Emmanuel E Sadava, Julieta A Giacone Aguiar, Agustin C Valinoti, Sofia Aramburu, Alexis M Flores Gaibor, Francisco Schlottmann
{"title":"评价游离直疝对腹膜疝联合腹疝修补术的影响。","authors":"Emmanuel E Sadava, Julieta A Giacone Aguiar, Agustin C Valinoti, Sofia Aramburu, Alexis M Flores Gaibor, Francisco Schlottmann","doi":"10.1007/s10029-025-03451-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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+.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"253"},"PeriodicalIF":2.4000,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating the impact of diastasis recti on ipom plus ventral hernia repair.\",\"authors\":\"Emmanuel E Sadava, Julieta A Giacone Aguiar, Agustin C Valinoti, Sofia Aramburu, Alexis M Flores Gaibor, Francisco Schlottmann\",\"doi\":\"10.1007/s10029-025-03451-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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+.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":13168,\"journal\":{\"name\":\"Hernia\",\"volume\":\"29 1\",\"pages\":\"253\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-08-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hernia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10029-025-03451-3\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03451-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Evaluating the impact of diastasis recti on ipom plus ventral hernia repair.
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.
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.
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