Laparoscopic Repair with Mesh Reinforcement is a Feasible Alternative for Epigastric Hernia: A Retrospective Study Comparing Laparoscopic with Open Repair

BACKGROUND: Epigastric hernias may lead to discomfort and pain. The mainstay of treatment is surgical repair with mesh reinforcement. The primary aim of this study was to compare the recurrence rates of laparoscopic epigastric hernia repair (LEHR) and conventional open epigastric hernia repair (OEHR) with mesh reinforcement. Secondary aims were to evaluate perioperative outcomes and quality of life. METHODS: Ninety-nine patients (58% female) from two non-academic hospitals were retrospectively reviewed. The Short-Form 36 Health Survey questionnaire and Carolina Comfort Scale were used to assess quality of life and complaints related to mesh implantation. RESULTS: Forty-two (42%) patients underwent LEHR and 57 (58%) underwent OEHR. The mean follow-up at the outpatient clinic was 7.1 months in the LEHR group and 8.1 months in the OEHR group. The mean follow-up by telephone contact was 67.8 months in the OEHR group and 58.1 months in the LEHR group. The risk of recurrence appeared to be slightly lower for LEHR (2%) compared to OEHR (7%), but this difference was not significant (p=0.298). The median surgical duration was 54 minutes in the LEHR group and 28 minutes in the OEHR group (p<0.001). The median hospitalization time was 1 day in the LEHR group and 0.5 days in the OEHR group (p<0.001). CONCLUSION: Laparoscopic hernia repair tended to be associated with a lower risk of recurrence, but this difference was not statistically significant. Although the surgical duration was longer for the LEHR group, the postoperative outcomes were similar between groups, making laparoscopic repair a feasible alternative to the open approach for epigastric hernias.