Woeste Guido, Dascalescu Sandrina, Wegner Felix, Meier Hansjörg, Sardoschau Nihad, Kiehle Adrien, Dag Halil, Malaibari Zaid, Niebuhr Henning
Goethe University Frankfurt, Faculty of Medicine, Frankfurt A.M., Germany.
Agaplesion Elisabethenstift Darmstadt, Darmstadt, Germany.
Hernia. 2025 May 2;29(1):154. doi: 10.1007/s10029-025-03297-9.
Different techniques for complex abdominal wall repair are utilised including intraoperative fascial traction (IFT) as the latest development. Despite increasing case numbers for IFT across Europe, long-term data especially on recurrence rates are not available yet.
Follow-up data from five different German hernia centers between 12/2019 and 9/2023 were assessed. All patients received Rives-Stoppa repair (RSR) and IFT intraoperatively with an additional transverse abdominis muscle release (TAR) in some cases. 30-day postoperative outcome data were retrospectively collected Standardized follow-up was performed after a minimum of 3 months including clinical examination and standardized ultrasound.
A total of 100 patients were included in the study. The mean age was 60.7 ± 14.3 years; the mean BMI was 31.3 ± 7.3 kg/m² with a mean follow-up of 19.7 ± 10.7 months. The mean defect width was 15.8 ± 5.2 cm. In 94% of the patients complete fascial closure was achieved; in 28% an additional TAR procedure was necessary During follow-up, 2 recurrences were found. The surgical site occurrence (SSO) rate was 33% including mainly seromas (54.5%) and surgical site infections (SSI) of 9% Comparing the groups of IFT + TAR and IFT + RSR a significantly higher incidence of SSO was found in the TAR group (50% vs. 26.4%, p<0.01).
This study, which is the first long-term follow-up, shows very promising results of the innovative IFT technique in terms of closure rate, wound morbidity, and recurrence rate.
复杂腹壁修复采用了不同技术，包括术中筋膜牵引（IFT）这一最新进展。尽管欧洲范围内IFT的病例数不断增加，但长期数据尤其是复发率数据尚无可用。
评估了2019年12月至2023年9月期间五个不同德国疝中心的随访数据。所有患者术中均接受里夫斯 - 斯托帕修补术（RSR）和IFT，部分病例还进行了腹横肌松解术（TAR）。回顾性收集术后30天的结局数据，至少3个月后进行标准化随访，包括临床检查和标准化超声检查。
该研究共纳入100例患者。平均年龄为60.7±14.3岁；平均体重指数为31.3±7.3kg/m²，平均随访时间为19.7±10.7个月。平均缺损宽度为15.8±5.2cm。94%的患者实现了筋膜完全闭合；28%的患者需要额外进行TAR手术。随访期间发现2例复发。手术部位发生率（SSO）为33%，主要包括血清肿（54.5%）和手术部位感染（SSI）占9%。比较IFT + TAR组和IFT + RSR组，TAR组的SSO发生率显著更高（50%对26.4%，p<0.01）。
这项首次长期随访研究表明，创新的IFT技术在闭合率、伤口发病率和复发率方面显示出非常有前景的结果。
