Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review

Background: Component separation techniques have recently gained popularity for the repair of complex ventral hernias. Anterior and posterior component separation techniques offer similar myofascial medialization, with a differing complication profile. The aim of this study is to compare the efficac...

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Main Authors: Jaini Gala, Pramod Nichat, Ajay Bhandarwar, Nikhil Dhimole, Rajeshwari Bhat, Gayatri Muley
Format: Article
Language:English
Published: Elsevier 2022-03-01
Series:Asian Journal of Surgery
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1015958421004590
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author Jaini Gala
Pramod Nichat
Ajay Bhandarwar
Nikhil Dhimole
Rajeshwari Bhat
Gayatri Muley
author_facet Jaini Gala
Pramod Nichat
Ajay Bhandarwar
Nikhil Dhimole
Rajeshwari Bhat
Gayatri Muley
author_sort Jaini Gala
collection DOAJ
description Background: Component separation techniques have recently gained popularity for the repair of complex ventral hernias. Anterior and posterior component separation techniques offer similar myofascial medialization, with a differing complication profile. The aim of this study is to compare the efficacy, patient morbidity and post-operative complications between anterior component separation (ACST) and transversus abdominis release (TAR) for large ventral hernias. Methods: Between December 2017 and September 2019, data was collected and analysed for patients undergoing ACST and TAR, in terms of demographics, peri-operative events, adverse events and hernia recurrence. Results: 25 patients each underwent ACST and TAR during our study period. Mean age was 53.5 and 52.8 years and mean BMI was 31.4 and 29.5 respectively. The mean defect area was 120.8 cm2 and 131.9 cm2, and average mesh size was 741.8 cm2 and 1429.04 cm2 respectively in the ACST and TAR groups. Four patients undergoing TAR had intra-operative complications with none in the ACST group. In the ACST group, 8 patients had an SSI, of which 5 patients needed operative intervention, while 3 patients in the TAR group had an SSI, all of whom were managed with bedside procedures. One patient in the ACST group had a recurrence. None of the patients in the TAR group had a recurrence. Conclusions: Component separation techniques are gaining popularity in treatment of large ventral hernias. While they have comparable outcomes with respect to recurrence, wound morbidity is more frequent and severe in the ACST group.
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spelling doaj.art-cb68b463fb5f454fa0bd8cb2961d47e12022-12-21T17:22:08ZengElsevierAsian Journal of Surgery1015-95842022-03-01453854859Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective reviewJaini Gala0Pramod Nichat1Ajay Bhandarwar2Nikhil Dhimole3Rajeshwari Bhat4Gayatri Muley5Corresponding author.; Department of General Surgery, Grant Government Medical College and Sir JJ, Group of Hospitals, 6th Floor, Hospital Building, Sir JJ Hospital Campus, Sir JJ Marg, Byculla, Mumbai, 400008, IndiaDepartment of General Surgery, Grant Government Medical College and Sir JJ, Group of Hospitals, 6th Floor, Hospital Building, Sir JJ Hospital Campus, Sir JJ Marg, Byculla, Mumbai, 400008, IndiaDepartment of General Surgery, Grant Government Medical College and Sir JJ, Group of Hospitals, 6th Floor, Hospital Building, Sir JJ Hospital Campus, Sir JJ Marg, Byculla, Mumbai, 400008, IndiaDepartment of General Surgery, Grant Government Medical College and Sir JJ, Group of Hospitals, 6th Floor, Hospital Building, Sir JJ Hospital Campus, Sir JJ Marg, Byculla, Mumbai, 400008, IndiaDepartment of General Surgery, Grant Government Medical College and Sir JJ, Group of Hospitals, 6th Floor, Hospital Building, Sir JJ Hospital Campus, Sir JJ Marg, Byculla, Mumbai, 400008, IndiaDepartment of General Surgery, Grant Government Medical College and Sir JJ, Group of Hospitals, 6th Floor, Hospital Building, Sir JJ Hospital Campus, Sir JJ Marg, Byculla, Mumbai, 400008, IndiaBackground: Component separation techniques have recently gained popularity for the repair of complex ventral hernias. Anterior and posterior component separation techniques offer similar myofascial medialization, with a differing complication profile. The aim of this study is to compare the efficacy, patient morbidity and post-operative complications between anterior component separation (ACST) and transversus abdominis release (TAR) for large ventral hernias. Methods: Between December 2017 and September 2019, data was collected and analysed for patients undergoing ACST and TAR, in terms of demographics, peri-operative events, adverse events and hernia recurrence. Results: 25 patients each underwent ACST and TAR during our study period. Mean age was 53.5 and 52.8 years and mean BMI was 31.4 and 29.5 respectively. The mean defect area was 120.8 cm2 and 131.9 cm2, and average mesh size was 741.8 cm2 and 1429.04 cm2 respectively in the ACST and TAR groups. Four patients undergoing TAR had intra-operative complications with none in the ACST group. In the ACST group, 8 patients had an SSI, of which 5 patients needed operative intervention, while 3 patients in the TAR group had an SSI, all of whom were managed with bedside procedures. One patient in the ACST group had a recurrence. None of the patients in the TAR group had a recurrence. Conclusions: Component separation techniques are gaining popularity in treatment of large ventral hernias. While they have comparable outcomes with respect to recurrence, wound morbidity is more frequent and severe in the ACST group.http://www.sciencedirect.com/science/article/pii/S1015958421004590Ventral herniaACSTTARComponent separation
spellingShingle Jaini Gala
Pramod Nichat
Ajay Bhandarwar
Nikhil Dhimole
Rajeshwari Bhat
Gayatri Muley
Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review
Asian Journal of Surgery
Ventral hernia
ACST
TAR
Component separation
title Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review
title_full Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review
title_fullStr Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review
title_full_unstemmed Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review
title_short Single institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review
title_sort single institute experiences in anterior and posterior component separation technique for the large ventral hernia a retrospective review
topic Ventral hernia
ACST
TAR
Component separation
url http://www.sciencedirect.com/science/article/pii/S1015958421004590
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