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Nationwide Analysis of Inpatient Laparoscopic Versus Open Inguinal Hernia Repair.

07:00 EST 14th January 2020 | BioPortfolio

Summary of "Nationwide Analysis of Inpatient Laparoscopic Versus Open Inguinal Hernia Repair."

Inguinal hernia repair is one of the more common procedures performed in the United States. The optimal surgical approach, however, remains controversial. We aimed to compare the postoperative outcomes and costs between laparoscopic and open inpatient inguinal hernia repairs in a national cohort. We performed a retrospective analysis of the National Inpatient Sample during the period 2009-2015. Adult patients (≥18 years old) undergoing laparoscopic and open inguinal hernia repair were included. Multivariable logistic, generalized logistic, and linear regression were used to assess the effect of the laparoscopic approach on postoperative complications, mortality, length of stay, and hospital charges. A total of 41,937 patients undergoing open inguinal hernia repair ( = 36,575) and laparoscopic inguinal hernia repair ( = 5282) were included. Patients undergoing laparoscopic inguinal hernia repair were less likely to have postoperative wound complications (odds ratio [OR]: 0.64, 95% confidence interval [CI]: 0.41-0.98), infection (
OR:
0.34, 95%
CI:
0.27-0.42), bleeding (
OR:
0.72, 95%
CI:
0.63-0.82), cardiac failure (
OR:
0.72, 95%
CI:
0.64-0.82), renal failure (
OR:
0.54, 95%
CI:
0.47-0.62), respiratory failure (
OR:
0.70, 95%
CI:
0.58-0.85), and inpatient mortality (
OR:
0.27, 95%
CI:
0.17-0.40). On average, the laparoscopic approach reduced length of stay by 1.28 days (95%
CI:
-1.58 to -1.18), and decreased hospital costs by $2400 (95%
CI:
-$4700 to -$700). Laparoscopic hernia repair is associated with significantly lower rates of postoperative morbidity and mortality, shorter length of hospital stays, and lower hospital costs for inpatient repairs. The laparoscopic approach should be encouraged for the management of appropriate patients with inpatient inguinal hernias.

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Journal Details

This article was published in the following journal.

Name: Journal of laparoendoscopic & advanced surgical techniques. Part A
ISSN: 1557-9034
Pages:

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An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.

A protrusion of abdominal structures through the retaining ABDOMINAL WALL. It involves two parts: an opening in the abdominal wall, and a hernia sac consisting of PERITONEUM and abdominal contents. Abdominal hernias include groin hernia (HERNIA, FEMORAL; HERNIA, INGUINAL) and VENTRAL HERNIA.

A groin hernia occurring inferior to the inguinal ligament and medial to the FEMORAL VEIN and FEMORAL ARTERY. The femoral hernia sac has a small neck but may enlarge considerably when it enters the subcutaneous tissue of the thigh. It is caused by defects in the ABDOMINAL WALL.

The tunnel in the lower anterior ABDOMINAL WALL through which the SPERMATIC CORD, in the male; ROUND LIGAMENT, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring.

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