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Comparing the outcomes of external oblique and transversus abdominus release using the AHSQC database

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Abstract

Purpose

Myofascial release techniques at the time of complex hernia repair allow for tension-free closure of the midline fascia. Two common techniques are the open external oblique release (EOR) and the transversus abdominis release (TAR). Each technique has its reported advantages and disadvantages, but there have been few comparative studies. The purpose of this project was to compare the outcomes of these two myofascial release techniques.

Methods

The Americas Hernia Society Quality Collaborative (AHSQC) database was queried and produced a data set on 24 May 2018. All patients undergoing open incision hernia repair with an open EOR or TAR were evaluated, and outcomes were compared including hernia recurrence, quality of life, and 30-day wound-related complications.

Results

3610 patients met the inclusion criteria of undergoing open incisional hernia repair (501 undergoing EOR and 3109 undergoing TAR). Seventy surgeons from 50 institutions contributed EOR patients, and 124 surgeons from 89 institutions contributed TAR patients with no differences between the two groups in surgeons’ affiliation. Comparing open EOR and TAR showed no significant differences in hernia recurrence, quality of life, or 30-day surgical site infection rate. EOR had a significantly higher rate of surgical site occurrences compared with TAR (p < 0.05); however, this did not result in an increase in surgical site occurrences requiring procedural interventions.

Conclusions

Equivalent outcomes were achieved using the EOR or TAR techniques in the open repair of incisional hernias. Both techniques offer consistently good outcomes and are important adjuncts in the repair of complex incisional hernias.

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Funding

No financial support was received for this study.

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Authors and Affiliations

  1. Department of Surgery, New Hanover Regional Medical Center, 2131 South 17th Street, PO Box 9025, Wilmington, NC, 28401, USA

    J. A. Bilezikian, P. L. Tenzel, J. D. Faulkner, M. J. Bilezikian, W. F. Powers & W. W. Hope

Authors
  1. J. A. Bilezikian
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  2. P. L. Tenzel
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  3. J. D. Faulkner
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  4. M. J. Bilezikian
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  5. W. F. Powers
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  6. W. W. Hope
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JB, PT, JF, MB, WP, and WH. The first draft of the manuscript was written by JB and PT, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to W. W. Hope.

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Conflict of interest

JAB, PLT, JDF, MJB, and WFP declare that they have no conflicts of interest. WWH declares the following: CR Bard/Davol consulting, speaker, research funding; Medtronic consulting; WL Gore speaker, research funding, and Intuitive Surgical speaker.

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Not applicable.

Human and animal rights

This study was performed in accordance with the accepted national and international ethical standards for human research.

Informed consent

For this retrospective review informed consent was not required.

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Not applicable.

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Not applicable.

Availability of data and material (data transparency)

Data were supplied by the AHSQC for the time period given.

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Bilezikian, J.A., Tenzel, P.L., Faulkner, J.D. et al. Comparing the outcomes of external oblique and transversus abdominus release using the AHSQC database. Hernia 25, 365–373 (2021). https://doi.org/10.1007/s10029-020-02310-7

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  • DOI: https://doi.org/10.1007/s10029-020-02310-7

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