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Multicenter Study
. 2024 Jun;28(3):871-881.
doi: 10.1007/s10029-024-03001-3. Epub 2024 Apr 3.

Two-meshes approach in posterior component separation with transversus abdominis release: the IMPACT study (Italian Multicentric Posterior-separation Abdominal Complex hernia Transversus-release)

F Pizza  1 , P Maida  2 , C Bertoglio  3 , A Antinori  4 , F M Mongardini  5 , L Cerbara  6 , I Sordelli  2 , B D Alampi  7 , G Marte  8 , L Morini  7 , S Grimaldi  7 , S Gili  9 , L Docimo  5 , C Gambardella  5
Affiliations
Multicenter Study

Two-meshes approach in posterior component separation with transversus abdominis release: the IMPACT study (Italian Multicentric Posterior-separation Abdominal Complex hernia Transversus-release)

F Pizza et al. Hernia. 2024 Jun.

Abstract

Background: Surgical management of large ventral hernias (VH) has remained a challenge. Various techniques like anterior component separation and posterior component separation (PCS) with transversus abdominis release (TAR) have been employed. Despite the initial success, the long-term efficacy of TAR is not yet comprehensively studied. Authors aimed to investigate the early-, medium-, and long-term outcomes and health-related quality of life (QoL) in patients treated with PCS and TAR.

Methods: This multicenter retrospective study analyzed data of 308 patients who underwent open PCS with TAR for primary or recurrent complex abdominal hernias between 2015 and 2020. The primary endpoint was the rate of hernia recurrence (HR) and mesh bulging (MB) at 3, 6, 12, 24, and 36 months. Secondary outcomes included surgical site events and QoL, assessed using EuraHS-QoL score.

Results: The average follow-up was 38.3 ± 12.7 months. The overall HR rate was 3.5% and the MB rate was 4.7%. Most of the recurrences were detected by clinical and ultrasound examination. QoL metrics showed improvement post-surgery.

Conclusions: This study supports the long-term efficacy of PCS with TAR in the treatment of large and complex VH, with a low recurrence rate and an improvement in QoL. Further research is needed for a more in-depth understanding of these outcomes and the factors affecting them.

Keywords: Abdominal wall reconstruction; Complex ventral hernia; Incisional hernia; Transversus abdominis release (TAR).

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References

    1. Holihan JL, Askenasy EP, Greenberg JA, Keith JN, Martindale RG, Roth JS, Mo J et al; Ventral Hernia Outcome Collaboration Writing Group (2016) Component separation vs. bridged repair for large ventral hernias: a multi-institutional risk-adjusted comparison, systematic review, and meta-analysis. Surg Infect (Larchmt) 17(1):17–26. https://doi.org/10.1089/sur.2015.124
    1. Ramirez OM, Ruas E, Dellon AL (1990) “Components separation” method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg 86(3):519–26. https://doi.org/10.1097/00006534-199009000-00023 - DOI - PubMed
    1. Krpata DM, Blatnik JA, Novitsky YW, Rosen MJ (2012) Posterior and open anterior components separations: a comparative analysis. Am J Surg 203(3):318–322; discussion 322. https://doi.org/10.1016/j.amjsurg.2011.10.009
    1. Pauli EM, Rosen MJ (2013) Open ventral hernia repair with component separation. Surg Clin North Am. 93(5):1111–33. https://doi.org/10.1016/j.suc.2013.06.010 - DOI - PubMed
    1. Lowe JB 3rd, Lowe JB, Baty JD, Garza JR (2003) Risks associated with “components separation” for closure of complex abdominal wall defects. Plast Reconstr Surg 111(3):1276–1283; quiz 1284–1285; discussion 1286–1288. https://doi.org/10.1097/01.PRS.0000047021.36879.FD

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