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Purpose <p>Acquired lateral abdominal wall hernias (LAWH) are rare, anatomically complex defects that pose a surgical challenge. This study aims to evaluate outcomes and compare surgical approaches for acquired LAWH repair.</p> Methods <p>A systematic search of PubMed and EMBASE was conducted in June 2024. Studies describing single surgical techniques or comparative approaches for acquired LAWHs were included. The primary outcome was recurrence; secondary outcomes included postoperative complications. Meta-analysis estimated pooled rates; pairwise analysis compared laparoscopic and open approaches.</p> Results <p>Data from 41 studies comprising 10,771 participants were pooled. The median age was 59.9&#xa0;years (36.4–70.0), BMI was 29&#xa0;kg/m<sup>2</sup> (20.95–33), and 47.2% were male. The median defect size was 8.28&#xa0;cm (2.18–100); area was 78.6 cm<sup>2</sup> (6.4–232). Median follow-up was 29.9&#xa0;months (3.6–170). The pooled recurrence rate was 5.4%. Recurrence rates were 3.8% for flank, 2.7% for lumbar, 3.5% for incisional, and 1.6% for primary hernias. Recurrence differed by surgical approach, with rates of 4.5% for laparoscopic and 5.9% for open repair, and by mesh placement, with rates of 4.1% for extraperitoneal and 5.2% for intraperitoneal placement. The overall complication rate was 15.8%, including SSOs (9.9%) and SSIs (2.7%). Specific postoperative complications included hematoma (1.4%), seroma (5.8%), and wound infection (2.3%). Pairwise analysis of three studies showed a significant reduction in recurrence with the laparoscopic approach (OR = 0.66 [0.53–0.83], <i>p</i> = 0.0003, <i>I</i><sup>2</sup> = 0%) but no significant difference in overall complication rates (OR = 0.82 [0.49–1.36], <i>p</i> = 0.44, <i>I</i><sup>2</sup> = 65%).</p> Conclusion <p>This meta-analysis presents the first pooled estimates of recurrence and complication rates for acquired LAWHs, highlighting variations based on hernia characteristics and management. Laparoscopic repair was associated with a 33.6% lower recurrence rate, with similar overall complication rates. Further research is needed to optimize surgical approaches and outcomes.</p>

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Outcomes of surgical repair of acquired lateral abdominal wall hernias: a meta-analysis

  • 期刊论文

  • 发表日期：

    2025年8月19日

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  • Michelle Hambleton,
  • Mohamed Moola,
  • Justin Dourado,
  • Sameh Hany Emile,
  • Brett Weiss,
  • Cameron Perrone,
  • Spencer Barnes,
  • Ana Peña,
  • Samuel Szomstein,
  • Raul Rosenthal,
  • Emanuele Lo Menzo

摘要

Purpose

Acquired lateral abdominal wall hernias (LAWH) are rare, anatomically complex defects that pose a surgical challenge. This study aims to evaluate outcomes and compare surgical approaches for acquired LAWH repair.

Methods

A systematic search of PubMed and EMBASE was conducted in June 2024. Studies describing single surgical techniques or comparative approaches for acquired LAWHs were included. The primary outcome was recurrence; secondary outcomes included postoperative complications. Meta-analysis estimated pooled rates; pairwise analysis compared laparoscopic and open approaches.

Results

Data from 41 studies comprising 10,771 participants were pooled. The median age was 59.9 years (36.4–70.0), BMI was 29 kg/m2 (20.95–33), and 47.2% were male. The median defect size was 8.28 cm (2.18–100); area was 78.6 cm2 (6.4–232). Median follow-up was 29.9 months (3.6–170). The pooled recurrence rate was 5.4%. Recurrence rates were 3.8% for flank, 2.7% for lumbar, 3.5% for incisional, and 1.6% for primary hernias. Recurrence differed by surgical approach, with rates of 4.5% for laparoscopic and 5.9% for open repair, and by mesh placement, with rates of 4.1% for extraperitoneal and 5.2% for intraperitoneal placement. The overall complication rate was 15.8%, including SSOs (9.9%) and SSIs (2.7%). Specific postoperative complications included hematoma (1.4%), seroma (5.8%), and wound infection (2.3%). Pairwise analysis of three studies showed a significant reduction in recurrence with the laparoscopic approach (OR = 0.66 [0.53–0.83], p = 0.0003, I2 = 0%) but no significant difference in overall complication rates (OR = 0.82 [0.49–1.36], p = 0.44, I2 = 65%).

Conclusion

This meta-analysis presents the first pooled estimates of recurrence and complication rates for acquired LAWHs, highlighting variations based on hernia characteristics and management. Laparoscopic repair was associated with a 33.6% lower recurrence rate, with similar overall complication rates. Further research is needed to optimize surgical approaches and outcomes.