A systematic review of laparoscopic versus open XXXX , with meta-analysis of randomized controlled trials.

@entity1 @entity281 @entity4036 @entity547
INTRODUCTION: Development of an incisional @entity547 after abdominal surgery is a common complication following laparotomy. Following recent advancements in laparoscopic and open repair a literature review has demonstrated no difference in the short term outcomes between open and laparoscopic repair, concluding there was no favourable method of repair over the other and that both techniques are appropriate methods of surgical repair. However, long term outcomes in the available literature between these two approaches were not clearly analysed or described. The objective of this study is to assess the effectiveness and safety of laparoscopic versus open @entity4036 , and to evaluate the short and long term outcomes in regards to @entity547 using meta-analysis of all randomised controlled trials from 2008 to end of 2013. STUDY AIMS AND OBJECTIVES: Population: @entity1 who developed an @entity4036 or @entity4036 following a laparotomy. INTERVENTION: Two methods of surgical repair, laparoscopic and open @entity4036 repair. Comparison: To compare between laparoscopic and open repair in abdominal wall incisional @entity547 . OUTCOME: length of hospital stay, operation time, wound @entity281 and @entity547 rate. METHODS: This study is a systematic review on all randomized controlled trials of laparoscopic versus open abdominal wall and incisional @entity547 repair. Medline, Pubmed, Cochrane library, Cinahl and Embase were the databases interrogated. Inclusion _ exclusion criteria had been defined. The relevant studies identified from January 2008 to December 2013, are included in the analysis. The primary end point can be described as @entity547 , and secondary outcomes can be described as length of hospital stay post operatively, operation time and wound @entity281 . RESULTS: Five randomized controlled trials (RCTs) were identified and included in the final analysis with a total number of 611 @entity1 randomized. Three hundreds and six @entity1 were in the laparoscopic group and 305 @entity1 in the open repair group. The range of follow up in the studies was two months to 35 months. The recurrence rate was similar (P  =  0.30), wound @entity281 was higher in the open repair group (P  <  0.001), length of hospital stay was not statistically different (P  =  0.92), and finally the operation time was longer in the laparoscopic group but did not reach statistical significance (P  =  0.05) CONCLUSION: The short and long-term outcomes of laparoscopic and open @entity4036 repairs are equivalent; both techniques are safe and credible and the outcomes are very comparable.
