Trocar Site Hernias in Bariatric Surgery-an Underestimated Issue: a Qualitative Systematic Review and Meta-Analysis.


Journal

Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714

Informations de publication

Date de publication:
03 2019
Historique:
pubmed: 20 1 2019
medline: 25 3 2020
entrez: 20 1 2019
Statut: ppublish

Résumé

The reported incidence of trocar site hernias in bariatric surgery ranges between 0.5 and 3%. The best available evidence derives from retrospective studies analysing prospective databases, thus including only patients who presented with symptoms or received surgical treatment due to trocar site hernias after a laparoscopic bariatric procedure. A systematic literature research was conducted up until September 2017. Search strategies included proper combinations of the MeSH terms 'laparoscopy' and 'bariatric surgery', 'trocar/port' and 'hernia'. Searches were not limited by publication type or language. The review was registered in PROSPERO (ID 85102) and performed according to the PRISMA guidelines. Sixty-eight publications were included. Pooled hernia incidence was 3.22 (range 0-39.3%). Thirteen trials reported systematic closure of the fascia; 12 trials reported no closure. Data availability did not allow for pooling to calculate relative risk. Higher BMI and specific hernia examination using imaging modalities were associated with a significantly higher incidence of trocar site hernias. Studies dedicated to detection of TsH reported a pooled incidence of 24.5%. Trocar site hernias are an underestimated complication of minimally invasive multiportal bariatric surgery. While high-quality trials are not available allowing for a precise calculation of the incidence, existing data are indicative of very high incidence rates. Risk factors for developing a trocar site hernia in bariatric surgery have not yet been systematically analysed. Prospective studies in this field are necessary.

Identifiants

pubmed: 30659465
doi: 10.1007/s11695-018-03687-2
pii: 10.1007/s11695-018-03687-2
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1049-1057

Commentaires et corrections

Type : ErratumIn

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Auteurs

Ioannis Karampinis (I)

Department of Surgery, Heidelberg University, Mannheim, Germany.

Eliette Lion (E)

Department of Surgery, Heidelberg University, Mannheim, Germany.

Maurizio Grilli (M)

Department of Library and Information Sciences, Heidelberg University, Mannheim, Germany.

Svetlana Hetjens (S)

Institute of Medical Statistic and Biomathematics, Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Christel Weiss (C)

Institute of Medical Statistic and Biomathematics, Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Georgi Vassilev (G)

Department of Surgery, Heidelberg University, Mannheim, Germany.

Steffen Seyfried (S)

Department of Surgery, Heidelberg University, Mannheim, Germany.

Mirko Otto (M)

Department of Surgery, Heidelberg University, Mannheim, Germany. mirko.otto@umm.de.
Department of Surgery, Mannheim University Medical Centre, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. mirko.otto@umm.de.

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