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采用新型混合网片加强材料的机器人经腹横纹肌后入路修补术的生活质量和手术结果。

Quality of life and surgical outcomes of robotic retromuscular ventral hernia repair using a new hybrid mesh reinforcement.

机构信息

Good Samaritan Medical Center, One Pearl Street, Brockton, MA, 02301, USA.

Tufts University School of Medicine, Boston, MA, USA.

出版信息

Hernia. 2022 Jun;26(3):881-888. doi: 10.1007/s10029-022-02619-5. Epub 2022 Apr 28.

Abstract

PURPOSE

The purpose of this study is to prospectively evaluate surgical and quality of life (QoL) outcomes of robotic retromuscular ventral hernia repair (rRMVHR) using a new hybrid mesh in high-risk patients.

METHODS

Data was prospectively collected for patients classified as high-risk based on the modified ventral hernia working group (VHWG) grading system, who underwent rRMVHR using Synecor™ Pre hybrid mesh in a single center, between 2019 and 2020. Pre-, intra- and postoperative variables including hernia recurrence, surgical site events (SSE), hernia-specific quality of life (QoL), and financial costs were analyzed. QoL assessments were obtained from preoperative and postoperative patient visits. Kaplan-Meier survival analysis was performed to analyze the estimated recurrence-free time.

RESULTS

Fifty-two high-risk patients, with a mean (±SD) age of 58.6 ± 13.7 years and BMI of 36.9 ± 6.6 kg/m, were followed for a mean (±SD) period of 22.4 ± 7.1 months. A total of 11 (21.2%) patients experienced postoperative complications, out of which eight were SSEs, including 7 (13.5%) seromas, 1 (1.9%) hematoma, and no infections. Procedural interventions were required for 2 (3.8%) surgical site occurrences. Recurrence was seen in 1 (1.9%) patient. The estimated mean (95% confidence interval) recurrence-free time was 33 (32.3-34.5) months. Postoperative QoL assessments demonstrated significant improvements in comparison to preoperative QoL, with a minimum ∆mean (±SD) of -15.5 ± 2.2 at one month (p < 0.001). The mean (±SD) procedure cost was $13,924.18 ± 7856.95 which includes the average mesh cost ($5390.12 ± 3817.03).

CONCLUSION

Our study showed favorable early and mid-term outcomes, in addition to significant improvements in QoL, after rRMVHR using Synecor™ hybrid mesh in high-risk patients.

摘要

目的

本研究旨在前瞻性评估使用新型混合网片行机器人腹侧后肌疝修补术(rRMVHR)治疗高危患者的手术和生活质量(QoL)结局。

方法

本研究前瞻性收集了 2019 年至 2020 年期间在一家中心接受基于改良腹疝工作组(VHWG)分级系统的高危患者行 rRMVHR 治疗的患者数据。分析了术前、术中、术后变量,包括疝复发、手术部位事件(SSE)、疝特异性生活质量(QoL)和经济成本。QoL 评估是在术前和术后的患者就诊时获得的。采用 Kaplan-Meier 生存分析来分析无复发时间的估计值。

结果

52 例高危患者,平均(±SD)年龄 58.6±13.7 岁,BMI 为 36.9±6.6kg/m²,平均随访时间(±SD)为 22.4±7.1 个月。共有 11 例(21.2%)患者出现术后并发症,其中 8 例为 SSE,包括 7 例(13.5%)血清肿,1 例(1.9%)血肿,无感染。2 例(3.8%)发生手术部位并发症需要进行介入治疗。1 例(1.9%)患者出现复发。估计的平均(95%置信区间)无复发时间为 33(32.3-34.5)个月。与术前 QoL 相比,术后 QoL 评估显示出显著改善,术后 1 个月的最小平均(±SD)差值为-15.5±2.2(p<0.001)。平均(±SD)手术费用为 13924.18±7856.95 美元,其中包括平均网片费用(5390.12±3817.03 美元)。

结论

我们的研究表明,在高危患者中使用 Synecor™ 混合网片行 rRMVHR 具有良好的早期和中期结果,并且 QoL 显著改善。

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