Preaponeurotic endoscopic repair (REPA) indication in men could be controversial

Area of Science:

• Minimally Invasive Surgery
• Abdominal Wall Reconstruction
• Surgical Outcomes Research

Background:

• Rectus Abdominis Diastasis (RAD) and midline defects are common surgical challenges.
• The Retromuscular Extended Pre-Aponeurotic Approach (REPA) is a surgical technique for abdominal wall reconstruction.
• Evaluating sex-based differences in surgical outcomes is crucial for personalized patient care.

Purpose of the Study:

• To assess the efficacy and safety of the REPA approach for correcting midline defects.
• To investigate potential sex-based disparities in postoperative complications and outcomes following REPA.

Main Methods:

• Retrospective analysis of consecutive patients undergoing REPA between November 2017 and April 2019.
• Collection of demographic data, operative times, complication rates, and hospital stay.
• Utilized the EuraHS-QoL score for pain, activity, and aesthetic discomfort assessment; compared outcomes between males and females.

Main Results:

• Fifty-four patients (53.7% male) with a mean age of 50.7 years were included.
• Seroma was significantly more frequent in males (55.2%) than females (24%, p=0.02).
• Three reinterventions (5.5%) were required, all in males (p=0.04); no surgical site infections or necrosis occurred.

Conclusions:

• REPA is a feasible and reproducible technique for small midline defects with minor RAD.
• While REPA shows good results in females, outcomes appear poorer in males due to higher complication rates.