Endoscopic enhanced-view totally extraperitoneal prosthetic (eTEP) versus open Rives-Stoppa repair as a treatment of midline abdominal wall hernias with rectus diastasis: comparison of postoperative pain and length of hospital stay in a single-centre surgical cohort

被引：1

作者：

Kinet, Sam ^{[1
,2
]}

Maes, Hendrik ^{[2
]}

Van Cleven, Stijn ^{[2
]}

Brusselaers, Nele ^{[3
,4
]}

Kuppens, Eddy F. P. ^{[2
]}

机构：

[1] Katholieke Univ Leuven, Fac Med, Herestr 49, B-3000 Leuven, Belgium

[2] AZ Alma Gen Hosp, Ringlaan 15, B-9900 Eeklo, Belgium

[3] Antwerp Univ, Global Hlth Inst, Dept Family Med & Populat Hlth, Antwerp, Belgium

[4] Karolinska Inst, Ctr Translat Microbiome Res, Dept Microbiol Tumour & Cell Biol, Stockholm, Sweden

来源：

UPDATES IN SURGERY | 2024年 / 76卷 / 08期

关键词：

eTEP; Retromuscular; Minimally invasive; Endoscopic; Hernia; Diastasis; CLASSIFICATION; SURGERY;

D O I：

10.1007/s13304-024-01905-4

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

The Rives-Stoppa (RS) procedure is a gold standard treatment of midline abdominal wall hernias. Comparability of pain control and outcomes to the enhanced-view totally extraperitoneal prosthetic (eTEP) repair remain unclear. A single-centre retrospective surgical cohort was selected including 30 RS repairs (January 2019-November 2021) and 30 consecutive eTEP procedures (September 2021-August 2022) for midline abdominal wall hernia(s) with rectus abdominis diastasis. Postoperative pain and outcomes were compared up to 1 month. Presence and median duration of patient-controlled analgesia were, respectively, 90% and 3 nights with RS, versus 30% and 0 nights with eTEP. Median switch to only oral analgesics occurred at postoperative day (POD) 3 after RS and at POD 2 after eTEP. Postoperative analgesics and opioid prescription at discharge were comparable. Median length of hospital stay was six nights after RS versus 3 nights after eTEP. Median duration of surgery was 110.5 and 164.5 min for RS and eTEP, respectively. After RS, 30 patients had postoperative drain(s) compared to 3 patients after eTEP. Conversion was needed in 3 eTEP procedures. Postoperative complications were comparable. No early recurrences were observed. Minimal residual diastasis was seen at postoperative consultation in 11 patients after eTEP. Compared to RS, eTEP is a minimally invasive alternative treatment of midline abdominal wall hernias with rectus abdominis diastasis and is associated with a shorter length of hospital stay, less postoperative pain and a comparable risk of short-term complications. At 1 month after eTEP, minimal residual diastasis can be present. ClinicalTrials.gov: NCT05446675. Secondary identifying number: EC/EH/220608-SK. Date of Registration: June 24, 2022.

引用

页码：2923 / 2931

页数：9