Extended-view totally extraperitoneal repair for ventral hernias: a retrospective analysis of perioperative outcomes and the role of ASA score

TL;DR

This study examines the outcomes of a minimally invasive hernia repair technique and its relation to patient health status.

Contribution

The study evaluates the role of ASA score in predicting complications for eTEP hernia repair using a retrospective cohort.

Findings

eTEP repair had low complication rates and short hospital stays.

All complications occurred in patients with ASA scores of ≥ II.

ASA score was not a statistically significant predictor of complications.

Abstract

Ventral hernias are frequently encountered in general surgery. In recent years, minimally invasive techniques, including the Extended View Totally Extraperitoneal Repair (eTEP), have gained popularity. Meta-analyses suggest that eTEP may offer both intraoperative and postoperative advantages over alternative approaches. This retrospective study aimed to evaluate intra- and postoperative complications, length of hospital stay, and the potential association between American Society of Anesthesiologists (ASA) Physical Status Classification and complication rates in patients who underwent eTEP. The findings may inform preoperative risk stratification and surgical planning based on ASA score.

A monocentric, retrospective study of 95 patients who underwent eTEP for ventral hernia repair between January 2019 and December 2021 was conducted. Descriptive statistics and binary logistic regression analyses were performed to explore the association between the ASA score and perioperative complications.

Intraoperative complications occurred in 2.1% (n = 2), and postoperative complications were observed in 7.4% (n = 7). The median length of hospital stay was three days (IQR = 1). Logistic regression analysis did not identify a statistically significant association between the ASA score and the occurrence of either intra- or postoperative complications. Nonetheless, all observed complications arose in patients with ASA scores of ≥ II.

eTEP repair was associated with a low complication rate and short hospitalization. While ASA classification was not a statistically significant predictor of perioperative complications in this cohort, the absence of complications in ASA I patients suggests potential relevance. These findings highlight the need for larger, prospective studies to further evaluate the role of ASA classification in risk assessment for eTEP procedures.

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