Safety of closing fascial defect in laparoscopic hernia repair
Journal name: World Journal of Pharmaceutical Research
Original article title: Safety of closure of fascial defect during laparoscopic incisional and ventral hernia repair
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Abdulrahman Osama K. Baghdadi, Marwah Saleh Alsultan, Abdulrahman Jalwi M. Korkoman, Hakimah Abdulrahman Albalawi, Abdulrahman Abu-Baker Alamoodi, Kholoud Khalid Almowald, Mohammed Matooq Mubarak, Atheer Ali Merzen Mobasher, Baiader Saleh Alsheikh, Ameer Hashim Munshi
World Journal of Pharmaceutical Research:
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Full text available for: Safety of closure of fascial defect during laparoscopic incisional and ventral hernia repair
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr201912-16181
Copyright (license): WJPR: All rights reserved
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Summary of article contents:
1) Introduction
Incisional and ventral hernias are common complications that may arise after surgical procedures, particularly laparotomy, with incidences ranging from 3% to 13%. These hernias occur when abdominal wall defects arise at the sites of previous surgeries. Laparoscopic techniques for repairing such hernias have gained popularity due to their potential advantages over traditional open surgery. A key focus of these techniques is the closure of fascial defects (CFD), which aims to restore the integrity of the abdominal wall and minimize complications, including seroma formation and recurrence rates. Research has been conducted on the safety and efficacy of CFD in laparoscopic incisional and ventral hernia repairs, analyzing whether closure of these defects reduces postoperative complications compared to non-closure.
2) The Importance of Closure of Fascial Defects (CFD)
The closure of fascial defects during laparoscopic procedures is critical for maintaining the functional integrity of the abdominal wall. By minimizing surgical dead space, CFD techniques can reduce the likelihood of seroma formation, improve the aesthetic results of the surgery, and decrease the risk of hernia recurrence by properly aligning the rectus muscles to restore abdominal function. The reviewed studies focused on comparing outcomes between groups where the fascial defect was closed and those where it was not, analyzing key metrics such as adverse outcomes, seroma formation, and recurrence rates.
3) Meta-Analysis and Safety Outcomes
A meta-analysis of six studies involving 2,549 patients (1,635 in the CFD group and 914 in the non-closure group) demonstrated significant safety benefits associated with the closure of fascial defects. Results indicated a notable decrease in adverse hernia-site outcomes, seroma formation, and recurrence rates in the CFD group. Specifically, the data revealed risk ratios (RR) of 0.217 for adverse outcomes, 0.228 for seroma formation, and 0.149 for recurrence rates, all indicating improved safety and fewer complications for patients undergoing CFD. These findings underscore the potential benefits of adopting CFD techniques in laparoscopic hernia repairs.
4) Comparison of Outcomes in Retrospective Studies
All studies included in the meta-analysis were retrospective, spanning from 2010 to 2019, and focused on the efficacy of defect closure techniques. The total patient count was 2,549, with a follow-up average of 34.9 months. Despite variations in individual studies, trends consistently showed that patients in the CFD group experienced fewer complications overall. For example, specific studies highlighted significant disparities in adverse outcomes; one study noted a seroma formation rate of 2.5% in the CFD group compared to 12.2% in the non-closure group. Discrepancies in findings across studies emphasized the need for further research to validate these results and enhance the understanding of repair techniques.
5) Conclusion
In conclusion, the addition of fascial defect closure during laparoscopic ventral hernia repair significantly reduces the incidence of postoperative complications and poses less risk for patients. By reinforcing the integrity of the abdominal wall and minimizing the occurrence of seromas and recurrence, CFD stands out as a crucial intervention in the surgical management of incisional and ventral hernias. The analysis of existing studies provides a compelling argument for adopting this technique routinely, although future randomized controlled trials would be beneficial to solidify these findings and expand the evidence base.
FAQ section (important questions/answers):
What is the main purpose of the study on CFD and NCFD?
The study aims to assess the safety and outcomes of Closure of Fascial Defect (CFD) techniques compared to non-closure (NCFD) during laparoscopic incisional and ventral hernia repair, focusing on adverse hernia-site outcomes, recurrence rates, and seroma formation.
What were the results regarding adverse hernia-site outcomes between CFD and NCFD?
The meta-analysis revealed a significant decrease in adverse hernia-site outcomes for the CFD group compared to the NCFD group, showing better safety in the closure of fascial defect.
How many studies were included in the meta-analysis of this research?
A total of six studies involving 2549 patients were included in the meta-analysis, which assessed the effectiveness of CFD versus NCFD in hernia repair.
What was the average follow-up time for the included studies?
The average follow-up time across the included studies was approximately 34.9 months, providing a substantial timeframe to evaluate the long-term outcomes of both techniques.
What significant outcomes did the study find concerning seroma formation rates?
The study found a highly significant decrease in seroma formation rates in the CFD group compared to the NCFD group, indicating that closure techniques may reduce this complication.
What conclusion did the authors reach regarding the closure of fascial defect?
The authors concluded that incorporating closure of the fascial defect during laparoscopic ventral hernia repair can effectively reduce complications and hazards after the procedure.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Safety of closing fascial defect in laparoscopic hernia repair”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Study (Studying):
In the context of medical research, study refers to the systematic investigation conducted to assess the outcomes of a specific treatment or intervention. This particular study looks into the safety and effectiveness of closure techniques used during laparoscopic incisional and ventral hernia repairs, providing data to guide clinical practices.
2) Repair:
Repair in this context relates to the surgical procedures aimed at correcting hernias, which are abnormal protrusions through the abdominal wall. The study evaluates laparoscopic techniques for repairing incisional and ventral hernias, focusing on whether the closure of fascial defects improves patient outcomes in terms of complications and recurrences.
3) Wall:
The term wall refers to the abdominal wall, which is critical in maintaining the integrity and function of the body's core structure. The study investigates techniques to address defects in this wall caused by hernias, emphasizing the importance of surgical repair methods to restore normal anatomy and function.
4) King:
King appears in the affiliations of the study's authors, notably associated with the King Fahad General Hospital and other Saudi medical institutions. This highlights the contribution of local healthcare professionals to the research, indicating a regional focus on improving surgical practices within the context of Saudi Arabia's healthcare system.
5) Forest:
Forest in the study context likely refers to the 'Forest Plot,' a graphical representation used in meta-analyses to present the results of different studies. It visually depicts the effect sizes and confidence intervals for various outcomes, allowing researchers to quickly evaluate the overall effectiveness of a treatment method.
6) Table:
Table in the study presents organized data summarizing patient characteristics and safety outcome measures. Tables aid in the clear communication of complex information, allowing peers and stakeholders to digest key findings efficiently and compare results across different studies assessed in the meta-analysis.
7) Relative:
Relative refers to relative risk ratios, a statistical measure used to compare the risk of adverse outcomes between study groups in the research. Analyzing relative risks helps quantify the impact of different surgical techniques, contributing to a better understanding of their safety and efficacy in hernia repair.
8) Sharman (Sarma, Sharma, Sarman):
Sharma is identified as one of the authors in the study, contributing to the body of research on surgical techniques for hernia repair. Specific studies referenced, such as Sharma et al. 2010, provide comparative data on various closure techniques, underscores contributions to surgical knowledge and practice in the field.
9) Ovid:
Ovid refers to a database utilized for academic and clinical research, indicating the systematic approach taken by the authors in gathering relevant literature. Its inclusion signifies the academic rigor and breadth of resources consulted in evaluating the effectiveness of closure techniques in hernia repairs.
10) Cina:
Sina is likely associated with Ibn Sina National College for Medical Sciences, reflecting another author's affiliation. This emphasizes the collaborative nature of the research, drawing expertise from various institutions, contributing diverse perspectives to optimize the standards of care in laparoscopic surgery.
11) Discussion:
Discussion in the context of the study refers to the section where authors interpret results, contrast findings with previous literature, and address clinical implications. This critical analysis helps convey the significance of the research outcomes, providing insights for future studies and improvements in surgical practices.
12) Science (Scientific):
Science represents the systematic pursuit of knowledge through experimentation and observation, fundamental in the study's context. The research embodies the scientific method, analyzing surgical interventions' efficacy based on established protocols, contributing to the broader medical field's understanding of laparoscopic hernia repair.
13) Doubt:
Doubt signifies the uncertainty that may arise during research when results differ among studies or when conflicting evidence exists. Addressing doubts is crucial in scientific discourse, and the study tackles such uncertainties surrounding the closure of fascial defects in hernia repairs based on gathered evidence.
14) Worry (Worried, Worrying):
Worry in this context relates to the concerns regarding postoperative complications and recurrence rates associated with surgical procedures. The study aims to alleviate such worries by providing evidence that may demonstrate lower complication rates when fascial defects are closed during laparoscopic hernia repair.
15) Pain:
Pain is a critical outcome measure in surgical procedures, relating to patient discomfort post-surgery. The study indirectly addresses pain by evaluating surgical methods that potentially reduce complications, thus aiming to improve overall recovery experiences and minimize pain associated with hernia repairs.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Safety of closing fascial defect in laparoscopic hernia repair’. Further sources in the context of Science might help you critically compare this page with similair documents:
Comparative studies, Inclusion criteria, Exclusion criteria, Clinical trial, Recurrence Rate, Systematic search, Meta-analysis study, Seroma formation, Surgical robot, Wound complications.