Comparison of eTEP and IPOM for ventral hernia surgery in the early postoperative period: a retrospective cohort study of a tertiary university centre

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2024-09-16 DOI:10.1007/s10029-024-03125-6

Lukas Wieland, Fadl Alfarawan, Maximilian Bockhorn, Nader El-Sourani

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引用次数: 0

Abstract

Purpose

The extended totally extraperitoneal technique (eTEP) is a relatively new laparoscopic approach to address ventral hernias. Since this technique is not widely used yet, the literature regarding its efficacy and safety is limited, especially when compared to more established surgical techniques like intraperitoneal onlay mesh (IPOM). This study aimed at contributing to the expanding body of evidence for eTEP, by comparing the early outcomes of eTEP and IPOM surgeries for ventral hernias.

Methods

This monocentric, retrospective cohort study compared patients with ventral hernias that were treated with eTEP or IPOM from 2019 to 2023.

Results

A total of 123 patients were analysed. 92 underwent eTEP and 31 IPOM respectively. Both groups were overall comparable. The IPOM group had a higher proportion of incisional hernias (61,29% vs. 21,74%, p < 0,001). This was taken into account for in a subgroup analysis of only primary hernias. The IPOM group had a significantly longer admission time (eTEP: 3 days, IPOM: 4 days, p < 0,001). The subgroup analysis revealed a statistically significant shorter surgery time in IPOM (median of 66,5 min vs. 106,5 min; p = 0,043) and a lower rate of postoperative complications in eTEP (eTEP: 4,17%, IPOM: 25%. p = 0,009). The eTEP group reported lower postoperative pain, yet without statistical significance.

Conclusion

eTEP for ventral hernia repair appears to be non-inferior to IPOM. Compared to IPOM it leads to shorter postoperative hospital stay and a potentially lower complication rate, despite a longer operation time.

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术后早期腹股沟疝手术中 eTEP 和 IPOM 的比较：一所大学三级医疗中心的回顾性队列研究

目的扩展腹膜外技术（eTEP）是一种相对较新的腹腔镜方法，用于治疗腹股沟疝。由于该技术尚未得到广泛应用，有关其疗效和安全性的文献十分有限，尤其是与腹膜内嵌网术（IPOM）等更成熟的手术技术相比。本研究旨在通过比较 eTEP 和 IPOM 手术治疗腹股沟疝的早期疗效，为不断扩大的 eTEP 证据库做出贡献。方法这项单中心、回顾性队列研究比较了 2019 年至 2023 年期间接受 eTEP 或 IPOM 治疗的腹股沟疝患者。其中 92 人接受了 eTEP 治疗，31 人接受了 IPOM 治疗。两组患者的总体情况相当。IPOM 组的切口疝比例更高（61.29% 对 21.74%，p < 0,001）。仅对原发性疝气进行分组分析时考虑到了这一点。IPOM 组的入院时间明显更长（eTEP：3 天，IPOM：4 天，p < 0,001）。亚组分析显示，IPOM 组的手术时间明显更短（中位数为 66.5 分钟对 106.5 分钟；p = 0.043），而 eTEP 组的术后并发症发生率更低（eTEP：4.17%；IPOM：25%；p = 0.009）。eTEP 组术后疼痛较轻，但无统计学意义。与 IPOM 相比，尽管手术时间更长，但术后住院时间更短，并发症发生率可能更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.