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A Comparison of Outcomes of the Component Separation Techniques in Large Incisional Hernias: Mesh vs. No Mesh

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Abstract

The repair of large incisional hernias (LIH) remains challenging. The component separation technique (CST) emerged and evolved. Retrospective evaluation was performed for the patients who underwent hernia repair utilizing CST between 2011 and 2020. The primary and secondary outcomes were determined as recurrence and seroma complications. Pre-, intra-, and postoperative variables were compared using univariate statistical tests. Kaplan–Meier’s time-to-event analysis was done to estimate “recurrence-free” time. A total of 115 patients were included: 65 (56.5%) patients in the CST-mesh group and 50 (43.5%) patients in the CST-no-mesh group. There were no differences in pre- and intraoperative variables except significantly longer operating time of the CST-mesh group (p < 0.001). Overall, complication rates were 14.6% vs. 27.4% for the “no-mesh” vs. “mesh” groups, respectively (p = 0.106). No difference was found in the recurrence rates (p = 1.000; 4.2% vs. 3.2%, respectively) and in the average estimated “recurrence-free” times (p = 0.749; 48.8 vs. 57.3 months, respectively). However, the seroma complication rate was higher in the CST-mesh group (19.4) than in the CST-no-mesh group (4.2%) (p = 0.018). The results suggested that the CST in the repair of LIHs can be performed with and without mesh, considering acceptable rates of overall complications and recurrence. However, it should be kept in mind that the CST with onlay mesh may increase the seroma formation rate compared to the CST without mesh.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ASA:

American Society of Anesthesiologists

AWR:

Abdominal wall reconstruction

BMI:

Body mass index

CD:

Clavien-Dindo

CST:

Component separation technique

EBL:

Estimated blood loss

LIH:

Large incisional hernias

LOS:

Length of stay

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Acknowledgements

The author thanks Dr. Muhammet Firat Oztepe for helping in this study.

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  1. Department of General Surgery, Batman Iluh State Hospital, Batman, 72060, Turkey

    Resul Nusretoglu

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Correspondence to Resul Nusretoglu.

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All procedures performed in studies involving human participants were per the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national). The Institutional Review Board approved this study. All patients participating in the study have provided informed consent.

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Nusretoglu, R. A Comparison of Outcomes of the Component Separation Techniques in Large Incisional Hernias: Mesh vs. No Mesh. Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03964-0

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