Koeller Eva, Liu Yao, Ortega-Goddard Emily, Giorgi Marcoandrea, Luhrs Andrew
Brown University General Surgery Program and The Miriam Hospital, 593 Eddy Street, Providence, RI, 02903, USA.
Surg Endosc. 2024 Dec;38(12):7596-7603. doi: 10.1007/s00464-024-11251-6. Epub 2024 Sep 28.
Tobacco smoking increases risk of complications after open hernia repair, however it is unknown whether this is true in minimally invasive hernia repair. We aim to determine whether there are differences in complication rates between smokers and non-smokers after robotic eTEP retrorectus repair.
Our study included 102 patients who underwent robotic eTEP retrorectus repair of ventral hernias at a single institution from November 2019 to October 2022. Data collected included demographics, smoking status, operative details and outcomes. Patients were sorted into groups based on smoking status and outcomes were compared using ANOVA and chi-squared to test for significance.
Out of 102 patients, 18 were currently smoking, 38 were former smokers, 56 had ever smoked, 46 had never smoked and 84 were not currently smoking. Those who had ever smoked were more likely to endorse alcohol use compared to never smokers (60.7 vs 37%, p = 0.0169) and COPD was significantly more common in current smokers compared to not current smokers (p = 0.00025) and ever smokers compared to never smokers (p = 0.0037). Average follow up was 59.17 days and there was only one recurrence, which occurred in a never smoker. Initial analysis showed no difference in any complication. We excluded asymptomatic seromas that never required intervention due to clinical insignificance and repeat analysis showed current smokers had a significantly higher rate of surgical site occurrences (SSO) compared to patients not smoking at the time of their operation (p = 0.012). There was no difference between ever smokers and never smokers (p = 0.77). There remained no difference in any other complication.
Active smoking at the time of robotic eTEP increases the risk of clinically significant surgical site occurrences. This same increase is not seen in former smokers suggesting that smoking cessation should be encouraged before minimally invasive hernia repair.
吸烟会增加开放性疝修补术后并发症的风险，然而在微创疝修补术中是否也是如此尚不清楚。我们旨在确定机器人经腹直肌后入路腹膜前疝修补术（eTEP）后吸烟者和非吸烟者的并发症发生率是否存在差异。
我们的研究纳入了2019年11月至2022年10月在单一机构接受机器人eTEP腹侧疝修补术的102例患者。收集的数据包括人口统计学资料、吸烟状况、手术细节和结果。根据吸烟状况将患者分组，并使用方差分析和卡方检验比较结果以检验显著性。
在102例患者中，18例为当前吸烟者，38例为既往吸烟者，56例曾吸烟，46例从未吸烟，84例当前不吸烟。与从未吸烟者相比，曾吸烟者更有可能认可饮酒（60.7%对37%，p = 0.0169），与当前不吸烟者相比，当前吸烟者慢性阻塞性肺疾病（COPD）明显更常见（p = 0.00025），与从未吸烟者相比，曾吸烟者COPD也明显更常见（p = 0.0037）。平均随访59.17天，仅发生1例复发，发生在1例从未吸烟者中。初步分析显示任何并发症均无差异。我们排除了因临床意义不大而从未需要干预的无症状血清肿，再次分析显示，与手术时不吸烟的患者相比，当前吸烟者的手术部位事件（SSO）发生率显著更高（p = 0.012）。曾吸烟者和从未吸烟者之间无差异（p = 0.77）。其他任何并发症均无差异。
机器人eTEP手术时主动吸烟会增加具有临床意义的手术部位事件的风险。既往吸烟者未出现同样的增加，这表明在微创疝修补术前应鼓励戒烟。
