BACKGROUND: Although the early results of laparoscopic ventral hernia repair have shown a low recurrence rate, there is a paucity of long-term data. This study reviews a single institution's experience with laparoscopic ventral hernia repair (LVHR). METHODS: We carried out a retrospective analysis of all LVHR performed at the Cleveland Clinic Foundation from January 1996 to March 2001. Recurrence rates were determined by physical exam or telephone follow-up. Factors predictive of recurrence were determined using Cox regression. RESULTS: Of 100 ventral hernias completed laparoscopically, 96 were available for long-term follow-up (average, 30 months; range 4-65). There were no deaths and major morbidity occurred in seven patients. Recurrences were identified in 17 patients. Nine recurrences occurred in the 1st postoperative year; however, hernia recurrence continued throughout the period of follow-up. Multivariate analysis showed that a prior failed hernia repair was associated with a more likely chance of another recurrence (65% vs 35%, odds ratio (OR) 3.6; p = 0.05) and that an increased estimated blood loss (106 cc vs 51 cc, OR 1.03; p = 0.005) predicted recurrence. Other variables, including body mass index (BMI) (32 vs 31 kg/m2, p = 0.38), defect size (115 cm2 vs 91 cm2; p = 0.23), size of mesh (468 cm2 vs 334 cm2, p = 0.19), type of mesh (p = 0.62), and mesh fixation (p = 0.99), did not predict recurrence. An additional 14 cases required conversion to an open operation, and seven of these cases (50%) had recurrence on long-term follow-up. CONCLUSION: Although LVHR remains the preferred method of hernia repair at our institution, this study documents a higher recurrence rate than many other short-term series. There results underscore the importance of long-term follow-up in assessing hernia surgery outcome.
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机译：背景：尽管腹腔镜腹疝修补术的早期结果显示复发率低，但缺乏长期数据。这项研究回顾了单个机构的腹腔镜腹疝修补术（LVHR）的经验。方法：我们对1996年1月至2001年3月在克利夫兰诊所基金会进行的所有LVHR进行了回顾性分析。复发率通过体检或电话随访确定。使用Cox回归确定预测复发的因素。结果：在腹腔镜下完成的100例腹疝中，有96例可以进行长期随访（平均30个月;范围4-65）。 7例患者没有死亡，也没有大的发病率。在17例患者中发现了复发。术后第一年发生了9例复发。但是，在整个随访期间，疝气复发仍在继续。多因素分析表明，先前的疝修补失败失败与再次复发的可能性更高（65％比35％，优势比（OR）3.6; p = 0.05），并且估计失血量增加（106 cc vs 51 cc） ，或1.03; p = 0.005）预测的复发率。其他变量包括体重指数（BMI）（32 vs 31 kg / m2，p = 0.38），缺陷尺寸（115 cm2 vs 91 cm2; p = 0.23），网眼尺寸（468 cm2 vs 334 cm2，p = 0.19） ），网状类型（p = 0.62）和网状固定（p = 0.99）不能预测复发。另外有14例需要转换为开放手术，其中有7例（50％）在长期随访中复发。结论：尽管LVHR仍然是我们机构疝气修复的首选方法，但本研究证明其复发率高于许多其他短期系列。结果强调了长期随访在评估疝气手术结果中的重要性。
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