Evaluating the impact of diastasis recti on ipom plus ventral hernia repair.

IF 2.4 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-08-14 DOI:10.1007/s10029-025-03451-3

Emmanuel E Sadava, Julieta A Giacone Aguiar, Agustin C Valinoti, Sofia Aramburu, Alexis M Flores Gaibor, Francisco Schlottmann

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引用次数: 0

Abstract

Introduction: Ventral hernia repair (VHR) via intraperitoneal onlay mesh with primary defect closure (IPOM+) is currently the most widely adopted technique. However, this procedure has not yet been evaluated in patients with diastasis recti (DR). We aimed to determine if the presence of DR affects long-term surgical outcomes of IPOM+.

Methods: We conducted a retrospective analysis of a consecutive series of patients who underwent IPOM + technique for VHR. Only patients with defects between 3 and 8 cm in width and with at least 1-year follow-up were included. The cohort was divided into two groups; IPOM+: patients with ventral hernia without DR, and IPOM + DR, patients with ventral hernia and DR. Preoperative, intraoperative and postoperative variables were compared between groups.

Results: A total of 106 patients undergoing VHR were included; 41 (39%) IPOM + and 65 (61%) IPOM + DR (the mean DR was: 4.5 ± 1.3 cm). Demographics and preoperative variables were similar between groups. Mean defect width was 5.3 ± 2 cm and: 4.7 ± 2 cm for IPOM + and IPOM + DR, respectively (p = 0.2). Mean follow-up was also similar between groups (IPOM+: 51.8 versus IPOM + DR: 46.3 months, p = 0.44). Recurrence rate was significantly higher in patients with IPOM + DR (21.5% versus 2.4%, p = 0.003). In addition, 5 (7.6%) patients in IPOM + DR group had DR-recurrence as clinical bulging, and all but one needed reoperation.

Conclusions: Although IPOM + remains as an effective technique for the repair of midline ventral hernias, the presence of DR increases recurrence rates significantly. Further research is needed to determine the optimal surgical approach in patients with ventral hernias and DR.

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评价游离直疝对腹膜疝联合腹疝修补术的影响。

腹膜内嵌补片初级缺损闭合（IPOM+）腹疝修补术（VHR）是目前应用最广泛的技术。然而，该方法尚未在直肠转移（DR）患者中进行评估。我们的目的是确定DR的存在是否影响IPOM+的长期手术结果。方法：我们对连续接受IPOM +技术治疗VHR的患者进行回顾性分析。仅包括缺陷宽度在3 - 8cm之间且随访至少1年的患者。研究对象被分为两组；IPOM+组：腹侧疝无DR患者，IPOM+ DR组，腹侧疝合并DR患者进行术前、术中、术后变量比较。结果：共纳入106例VHR患者；41 (39%) IPOM + 65 (61%) IPOM +博士(意思是:博士4.5±1.3厘米)。组间人口统计学和术前变量相似。IPOM +和IPOM + DR的平均缺陷宽度分别为5.3±2 cm和4.7±2 cm （p = 0.2）。两组间的平均随访时间相似（IPOM+: 51.8个月vs IPOM+ DR: 46.3个月，p = 0.44）。IPOM + DR患者的复发率明显更高（21.5%比2.4%,p = 0.003）。此外，IPOM + DR组有5例（7.6%）患者出现DR复发，表现为临床鼓包，除1例外均需再次手术。结论：尽管IPOM +仍然是修复中线腹疝的有效技术，但DR的存在显著增加了复发率。腹疝合并DR患者的最佳手术入路需要进一步的研究。

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.