Looft Phillip, Alfarawan Fadl, Bockhorn Maximilian, El-Sourani Nader
Department for Pediatric Surgery, University Hospital Oldenburg, Klinikum Oldenburg AöR, Rahel-Straus-Straße 10, 26133 Oldenburg, Germany.
Department for General and Visceral Surgery, University Hospital Oldenburg, Klinikum Oldenburg AöR, Rahel-Strauß-Straße 10, 26133 Oldenburg, Germany.
J Clin Med. 2025 Apr 9;14(8):2586. doi: 10.3390/jcm14082586.
Ventral hernias are common abdominal wall defects requiring surgical repair to prevent complications. This study compared two techniques: minimally invasive enhanced-view totally extraperitoneal (eTEP) approach and the open sublay (OS) method, historically regarded as the gold standard. A retrospective single-center study was conducted between July 2019 and March 2023 at the Department for General and Visceral Surgery, Klinikum Oldenburg. All patients who underwent either eTEP or OS for ventral hernia repair were included. Patient demographics and perioperative data were collected and compared. A total of 139 patients were analyzed, with 92 undergoing eTEP repair and 47 undergoing OS. Both groups were comparable in demographic and clinical characteristics. Significant differences were found in defect size (median 6 cm for eTEP vs. 16 cm for OS, < 0.028) and mesh size (median 450 cm for eTEP vs. 150 cm for OS < 0.001). Operative time ( = 0.119) and postoperative pain levels over 3 days showed no significant differences (VAS Day1 = 0.884; VAS Day3 = 0.636). Intraoperative complications were 2.17% for eTEP and 6.38% for OS ( = 0.207). Postoperative complications (6.52% vs. 21.28%, = 0.009) and hospital stay (median 3 days vs. 5 days, < 0.001) were significantly lower in the eTEP group. eTEP is a safe, effective procedure and appears to offer more advantages than OS for ventral hernia repair. It is associated with a significantly lower complication rate, as well as shorter hospital stay.
腹疝是常见的腹壁缺损，需要手术修复以预防并发症。本研究比较了两种技术：微创增强视野完全腹膜外（eTEP）入路和开放肌后补片植入（OS）法，后者历来被视为金标准。2019年7月至2023年3月期间，在奥尔登堡市立医院普通和内脏外科进行了一项回顾性单中心研究。纳入所有接受eTEP或OS腹疝修补术的患者。收集并比较患者的人口统计学和围手术期数据。共分析了139例患者，其中92例行eTEP修补术，47例行OS修补术。两组在人口统计学和临床特征方面具有可比性。发现两组在缺损大小（eTEP组中位数为6 cm，OS组为16 cm，<0.028）和补片大小（eTEP组中位数为450 cm²，OS组为150 cm²，<0.001）方面存在显著差异。手术时间（P = 0.119）和术后3天的疼痛水平无显著差异（视觉模拟评分法第1天：P = 0.884；第3天：P = 0.636）。eTEP组术中并发症发生率为2.17%，OS组为6.38%（P = 0.207）。eTEP组术后并发症（6.52% 对21.28%，P = 0.009）和住院时间（中位数3天对5天，P < 0.001）显著更低。eTEP是一种安全、有效的手术方法，在腹疝修补方面似乎比OS具有更多优势。它与显著更低的并发症发生率以及更短的住院时间相关。
