OBJECTIVE: To assess trends in utilization and perioperative outcomes of laparoscopic and open @entity4036 repair. METHODS: Using the ACS-NSQIP database between 2009 and 2012, @entity1 were identified as having an ICD-9 diagnosis of an umbilical, ventral, or incisional @entity547 as well as a CPT code for a laparoscopic or open @entity4036 repair. A coarsened exact matching procedure was utilized to create a matched cohort to mitigate selection bias. Thirty-day outcomes analysis was done for the aggregate and matched cohorts. Subcategory analysis was performed for inpatient/outpatient status, strangulated/incarcerated @entity547 , initial/recurrent repairs, and @entity547 type (umbilical, ventral, incisional). Chi-square analysis was performed to determine the statistical significance of each comparison. RESULTS: In total, 112,074 qualifying @entity1 were identified, 86,566 (77.24  %) open and 25,508 (22.76  %) laparoscopic. @entity1 undergoing laparoscopic repair were more likely to have preexisting comorbidities, but less likely to experience any postoperative morbidity (11.74 vs. 7.25  %, P  <  0.0001), serious morbidity (4.55 vs. 3.02  %, P  <  0.0001), or mortality (0.36 vs. 0.24  %, P  =  0.0030). Creation of the matched cohort produced 17,394 @entity1 in both the laparoscopic and open groups and resulted in a loss of advantage for the laparoscopic approach in terms of morbidity associated with @entity14147 (P  =  0.0082 vs. P  =  0.3172). @entity1 undergoing laparoscopic repair were still less likely to experience any postoperative (9.57 vs. 4.92  %, P  <  0.0001) or serious morbidity (3.37 vs. 1.70  %, P  <  0.0001). Hospital length of stay in the matched cohort supported initial primary repairs done by an open approach. CONCLUSION: The laparoscopic approach is used in a minority of @entity4036 , though utilization increased by 40  % from 2009 to 2012. The laparoscopic approach continues to be safer on many fronts, but not all, and is arguably not better for umbilical or primary @entity547 repairs on the basis of overall morbidity and length of stay.

Closing the gap between the laparoscopic and open approaches to XXXX repair: a trend and outcomes analysis of the ACS-NSQIP database.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity4036 :: ('MESH:D046449', 'Disease') :: ['abdominal wall hernia', 'abdominal wall hernia repairs'] @entity14147 :: ('MESH:D006554', 'Disease') :: ['umbilical hernia repairs'] @entity547 :: ('MESH:D006547', 'Disease') :: ['hernia', 'hernias']
@entity4036 :: (MESH:D046449,Disease) :: ['abdominal wall hernia']
