Liu Yao, Gabinet Nicholas, Ortega-Goddard Emily, Luhrs Andrew, Giorgi Marcoandrea
Brown University Health Comprehensive Hernia Center, Providence, RI, USA.
Surg Endosc. 2025 May;39(5):3373-3376. doi: 10.1007/s00464-025-11669-6. Epub 2025 Mar 31.
Obesity not only contributes to the pathology of primary and incisional ventral hernias but is also associated with increased rates of post-operative complications and hernia recurrence after repair. Whether this holds true for complex robotic eTEP retrorectus hernia repair has not been well researched. The aim of this study was to determine whether obesity increases risks of short-term recurrence or complications after robotic abdominal wall reconstruction.
A retrospective chart review was performed for 102 robotic eTEP abdominal wall reconstructions completed at a single institution between 2019 and 2022. Independent variables included patient demographics, hernia characteristics, and intraoperative data. Primary outcomes included 30-day post-operative complications resulting in readmission/ED visits. Outcomes were compared between two cohorts: BMI < 35 and BMI ≥ 35. Univariate analysis was used to compare the incidence of complications between both groups.
Our mean follow-up time was 59.2 +/- 98.7 days, and median was 18 days, with the range of 6-419 days. Of the 102 patients, the overall mean BMI was 32.1. 31 patients (30%) had a BMI ≥ 35, while 71 (70%) had a BMI < 35. The BMI ≥ 35 cohort had a mean BMI of 37.9, and the BMI < 35 cohort had a BMI of 29.6. There were no recurrences in the BMI ≥ 35 group and only one in the BMI < 35 group (0% vs. 1.4%, p = 0.51, 95% CI - 0.06 to 0.03). There were two complications in the BMI ≥ 35 group, and seven in the BMI < 35 group (6.5% vs. 9.9%, p = 0.58, 95% CI - 0.17 to 0.11).
The results of our single-center experience showed no significant increase in 30-day hernia recurrence or surgical site occurrences for patients with BMI ≥ 35 undergoing robotic eTEP. This study is limited by small patient cohort size and short follow-up interval.
肥胖不仅会导致原发性和切口性腹疝的病理改变，还与术后并发症发生率增加以及修补术后疝复发有关。对于复杂的机器人经腹膜外后直肌疝修补术而言，情况是否如此尚未得到充分研究。本研究的目的是确定肥胖是否会增加机器人腹壁重建术后短期复发或并发症的风险。
对2019年至2022年在单一机构完成的102例机器人经腹膜外腹壁重建手术进行回顾性病历审查。自变量包括患者人口统计学特征、疝的特征和术中数据。主要结局包括导致再次入院/急诊就诊的术后30天并发症。对两个队列进行结局比较：BMI<35和BMI≥35。采用单因素分析比较两组并发症的发生率。
我们的平均随访时间为59.2±98.7天，中位数为18天，范围为6-419天。102例患者的总体平均BMI为32.1。31例患者（30%）的BMI≥35，而71例（70%）的BMI<35。BMI≥35队列的平均BMI为37.9，BMI<35队列的BMI为29.6。BMI≥35组无复发，BMI<35组仅有1例复发（0%对1.4%，p=0.51，95%CI -0.06至0.03）。BMI≥35组有2例并发症，BMI<35组有7例并发症（6.5%对9.9%，p=0.58，95%CI -0.17至0.11）。
我们单中心的经验结果显示，接受机器人经腹膜外手术的BMI≥35患者在术后30天的疝复发或手术部位并发症方面没有显著增加。本研究受患者队列规模小和随访间隔短的限制。
