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Background <p>To evaluate the comparative effectiveness of extended totally extraperitoneal plasty Rives–Stoppa retromuscular repair (eTEP-RS) and open Rives–Stoppa retromuscular repair (Open-RS) in patients undergoing ventral hernia repair.</p> Methods <p>Clinical data from 850 patients were collected in a prospectively maintained database and retrospectively evaluated. 153 patients undergoing eTEP-RS were compared to 154 selected patients undergoing Open-RS (from the period prior to implementation of eTEP-RS at our university medical center). Short-term perioperative outcomes as well as long-term recurrence rate and quality of life by Carolina Comfort Scale (QoL) were evaluated. Results are shown as median (interquartile range).</p> Results <p>Our learning curve phase (first 60 eTEP-RS cases) was compared to eTEP-RS from the steady-state phase (cases 61–153). Significant differences with regard to operation time and perioperative complications were observed indicating a relevant learning curve in the procedure. The eTEP-RS cases from the steady-state cohort were compared to the Open-RS cases. After propensity score matching, 83 eTEP-RS cases were compared to 83 Open-RS cases. While operation time was longer (Open-RS: 135&#xa0;min (95–161); eTEP-RS: 160&#xa0;min (126–192); <i>i</i> = 0.004), length of stay was shorter in the eTEP-RS cohort (Open-RS: 7&#xa0;days (6–9); eTEP-RS: 4&#xa0;days (3–5); <i>p</i> &lt; 0.001) and postoperative pain was lower on postoperative days 2 and 3. Perioperative complications, hernia recurrence rates, and long-term QoL were not different between the two cohorts.</p> Conclusion <p>eTEP Rives–Stoppa repair offered superior short-term outcomes compared to open Rives–Stoppa repair in suitable patients with medium-sized ventral hernia and selected patients with large ventral hernia. Given the short follow-up period, no statistically significant differences could be observed regarding the long-term outcomes recurrence rate and QoL. Future long-term multicenter studies are necessary to evaluate long-term efficacy.</p> Graphical Abstract <p></p>

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Enhanced view/extended totally extraperitoneal plasty (eTEP) Rives–Stoppa repair versus open Rives–Stoppa repair: a single-center retrospective propensity score-matched cohort study

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  • 发表日期：

    2026年7月2日

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  • Robin Klewitz,
  • Nico Pfander,
  • York Gruenewald,
  • Hans Christian Hillebrecht,
  • Stefan Fichtner-Feigl,
  • Philipp Anton Holzner,
  • Julian Hipp

摘要

Background

To evaluate the comparative effectiveness of extended totally extraperitoneal plasty Rives–Stoppa retromuscular repair (eTEP-RS) and open Rives–Stoppa retromuscular repair (Open-RS) in patients undergoing ventral hernia repair.

Methods

Clinical data from 850 patients were collected in a prospectively maintained database and retrospectively evaluated. 153 patients undergoing eTEP-RS were compared to 154 selected patients undergoing Open-RS (from the period prior to implementation of eTEP-RS at our university medical center). Short-term perioperative outcomes as well as long-term recurrence rate and quality of life by Carolina Comfort Scale (QoL) were evaluated. Results are shown as median (interquartile range).

Results

Our learning curve phase (first 60 eTEP-RS cases) was compared to eTEP-RS from the steady-state phase (cases 61–153). Significant differences with regard to operation time and perioperative complications were observed indicating a relevant learning curve in the procedure. The eTEP-RS cases from the steady-state cohort were compared to the Open-RS cases. After propensity score matching, 83 eTEP-RS cases were compared to 83 Open-RS cases. While operation time was longer (Open-RS: 135 min (95–161); eTEP-RS: 160 min (126–192); i = 0.004), length of stay was shorter in the eTEP-RS cohort (Open-RS: 7 days (6–9); eTEP-RS: 4 days (3–5); p < 0.001) and postoperative pain was lower on postoperative days 2 and 3. Perioperative complications, hernia recurrence rates, and long-term QoL were not different between the two cohorts.

Conclusion

eTEP Rives–Stoppa repair offered superior short-term outcomes compared to open Rives–Stoppa repair in suitable patients with medium-sized ventral hernia and selected patients with large ventral hernia. Given the short follow-up period, no statistically significant differences could be observed regarding the long-term outcomes recurrence rate and QoL. Future long-term multicenter studies are necessary to evaluate long-term efficacy.

Graphical Abstract