Minimally invasive versus open abdominoperineal resection and the risk of postoperative perineal hernia: a systematic review and meta-analysis.
Beatriz Yukari Yokoyama, Victória Recidivi E Silva, Lucas Carvalho Lemos de Souza Aguiar et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the risk of postoperative perineal hernia in 763 patients undergoing minimally invasive versus open abdominoperineal resection (APR) or extralevator abdominoperineal excision (ELAPE). The study found that minimally invasive surgery significantly increased the risk of perineal hernia (OR 4.13; 95% CI 2.24-7.61; p < 0.001), despite lower intraoperative blood loss and shorter operative time.
Key findings
- Minimally invasive surgery had a significantly higher risk of postoperative perineal hernia (OR 4.13; 95% CI 2.24-7.61).
- Intraoperative blood loss was significantly lower in the minimally invasive group (MD -156.5 mL; 95% CI -298.4 to -14.5).
- Operative time was significantly shorter for minimally invasive surgery (MD -41.7 min; 95% CI -60.8 to -22.5).
- No significant differences were found in hospital stay or 30-day readmission rates.
Why it matters
Understanding the risks associated with minimally invasive surgical techniques is crucial for clinicians to make informed decisions about patient management and to weigh the benefits against potential complications.