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Truncal function after abdominal wall reconstruction via transversus abdominis muscle release (TAR) for large incisional hernias: a prospective case–control study

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Abstract

Background

Data about abdominal wall function in patients with incisional hernias (IH) are limited. Abdominal Wall Reconstruction (AWR) could be beneficial for the improvement of this function. The goal of the study was to evaluate if the abdominal wall function was restored after transversus abdominis muscle release (TAR).

Methods

We performed a prospective case–control study of 59 patients with IH equal or larger than 10 cm in their width undergoing AWR via TAR with mesh reinforcement and complete linea alba restoration. With two simple physical tests—Trunk Raising (TR) and Double Leg Lowering (DLL), we clinically assessed, preoperatively, 1 month and 1 year postoperatively the functionality of the abdominal wall (flexion). Patients were compared with a control group (n = 57) with an intact abdominal wall undergoing visceral surgery through a midline laparotomy.

Results

There were no differences between the groups in terms of sex and mean age. In the study group, TR demonstrated an increase from 1.93 preoperatively to 2.44 at 1 month and 4.27, respectively, at 1 year postoperatively (p < 0.001). DLL was improved from 2.067 to 4.37 at 1 year postoperatively (p = 0.016). In the control group, surgery resulted in a decrease of truncal flexion. At 1 year postoperatively, the abdominal wall function for study group patients was almost identical with that the functionality of the control group featuring an intact abdominal wall (TR 4.26 vs 4.33 p = 0.532; DLL 4.42 vs 4.21 p = 0.193).

Conclusion

AWR via TAR for large IH specifically improved long-term abdominal wall muscular function.

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Funding

No funds were used and necessary for this study.

Author information

Authors and Affiliations

  1. Clinical Department of Surgery, “Constantin Papilian” Emergency Clinical Military Hospital, Nr 22 GralTraianMosoiu street, 3400, Cluj-Napoca, Romania

    V. Oprea, M. Toma & O. Grad

  2. Second Department of Surgery, Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    O. Grad

  3. Clinical Department of Imagistic and Radiology, “Constantin Papilian” Emergency Clinical Military Hospital, Cluj-Napoca, Romania

    A. Pavel

  4. 1St Clinical Department of Surgery, Targu Mures University of Medicine and Pharmacy, Targu Mures, Romania

    C. Molnar

Authors
  1. V. Oprea
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  2. M. Toma
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  3. O. Grad
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  4. A. Pavel
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  5. C. Molnar
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Contributions

VO—study design, measurements, interpretation of data, writing the manuscript, final proof revision; MT—study design, measurements and data interpretation, writing the manuscript, final proof revision; OG—interpretation of data, statistics interpretation, final proof revision; AP—interpretation of CT scans, statistics and final proof revision; CM—supervision of the study, final proof revision and approval. VO and MT can share the first authorship with equal contribution. VO, MT, OG, AP, CM—nothing to disclose in relation with this study.

Corresponding author

Correspondence to V. Oprea.

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Conflict of interest

VO, MT, OG, AP, and CM have no competing interests to declare.

Ethical approval

Local Ethical Committee under AWF 29/October 13, 2015 approved the study.

Human and animal rights

No animal used for this study.

Informed consent

Every patient was informed about the goals of the study, about each procedure and surgery and signed an informed consent before enrollment in this study.

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Oprea, V., Toma, M., Grad, O. et al. Truncal function after abdominal wall reconstruction via transversus abdominis muscle release (TAR) for large incisional hernias: a prospective case–control study. Hernia 26, 1285–1292 (2022). https://doi.org/10.1007/s10029-022-02563-4

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  • DOI: https://doi.org/10.1007/s10029-022-02563-4

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