A stepwise approach based on a rational use of components separation and double mesh prosthesis for incisional hernia repair
Purpose We aimed to evaluate the results of a protocol for a tension-free reconstruction of the abdominal wall in midline incisional hernia repair, based on the rational association of components separation and prosthesis, independently of the hernia size. Methods A total of 100 consecutive patients...
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Published in | Hernia : the journal of hernias and abdominal wall surgery Vol. 20; no. 2; pp. 201 - 207 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Paris
Springer Paris
01.04.2016
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose
We aimed to evaluate the results of a protocol for a tension-free reconstruction of the abdominal wall in midline incisional hernia repair, based on the rational association of components separation and prosthesis, independently of the hernia size.
Methods
A total of 100 consecutive patients with midline incisional hernias were prospectively included in the study. Three groups according to the transverse diameter of the defect [group A (<4 cm,
N
= 18), group B (4–10 cm,
N
= 59), and group C (>10 cm,
N
= 23)] were identified.
Results
Components separation was necessary in 54 % of the patients: 16.7 % (3/18) in group A, 59.3 % (35/59) in group B, and 69.6 % (16/23) in group C. Complete tension-free reconstruction was achieved in 87 % of the patients: 94.4 % (17/18) in group A, 91.5 % (54/59) in group B, and 69.6 % (16/23) in group C. Overall morbidity rate was 21 % (21/100) [group A 16.7 % (3/18), group B 22 % (13/59), and group C 21.7 % (5/23)]. Hospital length of stay was 3.7 ± 3.3 days (group A 1.83 ± 1.43 days, group B 3.05 ± 2.11 days, and group C 6.91 ± 4.45 days). Median follow-up was 25 months (interquartile range 12.25–55.25) with overall recurrence of 2 %.
Conclusion
A tension-free abdominal wall reconstruction can be achieved in most cases of small and large midline incisional hernia repair, by a stepwise approach based on a rational association of components separation and double mesh prosthesis, with a low morbidity and recurrence rates. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1265-4906 1248-9204 |
DOI: | 10.1007/s10029-015-1438-6 |