LAPAROSCOPY VERSUS LAPAROTOMY IN THE REPAIR OF VENTRAL HERNIAS: systematic review and meta-analysis

OBJECTIVE: To compare the laparotomy and laparoscopy techniques for correction of ventral hernia when related to perioperative complications, length of hospitalization, surgical time, and recurrence of hernia. METHODS: This was a systematic review of randomized controlled trials, which included studies retrieved from four databases (MEDLINE, Embase, Cochrane and LILACS), using a combination of the terms (Hernia, Ventral) and (Laparoscopy) and (Laparotomy). RESULTS: Six randomized trials were included, totaling 566 patients, 283 in the Laparoscopy group and 283 in the Laparotomy group. Laparoscopy reduced the risk of infection of the surgical wound (NNT = 5) and seroma formation (NNT = 13) and less length hospitalization (P = 0.02) compared to laparotomy in the correction of ventral hernias. Furthermore, laparoscopy increased the incidence of enterotomy (NNH = 25) and post operative pain (NNH = 8) and longer surgical time (P = 0.0009) when compared with laparotomy. There was no difference related to abscess (P = 0.79), hematoma (P = 0.43) and recurrency of ventral hernias (P = 0.25). CONCLUSIONS: In the correction of ventral hernias, the use of laparoscopic technique is effective to reduce infections of the surgical wound and seroma formation, as well as, decrease the length hospitalization.