Long-term outcomes of repa for ventral hernias and diastasis: recurrence risk and aesthetic challenges.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-05-23 DOI:10.1007/s10029-025-03373-0

Micaela Milagros Rossi, Digby Aylen Montechiari, Ignacio Portela, Santiago Andrés Flores, Alejandro Rossini, Franco José Signorini, Lucio Obeide

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引用次数: 0

Abstract

Purpose: To evaluate outcomes of the REPA technique in patients with midline ventral or incisional hernias and associated diastasis during long-term follow-up, complemented with computed tomographic (CT) imaging.

Methods: A retrospective study including patients who underwent REPA surgery between November 2017 and April 2024 was performed. Demographic data, operative times, postoperative complications, and hospital stay were analyzed. Functional and aesthetic outcomes were assessed using the EHS quality-of-life score. Patients with more than one year since surgery underwent a CT. Based on CT results, patients were divided into two groups to compare (recurrence/no recurrence).

Results: A total of 142 patients underwent REPA. The associated diastasis had a mean size of 33.8 ± 13.3 mm. The median follow-up time was 47.9 ± 23.97 months. 62 patients completed the EHS-QoL questionnaire. Regarding aesthetics, the general shape of the abdomen had a mean score of 5.66 (± 3.55) and the hernia site and scar scored 3.37 (± 3.58). Among the 33 patients who underwent follow-up CT scans, recurrence was identified in 9 cases (27.3%). Statistically significant differences were observed in BMI (26.01 ± 5.45 vs. 30.52 ± 4.99 kg/m², p = 0.04) and diastasis size (30.3 ± 8.95 vs. 56.6 ± 17.4 mm, p < 0.001) between patients with and without recurrence.

Conclusion: Our findings suggest a higher risk of recurrence in patients with diastasis > 5 cm and obesity, highlighting the need for careful patient selection. Furthermore, overall abdominal shape may be unsatisfactory despite minimal scarring. Overweight and obesity should be considered exclusion criteria to optimize functional and aesthetic outcomes.

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腹疝和腹膜转移的长期预后：复发风险和美学挑战。

目的：评估REPA技术在中线腹疝或切口疝及相关转移患者长期随访期间的效果，并辅以计算机断层扫描（CT）成像。方法：回顾性研究包括2017年11月至2024年4月期间接受REPA手术的患者。统计数据、手术时间、术后并发症和住院时间。使用EHS生活质量评分评估功能和美学结果。术后一年以上的患者接受CT检查。根据CT结果将患者分为两组进行比较（复发/未复发）。结果：142例患者行REPA。相关转移的平均大小为33.8±13.3 mm。中位随访时间为47.9±23.97个月。62例患者完成EHS-QoL问卷。在美学方面，腹部总体形状平均得分为5.66（±3.55）分，疝部位和疤痕平均得分为3.37（±3.58）分。在随访的33例患者中，9例（27.3%）复发。BMI（26.01±5.45 vs. 30.52±4.99 kg/m2, p = 0.04）和转移灶大小（30.3±8.95 vs. 56.6±17.4 mm, p = 0.04）的差异有统计学意义。结论：转移灶直径为0.5 cm且肥胖的患者复发风险较高，需要谨慎选择患者。此外，尽管有最小的疤痕，但整体腹部形状可能不令人满意。超重和肥胖应考虑排除标准，以优化功能和美观的结果。

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.