Krollmann, Niklas;
Hunger, Richard;
Paasch, Christoph;
Mantke, René
Incidence of incisional hernias and cosmetic outcome after laparoscopic single-incision cholecystectomy: a long-term follow-up cohort study of 125 patients
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Medientyp:
E-Artikel
Titel:
Incidence of incisional hernias and cosmetic outcome after laparoscopic single-incision cholecystectomy: a long-term follow-up cohort study of 125 patients
Beteiligte:
Krollmann, Niklas;
Hunger, Richard;
Paasch, Christoph;
Mantke, René
Beschreibung:
<jats:sec>
<jats:title>Background:</jats:title>
<jats:p>Studies have evaluated long-term occurrence of incisional hernia, cosmesis, and postoperative pain after single-incision laparoscopic cholecystectomy (SILC). However, the follow-up periods were rarely defined longer than 12 months. The authors performed a cohort study to evaluate hernia rate and cosmesis in a prolonged follow-up period.</jats:p>
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<jats:title>Methods:</jats:title>
<jats:p>All patients that underwent SILC at the University Hospital Brandenburg an der Havel Hospital between December 2008 and November 2014 were evaluated in terms of postoperative complications, and a follow-up telephone interview including the existence of hernias and chronic pain was performed. Cosmesis and the overall satisfaction of the scar was measured by POSAS (Patient and Observer Scar Assessment Scale).</jats:p>
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<jats:title>Results:</jats:title>
<jats:p>In total 125 patients underwent SILC. The single-incision approach was completed in 94.4%, an additional trocar was necessary in 3.2% (<jats:italic toggle="yes">n</jats:italic>=4) and a conversion to 4 trocar cholecystectomy was required in 2.4% (<jats:italic toggle="yes">n</jats:italic>=3). Intraoperative complications occurred in 0.8% and postoperative complication in 12.8% of all patients. Follow-up telephone interview was performed in 49.6% of 125 patients. The mean follow-up period was 138.9 months (11.6 years). Overall, in 3.6%, an incisional hernia was diagnosed. A total of 3.6% reported pain in the region of the umbilicus with a mean VAS (visual analog scale) of 2/10. The mean POSAS score was 7.8. Overall, 82.3% of this cohort rate their satisfaction of the scar with a 1/7, resembling the best possible result of the scar.</jats:p>
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<jats:title>Conclusion:</jats:title>
<jats:p>The present study demonstrates that SILC is a safe alternative in terms of incisional hernia rate and complications with a high satisfaction of the scar even after one decade after surgery. In comparison to shorter follow-up period and multiport laparoscopic cholecystectomy, our result is comparable.</jats:p>
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