Short‑term outcomes of minimally invasive endoscopic onlay repair for diastasis recti and ventral hernia repair: a systematic review and meta‑analysis.
Francesco Brucchi, Luigi Boni, Elisa Cassinotti, Ludovica Baldari
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引用次数: 0
Abstract
Background: Endoscopic onlay repair (ENDOR) approach is gaining traction as a promising technique for the treatment of diastasis recti and associated ventral hernia. However, comprehensive evidence regarding its perioperative and short-term outcomes remains scarce. The objective of this meta-analysis is to provide a comprehensive summary of the existing evidence concerning perioperative and short-term postoperative outcomes.
Methods: A systematic literature review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was conducted in MEDLINE, Embase, and CENTRAL until August 1st, 2024. Articles reporting outcomes of ENDOR in adult population diagnosed with diastasis recti associated or not with primary or incisional ventral hernia were included. Primary outcomes were evaluated based on safety and short-term measures, including intraoperative and short-term postoperative characteristics. A fixed effects model was used for meta-analysis. The methodological quality of the studies was assessed using the Methodological Index for Non-randomized Studies (MINORS) criteria.
Results: A total of 12 studies (480 patients) were identified. Minimally invasive ENDOR resulted in an intraoperative complications and conversion rate of 1.0% [95% CI 0.0-2.0%]. The rate of seroma was 25% [95% CI 12.0-39.0%], the one of surgical site infection was 1% [95% CI 0.0-2.0%] and the rate of hematoma was 2% [95% CI 1.0-3.0%]. After a median follow-up of 16 months (1.8-39), the rate of recurrence was 2% [95% CI 0.0-3.0%].
Conclusions: The minimally invasive ENDOR approach stands out as a safe and effective method for diastasis recti and associated ventral hernia repair in selected patients, exhibiting low rates of intraoperative complications and yielding favorable outcomes. Prospero registry Registration number: CRD42024573235.
背景：内镜下全修复（endoor）入路作为一种有前途的治疗直肠移位和相关腹疝的技术正在获得关注。然而，关于其围手术期和短期结果的综合证据仍然很少。本荟萃分析的目的是提供有关围手术期和术后短期结果的现有证据的综合总结。方法：根据系统评价和荟萃分析首选报告项目（PRISMA）进行系统文献综述。在MEDLINE， Embase和CENTRAL进行了全面的搜索，直到2024年8月1日。报道了与原发性或切口腹疝相关或不相关的直肠转移的成人人群的ENDOR结果的文章被纳入。主要结果根据安全性和短期措施进行评估，包括术中和术后短期特征。meta分析采用固定效应模型。研究的方法学质量采用非随机研究方法学指数（minor）标准进行评估。结果：共纳入12项研究（480例患者）。微创ENDOR导致术中并发症，转化率为1.0% [95% CI 0-2.0%]。血肿发生率为25% [95% CI 12.0 ~ 39.0%]，手术部位感染发生率为1% [95% CI 0.0 ~ 2.0%]，血肿发生率为2% [95% CI 1.0 ~ 3.0%]。中位随访16个月（1.8-39）后，复发率为2% [95% CI 0.0-3.0%]。结论：在特定的患者中，微创ENDOR入路是一种安全有效的手术方法，术中并发症发生率低，预后良好。普洛斯彼罗注册登记号：CRD42024573235。
期刊介绍：
Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research.
Topics covered in the journal include:
-Surgical aspects of:
Interventional endoscopy,
Ultrasound,
Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology,
-Gastroenterologic surgery
-Thoracic surgery
-Traumatic surgery
-Orthopedic surgery
-Pediatric surgery
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