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Component separation repair of incisional hernia: evolution of practice and review of long-term outcomes in a single center

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Abstract

Purpose

To review the long-term outcomes of complex abdominal wall reconstruction using anterior and posterior component separation (CS) techniques in our center.

Methods

This was a descriptive analytical study. Analysis of data from a prospectively collected database of patients who had undergone Component Separation (CS) repair of incisional hernias was performed. Two techniques were used. Anterior component separation (ACS) and posterior component separation with transversus abdominis release (PCS/TAR). Follow-up was clinical review at 6 weeks, 6 months, and 12 months with direct access telephone review thereafter. Long-term outcome data was obtained from electronic records and based on either clinical or CT assessment. Minimum physical follow-up was 6 months for all patients.

Results

89 patients with large incisional hernias underwent CS repair. 29 patients had ACS while 60 underwent PCS/TAR. Mean follow-up was 60 months (range 6–140 months) in the ACS group and 20 months (range 6–72 months) in the PCS group. Twenty-five patients (28%) had simultaneous major procedures including 21 intestinal anastomoses. Twenty-six (29%) of patients had associated stomas. Twenty-seven (30.3%) of the patients had undergone previous hernia repairs. Seromas occurred in 24 (26.97%) patients. Wound infections were more common after ACS. There have been 10 (11.2%) recurrences to date.

Conclusion

Component separation repair techniques result in good long-term outcomes with acceptable complication rates. They can be performed simultaneously with gastrointestinal procedures with low morbidity. Appropriate patient selection and use of appropriate mesh are important.

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Data availability

The data that support the findings of this study are available from the corresponding author, [SO], upon reasonable request.

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Acknowledgements

The study has received no formal funding. Some of the meshes were provided by the manufacturer without charge; however, they had no role in study design or writing of this report.

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Authors and Affiliations

  1. Walsall Healthcare NHS Trust, West Midlands, Walsall, WS2 9PS, England, UK

    S. O. Odogwu, E. Spurring, M. Malik, K. Cutler, S. Abdelrahman & C. Prescornita

  2. Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE, East Sussex, England, UK

    A. M. Magsi

  3. University Hospitals Birmingham, Mindelsohn Way, Birmingham, B15 2GW, England, UK

    B. Kadir & E. Li

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  1. S. O. Odogwu
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Correspondence to S. O. Odogwu.

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Conflict of interest

Dr. Odogwu reports grants to attend Congress and personal fees from Gore regarding proctorships and workshops in AWR. Dr. Magsi, Dr Spurring, Dr. Malik, Ms. Cutler, Mr Kadir, Dr. Abdelrahman, Dr. Prescornita and Dr Li declare no conflicts of interest.

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Odogwu, S.O., Magsi, A.M., Spurring, E. et al. Component separation repair of incisional hernia: evolution of practice and review of long-term outcomes in a single center. Hernia 28, 465–474 (2024). https://doi.org/10.1007/s10029-023-02932-7

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