Short- to Midterm Results After Posterior Component Separation with Transversus Abdominis Release: Initial Experience fr
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ORIGINAL SCIENTIFIC REPORT
Short- to Midterm Results After Posterior Component Separation with Transversus Abdominis Release: Initial Experience from India Pallawi Priya1 • Nimisha Kantharia2 • Jugal B. Agrawal3 • Abhay Agrawal3 • Laksh Agrawal4 • Md Yusuf Afaque5 • Amjad Syed Ali Rizvi5 • Sarfaraz J. Baig1
Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Purpose Posterior component separation with transversus abdominis release is a new procedure and is quickly gaining popularity. It has shown promising results in terms of low recurrence rates for large and complex hernias. However, there are very little Indian data available on this to date. The purpose of this study was to assess the outcomes of the technique at three centers in India. Methods This was a retrospective analysis of the prospectively collected data. Patients with a minimum follow-up of 3 months who underwent open or minimal access posterior component separation were included. Results A total of 72 patients (open = 44, minimal access = 25, and hybrid = 3) were included in the analysis. At a follow-up ranging from 3 months to 35 months, there were two recurrences (2.78%). Surgical site occurrences were seen in 23/72 (31.9%), and surgical site infection was seen in 7/72 (9.7%). Surgical site occurrence requiring procedural intervention was 3/72 (4.2%). There were two (2.78%) mortalities in the open group due to myocardial infarction. Conclusion Posterior component separation with transversus abdominis release may have advantages in terms of low recurrence in large hernias in the Indian population and can be used in carefully selected patients.
Pallawi Priya and Sarfaraz J. Baig contributed equally. & Pallawi Priya [email protected]
Sarfaraz J. Baig [email protected]
Nimisha Kantharia [email protected]
1
Belle Vue Clinic, 9 and 10, Loudon Street, Kolkata 700046, India
Jugal B. Agrawal [email protected]
2
Bhatia Hospital, Mumbai, India
3
Seven Hills Hospital, Mumbai, India
4
MGM Hospital, Mumbai, India
5
J N Medical College, Aligarh Muslim University, Aligarh, India
Abhay Agrawal [email protected] Laksh Agrawal [email protected] Md Yusuf Afaque [email protected] Amjad Syed Ali Rizvi [email protected]
123
World J Surg
Abbreviations ACS Anterior component separation PCS Posterior component separation TA Transversus abdominis IO Internal oblique TAR Transversus abdominis release TF Transversalis fascia BMI Body mass index PRS Posterior rectus sheath RS Rives-Stoppa MIS Minimally invasive surgery POD Postoperative day LOD Loss of domain PDS Polydioxanone VHWG Ventral Hernia Working Group PPP Progressive pneumoperitoneum SSI Surgical site infection SSO Surgical site occurrence SSOPI Surgical site occurrence requiring procedural intervention MI Myocardial infarction
Introduction Large ventral hernias are difficult to treat. Till recently, bridging repair has been commonly used to treat large hernias. However, recent literature has shown high recurrence rates with bridging repairs [1]. S
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