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Outcomes of posterior component separation with transversus abdominis release (TAR) in large and other complex ventral hernias: a single-surgeon experience

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Abstract

Purpose

Over the last years, great advances in the repair of abdominal wall hernias have dramatically improved patients’ outcomes. Especially for large and other complex ventral hernias, the application of component separation techniques has been a landmark in their successful management. The aim of this study is to present our experience with the posterior component separation with transversus abdominis release (TAR) in patients with these demanding ventral hernias.

Methods

A retrospective analysis of prospectively collected data of all patients who underwent elective ventral hernia repair with TAR between January 2016 and December 2019 was performed. Preoperative, intraoperative, and postoperative data were analyzed.

Results

A total of 125 patients with large and other complex ventral hernias were included in the final analysis. More than 80% of patients had one or more comorbidities. Of all patients, 116 (92.8%) had a history of previous abdominal surgery, 27 (21.6%) had a history of SSI and nine (7.2%) had active fistulas. Postoperatively, SSOs were presented in 11 patients (8.8%), including three cases of SSI. Neither mesh infection occurred, nor mesh excision required. With a mean follow-up of 2.5 years, only one recurrence was observed.

Conclusions

With a wound complication rate of less than 9% and a recurrence rate of less than 1%, our results show that TAR is a reliable, safe and effective technique for the repair of massive and other complex ventral hernias. The combination of knowledge of the abdominal wall anatomy at a proficient level, proper training, and adoption of a strict prehabilitation program are considered prerequisites for the successful management of such demanding hernias.

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Authors and Affiliations

  1. 2nd Surgical Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, Thessaloniki, Greece

    G. Chatzimavroudis, G. Kotoreni, I. Kostakis, N. Voloudakis, E. Christoforidis & B. Papaziogas

  2. Complex Hernia and Abdominal Wall Reconstruction Center, European Interbalkan Medical Center, Thessaloniki, Greece

    G. Chatzimavroudis & G. Kotoreni

Authors
  1. G. Chatzimavroudis
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  2. G. Kotoreni
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  3. I. Kostakis
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  4. N. Voloudakis
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  5. E. Christoforidis
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  6. B. Papaziogas
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Corresponding author

Correspondence to G. Chatzimavroudis.

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Conflict of interest

Grigoris Chatzimavroudis has received honoraria for speaking from BD. All the other authors have no conflict of interest to declare.

Ethical approval

Local ethics committee approvals were obtained prior to commencing this retrospective study.

Human and animal studies

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Chatzimavroudis, G., Kotoreni, G., Kostakis, I. et al. Outcomes of posterior component separation with transversus abdominis release (TAR) in large and other complex ventral hernias: a single-surgeon experience. Hernia 26, 1275–1283 (2022). https://doi.org/10.1007/s10029-021-02520-7

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  • DOI: https://doi.org/10.1007/s10029-021-02520-7

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