A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step
Abstract Background This study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of posto...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13017-023-00485-9 |
| _version_ | 1797865191904378880 |
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| author | Tamer A. A. M. Habeeb Abdulzahra Hussain Vishal Shelat Massimo Chiaretti Jose Bueno-Lledó Alfonso García Fadrique Abd-Elfattah Kalmoush Mohamed Elnemr Khaled Safwat Ahmed Raafat Tamer Wasefy Ibrahim A. Heggy Gamal Osman Waleed A. Abdelhady Walid A. Mawla Alaa A. Fiad Mostafa M. Elaidy Wessam Amr Mohamed I. Abdelhamid Ahmed Mahmoud Abdou Abdelaziz I. A. Ibrahim Muhammad Ali Baghdadi |
| author_facet | Tamer A. A. M. Habeeb Abdulzahra Hussain Vishal Shelat Massimo Chiaretti Jose Bueno-Lledó Alfonso García Fadrique Abd-Elfattah Kalmoush Mohamed Elnemr Khaled Safwat Ahmed Raafat Tamer Wasefy Ibrahim A. Heggy Gamal Osman Waleed A. Abdelhady Walid A. Mawla Alaa A. Fiad Mostafa M. Elaidy Wessam Amr Mohamed I. Abdelhamid Ahmed Mahmoud Abdou Abdelaziz I. A. Ibrahim Muhammad Ali Baghdadi |
| author_sort | Tamer A. A. M. Habeeb |
| collection | DOAJ |
| description | Abstract Background This study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of postoperative surgical site occurrence and risk factors of incisional hernia (IH) development following AWD repair with posterior CS with TAR reinforced by retromuscular mesh. Methods Between June 2014 and April 2018, 202 patients with grade IA primary AWD (Björck's first classification) following midline laparotomies were treated using posterior CS with TAR release reinforced by a retro-muscular mesh in a prospective multicenter cohort study. Results The mean age was 42 ± 10 years, with female predominance (59.9%). The mean time from index surgery (midline laparotomy) to primary AWD was 7 ± 3 days. The mean vertical length of primary AWD was 16 ± 2 cm. The median time from primary AWD occurrence to posterior CS + TAR surgery was 3 ± 1 days. The mean operative time of posterior CS + TAR was 95 ± 12 min. No recurrent AWD occurred. Surgical site infections (SSI), seroma, hematoma, IH, and infected mesh occurred in 7.9%, 12.4%, 2%, 8.9%, and 3%, respectively. Mortality was reported in 2.5%. Old age, male gender, smoking, albumin level < 3.5 gm%, time from AWD to posterior CS + TAR surgery, SSI, ileus, and infected mesh were significantly higher in IH. IH rate was 0.5% and 8.9% at two and three years, respectively. In multivariate logistic regression analyses, the predictors of IH were time from AWD till posterior CS + TAR surgical intervention, ileus, SSI, and infected mesh. Conclusion Posterior CS with TAR reinforced by retro-muscular mesh insertion resulted in no AWD recurrence, low IH rates, and low mortality of 2.5%. Trial registration Clinical trial: NCT05278117. |
| first_indexed | 2024-04-09T23:05:11Z |
| format | Article |
| id | doaj.art-6307ec9cd142445ca3dc2ac3784563f3 |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-04-09T23:05:11Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-6307ec9cd142445ca3dc2ac3784563f32023-03-22T10:45:03ZengBMCWorld Journal of Emergency Surgery1749-79222023-03-0118111110.1186/s13017-023-00485-9A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a stepTamer A. A. M. Habeeb0Abdulzahra Hussain1Vishal Shelat2Massimo Chiaretti3Jose Bueno-Lledó4Alfonso García Fadrique5Abd-Elfattah Kalmoush6Mohamed Elnemr7Khaled Safwat8Ahmed Raafat9Tamer Wasefy10Ibrahim A. Heggy11Gamal Osman12Waleed A. Abdelhady13Walid A. Mawla14Alaa A. Fiad15Mostafa M. Elaidy16Wessam Amr17Mohamed I. Abdelhamid18Ahmed Mahmoud Abdou19Abdelaziz I. A. Ibrahim20Muhammad Ali Baghdadi21Department of General Surgery, Faculty of Medicine, Zagazig UniversityHomerton University HospitalDepartment of General Surgery, Tan Tock Seng HospitalDepartment of General Surgery, Surgical Specialities and Organ Transplantation “Paride Stefanini”, Sapienza University of RomeUnit of Abdominal Wall Surgery, Department of General Surgery, Hospital Universitari i Politècnic la FeDepartment of General Surgery, Instituto Valenciano de OncologiaGeneral Surgery Department, Al-Azhar UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityObstetrics and Gynecology Department, Faculty of Medicine, Zagazig UniversityObstetrics and Gynecology Department, Faculty of Medicine, Zagazig UniversityDepartment of General Surgery, Faculty of Medicine, Zagazig UniversityAbstract Background This study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of postoperative surgical site occurrence and risk factors of incisional hernia (IH) development following AWD repair with posterior CS with TAR reinforced by retromuscular mesh. Methods Between June 2014 and April 2018, 202 patients with grade IA primary AWD (Björck's first classification) following midline laparotomies were treated using posterior CS with TAR release reinforced by a retro-muscular mesh in a prospective multicenter cohort study. Results The mean age was 42 ± 10 years, with female predominance (59.9%). The mean time from index surgery (midline laparotomy) to primary AWD was 7 ± 3 days. The mean vertical length of primary AWD was 16 ± 2 cm. The median time from primary AWD occurrence to posterior CS + TAR surgery was 3 ± 1 days. The mean operative time of posterior CS + TAR was 95 ± 12 min. No recurrent AWD occurred. Surgical site infections (SSI), seroma, hematoma, IH, and infected mesh occurred in 7.9%, 12.4%, 2%, 8.9%, and 3%, respectively. Mortality was reported in 2.5%. Old age, male gender, smoking, albumin level < 3.5 gm%, time from AWD to posterior CS + TAR surgery, SSI, ileus, and infected mesh were significantly higher in IH. IH rate was 0.5% and 8.9% at two and three years, respectively. In multivariate logistic regression analyses, the predictors of IH were time from AWD till posterior CS + TAR surgical intervention, ileus, SSI, and infected mesh. Conclusion Posterior CS with TAR reinforced by retro-muscular mesh insertion resulted in no AWD recurrence, low IH rates, and low mortality of 2.5%. Trial registration Clinical trial: NCT05278117.https://doi.org/10.1186/s13017-023-00485-9Abdominal wall dehiscenceIncisional herniaPosterior component separationRetro-muscular mesh |
| spellingShingle | Tamer A. A. M. Habeeb Abdulzahra Hussain Vishal Shelat Massimo Chiaretti Jose Bueno-Lledó Alfonso García Fadrique Abd-Elfattah Kalmoush Mohamed Elnemr Khaled Safwat Ahmed Raafat Tamer Wasefy Ibrahim A. Heggy Gamal Osman Waleed A. Abdelhady Walid A. Mawla Alaa A. Fiad Mostafa M. Elaidy Wessam Amr Mohamed I. Abdelhamid Ahmed Mahmoud Abdou Abdelaziz I. A. Ibrahim Muhammad Ali Baghdadi A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step World Journal of Emergency Surgery Abdominal wall dehiscence Incisional hernia Posterior component separation Retro-muscular mesh |
| title | A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step |
| title_full | A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step |
| title_fullStr | A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step |
| title_full_unstemmed | A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step |
| title_short | A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step |
| title_sort | prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro muscular mesh filling a step |
| topic | Abdominal wall dehiscence Incisional hernia Posterior component separation Retro-muscular mesh |
| url | https://doi.org/10.1186/s13017-023-00485-9 |
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