Robotic intraperitoneal onlay versus totally extraperitoneal (TEP) retromuscular mesh ventral hernia repair: A propensity score matching analysis of short-term outcomes

Kudsi O. Y., Gokcal F., Chang K.

American Journal of Surgery, cilt.220, sa.4, ss.837-844, 2020 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 220 Sayı: 4
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1016/j.amjsurg.2020.01.003
  • Dergi Adı: American Journal of Surgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Agricultural & Environmental Science Database, Biotechnology Research Abstracts, CAB Abstracts, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.837-844
  • Anahtar Kelimeler: Intraperitoneal onlay mesh, IPOM, Robotic ventral hernia repair, TEP, Totally extraperitoneal
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır

Özet

Background: Short-term outcomes of robotic intraperitoneal onlay mesh(rIPOM) versus robotic totally extraperitoneal retromuscular mesh(rTEP-RM) ventral hernia repair were compared. Methods: A retrospective review of prospectively collected data of patients was conducted. A one-to-one propensity score matching(PSM) analysis was performed to achieve two well-balanced groups in terms of preoperative variables. A univariate and multivariate analysis were conducted to determine factors influencing post-operative outcomes. Results: Of 291 rIPOM and rTEP-RM procedures, 68 patients were assigned to each group after PSM. Operative times were longer for the rTEP-RM group. Adhesiolysis was more frequently required in rIPOM. The rTEP-RM allowed for a greater mesh-to-defect ratio. The rate of overall perioperative complications, Clavien-Dindo grades, and surgical site events were higher for the rIPOM group than the rTEP-RM group. The Comprehensive Complication Index® morbidity scores were lower in favor of rTEP-RM group. Adhesiolysis, rIPOM, and craniocaudal defect size were predictors for post-operative complications. Conclusion: Robotic TEP-RM repair has better early postoperative outcomes for ventral hernias, suggesting that it may be preferable over robotic IPOM repair. Further studies with longer follow-up are needed.