonary disease, nonsignificant association with respect to comorbidities (χ = 1.041;
ascites, and renal failure. p = 0.7913) (Table 5).
• Patients not fit for surgery. Mean defect size was higher for open group (1.70) as compared
to LAP group (1.66). Independent sample t-test was applied to
Methods compare the defect size between the two groups and showed
Institutional ethical committee clearance and written informed nonsignificant difference between the groups (p = 0.691) with
consent were obtained, patients were then admitted in the surgical respect to defect size (Table 6).
wards with the diagnosis of umbilical hernia, and those coming Table 1: Agewise distribution of the subjects
under the inclusion criteria were enrolled into the study. A total
number of patients with umbilical hernia enrolled into the study Groups
were 80, among them 40 patients were operated by open mesh Lap Open Total
repair technique and 40 patients were operated by laparoscopic 25–35 years
mesh repair technique. Each patient was given a unique identity Count 8 6 14
number. Demographic data, medical history, and history of Percent 20% 15.0% 17.50%
concomitant medications were taken at the baseline visit. Physical 36–45 years
examination, clinical examination, and other details according to Count 18 15 33
the proforma were recorded, and relevant investigations were Percent 45.0% 37.5% 41.25%
also done at the baseline visit. After relevant investigations and
confirmation of diagnosis, preanesthetic evaluation is done and 46–55 years
patients were randomly selected for open or LAP mesh repair. Count 10 13 23
Operated patients were divided into two groups. Percent 25.0% 32.5% 28.75%
Above 55 years
• Group I (LAP) patients undergoing laparoscopic mesh repair.
• Group II (OPEN) patients undergoing open mesh repair. Count 4 6 10
Percent 10.0% 15.0% 12.50%
Postoperative evaluation was done until the patient was Total
discharged and followed up at 2, 4, and 12 weeks. At the follow-up Count 40 40 80
visits, detailed physical and clinical examinations were conducted.
Data were collected during preoperative and postoperative Percent 100.0% 100.0% 100.0%
evaluation. All the data were compiled and subjected to statistical Chi-square value—1.349; p value—0.717
analysis. Collected data were subjected to descriptive statistics Table 2: Comparison of age between the groups using independent
such as mean, median, standard deviation, interquartile range, sample t-test
percentages, tables, and graphs wherever necessary. Chi-square
test and independent t-test were used for significant difference Min Max Mean Std. deviation Mean diff p value
between the two groups, and p <0.05 was considered statistically Lap 25 60 42.37 9.220 −2.63 0.2309
significant. Open 25 68 45.00 10.201

36 World Journal of Laparoscopic Surgery, Volume 15 Issue 1 (January–April 2022)