Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Closure of the fascial defect during laparoscopic umbilical hernia repair: a randomized clinical trial

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Differential recurrence after laparoscopic incisional hernia repair: importance of a nationwide registry-based mesh surveillance

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Response to: Meticulous surgical technique cannot be replaced by cholangiography

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Fluorescence or X-ray cholangiography in elective laparoscopic cholecystectomy: a randomized clinical trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Associations between blood cultures after surgery for colorectal cancer and long-term oncological outcomes

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Differential recurrence after laparoscopic incisional hernia repair: importance of a nationwide registry-based mesh surveillance

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Half of Cochrane reviews were published more than 2 years after the protocol

    Research output: Contribution to journalReviewResearchpeer-review

  3. Impact on Fertility after Failure of Restorative Proctocolectomy in Men and Women with Ulcerative Colitis: A 17-Year Cohort Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Fluorescence or X-ray cholangiography in elective laparoscopic cholecystectomy: a randomized clinical trial

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: The objective of the study was to analyse patient-reported outcome measures (PROMs), seroma formation, long-term recurrence and chronic pain after closure of the fascial defect in patients undergoing laparoscopic umbilical hernia mesh repair.

METHODS: This was a randomized double-blinded trial in patients undergoing elective laparoscopic umbilical hernia repair comparing sutured closure of the fascial defect before intraperitoneal onlay mesh (IPOM) repair with a no-closure IPOM repair. Postoperative pain, movement limitations, discomfort and fatigue were registered before surgery and on postoperative days 1-3, 7 and 30. Seroma formation, quality of life and cosmesis were assessed at day 30, and at 2 years of follow-up. Recurrence (clinical and reoperation) and chronic pain were assessed after 2 years.

RESULTS: Eighty patients were randomized. Median defect sizes in closure and no-closure groups were 2·5 (range 1·5-4·0) and 2·5 (2·0-5·5) cm respectively (P = 0·895). There were no significant differences in early and late postoperative pain or in any other early or late PROMs, except for early fatigue which was higher in the closure group (P = 0·011). Seroma formation after 30 days was significantly reduced after closure (14 of 40; 35 (95 per cent c.i. 22 to 51) per cent) compared with no closure (22 of 38; 58 (42 to 72) per cent) (P = 0·043). Cumulative recurrence after 2 years was lower in the closure group: 5 of 36 (7 (3 to 17) per cent) versus 12 of 37 (19 (10 to 33) per cent) for no closure (P = 0·047).

CONCLUSION: Closure of the fascial defect in laparoscopic umbilical hernia IPOM repair significantly reduced early seroma formation and long-term recurrence without inducing side-effects such as pain, or other early or late PROMs. Registration number: NCT01962480 ( https://www.clinicaltrials.gov).

Original languageEnglish
JournalThe British journal of surgery
Volume107
Issue number3
Pages (from-to)200-208
Number of pages9
ISSN0007-1323
DOIs
Publication statusPublished - Feb 2020

ID: 59102996