The Impact of Surgical Approach on Postoperative Recovery and Quality of Life in Obstructed Incisional Hernias.

Abstract

Background: Incisional hernias are a frequent complication after abdominal surgery, affecting a significant number of patients worldwide. When complicated by bowel obstruction, these hernias require urgent surgical intervention, which can lead to increased perioperative risks and prolonged recovery. This study aims to evaluate and compare the clinical outcomes and quality of life between open and laparoscopic surgery for incisional hernias complicated by bowel obstruction. Methods: AA 6-year prospective cohort study was conducted between January 2019 and 2024. A total of 117 patients who presented with incisional hernias complicated by bowel obstruction were included. Patients were divided into two groups: open surgery (n=91) and laparoscopic surgery (n=26). Pain and quality of life were assessed using the Visual Analog Scale and the questionnaire of the European Hernia Society. Results: Complication rates were significantly lower in the laparoscopic group (23.1% vs. 38.5%), although no significant differences were found in Clavien-Dindo complication grades. Patients who underwent laparoscopic surgery reported significantly lower postoperative pain scores on day 1 and discharge, and they showed superior quality of life scores, especially regarding pain during physical activity and cosmetic concerns, as measured by the EuraHS-QoL questionnaire. Conclusions: Laparoscopic surgery for incisional hernias complicated by bowel obstruction results in fewer complications, reduced postoperative pain, and improved quality of life compared to open surgery.