General Surgery Unit, Chivasso Hospital, Chivasso, Italy.
Department of Surgery, University of Turin, Turin, Italy.
Surg Endosc. 2022 Feb;36(2):1302-1309. doi: 10.1007/s00464-021-08405-1. Epub 2021 Mar 4.
Diastasis recti is a pathology that affects not only the abdominal wall but also the stability of lumbopelvic muscles, consequently altering urinary and digestive functionality. Preaponeurotic endoscopic repair (REPA) is an endoscopic alternative to tummy tuck for the treatment of diastasis. In this study, the outcomes of REPA application by a single surgeon are presented.
A total of 172 patients underwent REPA for the treatment of diastasis recti between August 2017 and December 2019. One hundred twenty-four patients were followed for at least one year. Sixty-three patients responded to a survey on satisfaction and quality of life 12 months after surgery.
Three (2.4%) recurrences occurred, of which two occurred in the same patient. The main postoperative complications observed were 12 (9.7%) seromas, 3 (2.4%) haematomas, a single wound infection, 3 (2.4%) cases of skin fold formation, and a case of trophic skin lesion that required negative pressure therapy. Quality of life after surgery, as reported by 63 patients who responded to the survey, was satisfactory.
REPA is a safe and effective technique for diastasis recti treatment, representing a valid alternative to abdominoplasty. Since there is no need to access the peritoneal cavity and the mesh is onlay, there are no risks of bowel damage or adhesions between the intestine and prosthesis.
腹直肌分离不仅影响腹壁,还会影响腰骨盆肌肉的稳定性,从而改变泌尿和消化功能。前盆网片修补术(REPA)是一种治疗腹直肌分离的内镜替代腹部整形术。本研究介绍了一位外科医生应用 REPA 的治疗结果。
2017 年 8 月至 2019 年 12 月,共有 172 例腹直肌分离患者接受 REPA 治疗。至少随访 1 年的患者有 124 例。63 例患者在术后 12 个月时对满意度和生活质量进行了调查。
3 例(2.4%)复发,其中 2 例发生在同一位患者。观察到的主要术后并发症有 12 例(9.7%)血清肿、3 例(2.4%)血肿、1 例单纯伤口感染、3 例(2.4%)皮肤褶皱形成和 1 例营养性皮肤病变,需要负压治疗。对调查中 63 例回复的患者进行生活质量评估,结果满意。
REPA 是治疗腹直肌分离的一种安全有效的技术,是腹部整形术的有效替代方法。由于无需进入腹腔,且网片是覆盖式放置,因此不存在肠损伤或肠与假体粘连的风险。