腹侧 ETEP 与 REPA,两种治疗中线缺损的新型微创技术的比较。

IF 1.1 4区 医学 Q3 SURGERY
Franco Signorini, Belen Soria, Digby Montechiari, Micaela Rossi, Lucio Obeide, Alejandro Rossini
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引用次数: 0

摘要

导言:本报告旨在比较腹腔镜腹膜外延伸视野(ETEP)和腹膜前修复(REPA)技术在手术过程、结果和患者演变方面的优势。研究方法这是一项回顾性研究,于2017年至2022年间在一家三级医疗学术中心进行。纳入了所有使用 REPA 和 ETEP 对中线疝和直肌舒张症进行手术的连续患者。随访时间为术后 15 天、30 天和 6 个月。对年龄、性别、体重指数(BMI)、美国外科麻醉学分类(ASA)、手术时间、是否需要转为开放手术、住院时间、血清肿、血肿、手术部位感染(SSI)、复发和再次干预进行了评估。结果本研究共纳入 148 名患者。其中 62 名患者接受了 REPA 手术,86 名患者使用 ETEP 技术进行了手术。REPA 平均时间为 105 分钟(四分位数间距 [IR] 80-130),ETEP 平均时间为 120 分钟(RIC 95-285)(P = 0.03)。门诊手术中,REPA 占 32.3%(n = 20),ETEP 占 20.9%(n = 18)(p = 0.23)。在 REPA 中,拔出引流管的平均时间为 11.92 天,而在 ETEP 中为 8 天(p < 0.001)。40.3% 的 REPA 病例(n = 25)和 5.8% 的 ETEP 病例(n = 5)发现了血清肿发生率(p = 0.001)。在血清肿发生率的多变量分析中,REPA 技术与血清肿发生率的显著风险相关[几率比(OR)16.67,95% 置信区间(CI95)4.67-59.52,P <0.001]。结论REPA 和 ETEP 安全且可重复。两种方法的住院时间都很短,几乎没有重大并发症。我们发现 ETEP 的手术时间更长,而 REPA 的血清肿发生率更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ventral ETEP Versus REPA, Comparison of Two Novel Minimally Invasive Techniques for Midline Defects.

Introduction: This report aimed to compare ventral extended vision extraperitoneal (ETEP) and preaponeurotic repair (REPA) techniques in terms of surgical procedure, outcomes, and patient evolution. Methods: This was a retrospective study performed at a tertiary care academic center between 2017 and 2022. All consecutive patients operated on for midline hernias and rectus diastasis using REPA and ETEP were included. Follow-up visits were at 15 days, 30 days, and 6 months postoperative. Age, sex, BMI, American Surgical Anesthesiologic Classification (ASA), surgical time, need for conversion to open surgery, time of stay, seroma, hematoma, surgical site infection (SSI), recurrence, and re-interventions were assessed. Results: For the present study, 148 patients were included. From them, 62 patients received the REPA procedure and 86 were operated on using the ETEP technique. REPA average time was 105 minutes (interquartile range [IR] 80-130), and ETEP average time was 120 minutes (RIC 95-285) (p = 0.03). Ambulatory procedures were 32.3% (n = 20) REPA and 20.9% (n = 18) ETEP (p = 0.23). In REPA, the mean time for drain extraction was 11.92 days and 8 days in ETEP (p < 0.001). Seroma incidence was identified in 40.3% (n = 25) of the REPA cases and 5.8% (n = 5) of the ETEP procedures (p = 0.001). In a multivariate analysis for seroma incidence REPA technique was associated with a significant risk of its incidence [odds ratio (OR) 16, 67 95% confidence interval ((CI95) 4.67-59.52), p < 0.001]. Conclusion: REPA and ETEP are safe and reproducible. Both approaches reported short hospitalization times and almost no major complications. We found a longer surgical time in ETEP and a higher incidence of seroma in REPA.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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