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Background <p>Surgical repair of incisional ventral hernias (VH) is a standard procedure globally, with an increasing role in minimally invasive techniques. This study aims to evaluate postoperative outcomes in emergency repairs for VH, comparing surgical features of open and laparoscopic approaches.</p> Methods <p>A retrospective multicentric study (ACTIVE study) was created to evaluate the surgical outcome of VH repair in emergency settings. Data were collected from demographic, preoperative, intra-operative, and postoperative variables, focusing on 30-day morbidity and other short- and long-term outcomes.</p> Results <p>Data from 556 patients who underwent emergency VH repair were collected and analyzed, with 175 patients treated with a Minimally Invasive (MIS) approach (31.5%) and 381 (68.5%) receiving open repair. The defect size was larger in the open group (<i>p</i> &lt; 0.001), and operative time was shorter in the MIS group (<i>p</i> = 0.002).</p> <p>Prosthetic repair was more frequently chosen in the MIS group (<i>p</i> &lt; 0.001), with a shorter length of stay (<i>p</i> = 0.013). Postoperative complications and Intensive Care Unit admissions were higher in the open group. The MIS had shorter operative times, smaller defect sizes, and higher mesh usage, even with concurrent bowel resection.</p> Conclusions <p>This study confirmed the feasibility and safety of the laparoscopic approach to VH in emergency settings. Despite the lack of solid evidence for routine adoption in emergency settings, the MIS approach demonstrated a lower overall complication rate, shorter hospital stays, and reduced mortality. The laparoscopic approach is a safe and valid tool for tailored surgery, even in emergent settings in selected patients.</p>

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The ACTIVE study: surgical outcomes for minimally invasive and open approach to incisional ventral hernias in a non-elective setting

  • 期刊论文

  • 发表日期：

    2025年6月23日

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  • Lorenzo Crepaz,
  • Alberto Sartori,
  • Stefano Olmi,
  • Mauro Podda,
  • Alberto Di Leo,
  • Cesare Stabilini,
  • Michele Carlucci,
  • Monica Ortenzi,
  • Giorgio Ercolani,
  • Elena Falsetti,
  • Isabella Mondi,
  • Miriam Cappiello,
  • Silvia Palmisano,
  • Alessandro Capozucco,
  • Alessandro De Troia,
  • Silvio Laureti,
  • Paola Marongiu,
  • Corrado Bottini,
  • Luca Domenico Bonomo,
  • Alberto Patriti,
  • Ferdinando Agresta,
  • Sofia Esposito,
  • Martina Padula,
  • Pasquale Lepiane,
  • Vania Silvestri,
  • Luca Leonardi,
  • Paolo Millo,
  • Daniele Delogu,
  • Nicola Baldan,
  • Valentina Bianchi,
  • Bruno Scotto,
  • Carmelo Mazzeo,
  • Alessandro Spolini,
  • Maria Clelia Gervasi,
  • Alessandro Ferraro,
  • Daniela Di Pietrantonio,
  • Francesco Renzi,
  • Daunia Verdi,
  • Pasquale Cianci,
  • Hussein Abdallah,
  • Niccolò Petrucciani,
  • Lidia Bressan,
  • Giorgio Soliani,
  • Beatrice Torre,
  • Carla Piras,
  • Giovanni Cestaro,
  • Antonella Nicotera,
  • Diletta Corallino,
  • Giulia Montori,
  • Anna Guariniello,
  • Micaela Piccoli,
  • Lucia Romano,
  • Andrea Balla,
  • Emanuele Pontecorvi,
  • Silvia Neri,
  • Alberto Oldani,
  • Mario Jr. Nardi,
  • Pier Luigi Tilocca,
  • Elisa Sefora Pierobon,
  • Gabriele Sganga,
  • Francesca Ascari,
  • Laura Vedana,
  • Francesco Fleres,
  • Guglielmo Clarizia,
  • Giorgio Brancato,
  • Jacopo Andreuccetti

摘要

Background

Surgical repair of incisional ventral hernias (VH) is a standard procedure globally, with an increasing role in minimally invasive techniques. This study aims to evaluate postoperative outcomes in emergency repairs for VH, comparing surgical features of open and laparoscopic approaches.

Methods

A retrospective multicentric study (ACTIVE study) was created to evaluate the surgical outcome of VH repair in emergency settings. Data were collected from demographic, preoperative, intra-operative, and postoperative variables, focusing on 30-day morbidity and other short- and long-term outcomes.

Results

Data from 556 patients who underwent emergency VH repair were collected and analyzed, with 175 patients treated with a Minimally Invasive (MIS) approach (31.5%) and 381 (68.5%) receiving open repair. The defect size was larger in the open group (p < 0.001), and operative time was shorter in the MIS group (p = 0.002).

Prosthetic repair was more frequently chosen in the MIS group (p < 0.001), with a shorter length of stay (p = 0.013). Postoperative complications and Intensive Care Unit admissions were higher in the open group. The MIS had shorter operative times, smaller defect sizes, and higher mesh usage, even with concurrent bowel resection.

Conclusions

This study confirmed the feasibility and safety of the laparoscopic approach to VH in emergency settings. Despite the lack of solid evidence for routine adoption in emergency settings, the MIS approach demonstrated a lower overall complication rate, shorter hospital stays, and reduced mortality. The laparoscopic approach is a safe and valid tool for tailored surgery, even in emergent settings in selected patients.