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Outcomes after open posterior component separation via transversus abdominis release (TAR) for incisional hernia repair. A systematic review and meta-analysis.
Sadava, Emmanuel E; Laxague, Francisco; Valinoti, Agustin C; Angeramo, Cristian A; Schlottmann, Francisco.
Afiliação
  • Sadava EE; Department of Surgery, Hospital Alemán of Buenos Aires, Av. Pueyrredon 1640, Buenos Aires, C1118AAT, Argentina. esadava@hospitalaleman.com.
  • Laxague F; Division of Abdominal Wall Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina. esadava@hospitalaleman.com.
  • Valinoti AC; Department of Surgery, Hospital Alemán of Buenos Aires, Av. Pueyrredon 1640, Buenos Aires, C1118AAT, Argentina.
  • Angeramo CA; Department of Surgery, Hospital Alemán of Buenos Aires, Av. Pueyrredon 1640, Buenos Aires, C1118AAT, Argentina.
  • Schlottmann F; Division of Abdominal Wall Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina.
Hernia ; 2024 Aug 27.
Article em En | MEDLINE | ID: mdl-39192038
ABSTRACT

PURPOSE:

Given its potential advantages, open Transversus Abdominis Release (oTAR) has been proposed as a durable solution for complex AWR. However, its applicability in different scenarios remains uncertain. We aimed to analyze the current available evidence and determine surgical outcomes after oTAR.

METHODS:

We performed a systematic electronic search on oTAR in PubMed/Medline, Embase, and Cochrane Central Register of Controlled Trials databases. Postoperative morbidity and recurrence rates were included as primary endpoints and Quality of life (QoL) was included as secondary endpoint. A random-effect model was used to generate a pooled proportion with 95% confidence interval (CI) between all studies.

RESULTS:

A total of 22 studies with 4,910 patients undergoing oTAR were included for analysis. Mean hernia defect and mesh area were 394 (140-622) cm2 and 1065 (557-2206) cm2, respectively. Mean follow-up was 19.7 (1-32) months. The weighted pooled proportion of recurrence, overall morbidity, surgical site occurrences (SSO), surgical site infection (SSI), surgical site occurrences requiring procedural intervention (SSOPI), major morbidity and mortality were 6% (95% CI, 3-10%), 34% (95% CI, 26-43%), 22% (95% CI, 16-29%), 11% (95% CI, 8-16%), 4% (95% CI, 3-7%), 6% (95% CI, 4-10%) and 1% (95% CI, 1-2%), respectively. A significant improvement in QoL after oTAR was reported among studies.

CONCLUSION:

Open TAR is an effective technique for complex ventral hernias as it is associated with low recurrence rate and a significant improvement in QoL. However, the relatively high morbidity rates observed emphasize the necessity of further patients' selection and optimization to improve outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Hernia Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Argentina País de publicação: França
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Hernia Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Argentina País de publicação: França