Wound Morbidity in Minimally Invasive Anterior Component Separation Compared to Transversus Abdominis Release

Parent, Brodie; Horn, Dara L.; Jacobson, Lauren; Petersen, Rebecca P.; Hinojosa, Marcelo W.; Yates, Robert D.; Wright, Andrew S.; Louie, Otway

doi:10.1097/prs.0000000000002957

Cited by 19 publications

(10 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Univariate analysis for an increased risk of SSO demonstrated a significant association with obesity, preoperative RT, hypertension, and bilateral component separation ( abdominis release and should be considered whenever possible. [27][28][29] Similar to Rooijen et al 30 our study demonstrated that obesity had a greater impact on hernia occurrence and SSOs than sarcopenia.…”

Section: Surgical Site Occurrencesupporting

confidence: 81%

The impact of sarcopenia on oncologic abdominal wall reconstruction

Bailey¹,

Schaverien

Garvey

et al. 2020

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives: Sarcopenia is an objective measure of patient frailty and is a predictor of adverse surgical outcomes. We hypothesized that sarcopenia is associated with increased surgical site occurrence (SSO) and hernia occurrences in patients undergoing oncologic abdominal wall reconstruction. Methods: Consecutive patients who underwent abdominal wall reconstruction (AWR) for an abdominal wall ablative defect at a single center from 2005 to 2015 were evaluated. The total psoas index (TPI) was used to define sarcopenia. The primary endpoint of the study was hernia occurrence; (SSO) was a secondary outcome measure. Results: Eighty-six patients met the inclusion criteria. Multivariate analysis demonstrated that sarcopenia increased the risk of hernia more than threefold, trending toward significance (OR = 3.3; 95% CI: 0.69-15.4; P = .13). Multivariate logistic regression demonstrated that preoperative radiotherapy (OR = 4.8, 95% CI: 1.4-16; P = .01) and obesity (OR = 4.9, 95% CI: 1.5-16.3; P =.009) were independent predictors of developing an SSO. Conclusions: Sarcopenia, as defined by TPI, is correlated with hernia occurrence, but not SSO. These findings emphasize the importance of preoperative fitness and nutritional optimization and provide useful information for preoperative counseling and risk stratification.

show abstract

Section: Surgical Site Occurrencesupporting

confidence: 81%

The impact of sarcopenia on oncologic abdominal wall reconstruction

Bailey¹,

Schaverien

Garvey

et al. 2020

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Our results were compared to similar publications from single institutions, that also reported on their initial TARs (maximum 100 patients) (8,11,13,15,20,(45)(46)(47)(48)(49). Three studies described the rate of patients without any wound complications during hospitalization, which was 61-76% (45)(46)(47).…”

Section: Evaluation Of Outcomesmentioning

confidence: 73%

Assessing Textbook Outcome After Implementation of Transversus Abdominis Release in a Regional Hospital

Wegdam

Jong

Reilingh

et al. 2022

J. Abdom. Wall Surg.

View full text Add to dashboard Cite

Background: The posterior component separation technique with transversus abdominis release (TAR) was introduced in 2012 as an alternative to the classic anterior component separation technique (Ramirez). This study describes outcome and learning curve of TAR, five years after implementation of this new technique in a regional hospital in the Netherlands.Methods: A standardized work up protocol, based on the Plan-Do-Check-Act cycle, was used to implement the TAR. The TAR technique as described by Novitsky was performed. After each 20 procedures, outcome parameters were evaluated and new quality measurements implemented. Primary outcome measure was Textbook Outcome, the rate of patients with an uneventful clinical postoperative course after TAR. Textbook Outcome is defined by a maximum of 7 days hospitalization without any complication (wound or systemic), reoperation or readmittance, within the first 90 postoperative days, and without a recurrence during follow up. The number of patients with a Textbook Outcome compared to the total number of consecutively performed TARs is depicted as the institutional learning curve. Secondary outcome measures were the details and incidences of the surgical site and systemic complications within 90 days, as well as long-term recurrences.Results: From 2016, sixty-nine consecutive patients underwent a TAR. Textbook Outcome was 35% and the institutional learning curve did not flatten after 69 procedures. Systemic complications occurred in 48%, wound complications in 41%, and recurrences in 4%. Separate analyses of three successive cohorts of each 20 TARs demonstrated that both Textbook Outcome (10%, 30% and 55%, respectively) and the rate of surgical site events (45%, 15%, and 10%) significantly (p < 0.05) improved with more experience.Conclusion: Implementation of the open transversus abdominis release demonstrated that outcome was positively correlated to an increasing number of TARs performed. TAR has a long learning curve, only partially determined by the technical aspects of the operation. Implementation of the TAR requires a solid plan. Building, and maintaining, an adequate setting for patients with complex ventral hernias is the real challenge and driving force to improve outcome.

show abstract

“…Eine retrospektive Kohortenstudie von Parent et al. [ 26 ] zeigte eine Reoperationsrate von 19 % nach minimal-invasiver anteriorer Komponentenseparation und von 12 % nach TAR.…”

Section: Diskussionunclassified

Intraoperative Faszientraktion (IFT) zur Behandlung großer ventraler Hernien

Niebuhr

Malaibari

Köckerling

et al. 2021

Chirurg

View full text Add to dashboard Cite

Intraoperative fascial traction (IFT) for treatment of large ventral hernias. A retrospective analysis of 50 casesObjective: The aim was to evaluate the effectiveness, clinical practicability, and complication rate of the intraoperative fascial traction (IFT) procedure for the treatment of large ventral hernias. Method: This study evaluated 50 patients from 11 specialized centers with an intraoperatively measured fascial distance of more than 8 cm, who were treated by IFT (traction time 30-35 min) using the fasciotens ® hernia traction procedure.Results: Fascial gaps measured preoperatively ranged from 8 cm to 44 cm, with most patients (94%) having a fascial gap above 10 cm (W3 according to the European Hernia Society classification). The mean fascial distance was reduced from 16.1 ± 0.8 cm to 5.8 ± 0.7 cm (stretch gain 10.2 ± 0.7 cm, p < 0.0001, Wilcoxon matched-pairs signedranks test). A reduction in fascial distance of at least 50% was achieved in three quarters of the patients and in half of the treated patients the reduction in fascial distance amounted to even more than 70%. The closure rate achieved by IFT after a mean surgical duration of 207.3 ± 11.0 min was 90% (45/50). Hernia closure was performed in all cases with a mesh augmentation in a sublay position. Postoperative complications occurred in 6 patients (12%). A reoperation was required in 3 patients (6%). Conclusion:The described IFT method is a new procedure for abdominal wall closure in large ventral hernias. The presented results demonstrate a high effectiveness, a good clinical practicability and a low complication rate of IFT.

show abstract

Wound Morbidity in Minimally Invasive Anterior Component Separation Compared to Transversus Abdominis Release

Abstract: Therapeutic, III.

Cited by 19 publications

References 16 publications

The impact of sarcopenia on oncologic abdominal wall reconstruction

The impact of sarcopenia on oncologic abdominal wall reconstruction

Assessing Textbook Outcome After Implementation of Transversus Abdominis Release in a Regional Hospital

Intraoperative Faszientraktion (IFT) zur Behandlung großer ventraler Hernien

Contact Info

Product

Resources

About