A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias
Autor: | Carolynne J. Vaizey, J. D. Hodgkinson, Paul Bassett, S. M. Oke, Yasuko Maeda, C. A. Leo, Janindra Warusavitarne |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Incisional hernia Abdominal Hernia 030230 surgery 03 medical and health sciences 0302 clinical medicine medicine Humans Incisional Hernia Transversus abdominis Herniorrhaphy Abdominal Muscles business.industry Abdominal Wall Middle Aged Surgical Mesh medicine.disease Hernia Ventral Component separation Surgery Pooled analysis 030220 oncology & carcinogenesis Meta-analysis Ventral hernia Female business Abdominal surgery |
Zdroj: | Hernia. 22:617-626 |
ISSN: | 1248-9204 1265-4906 |
Popis: | This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519–526, 1990), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709–716, 2012), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair. Analysis was conducted according to PRISMA guidelines. A systematic search of the MEDLINE, EMBASE and Pubmed databases was performed. Studies reporting exclusively on midline ventral hernia repair were reviewed. Studies describing PCSTAR were selected and compared to matched studies describing OACS. Meta-analysis was used to compare outcomes between the two-pooled groups. Seven studies describing 281 cases of PCSTAR for midline incisional hernia using a retromuscular mesh placement were identified. Six comparable studies describing 285 cases of OACS and retromuscular mesh placement were identified from the same search. Pooled analysis demonstrated a hernia recurrence rate of 5.7% (3.0–8.5) for PCSTAR and 9.5% (4.0–14.9) for OACS. Comparative analysis demonstrated no significant difference between hernia recurrence rate (p = 0.23). The use of bridging mesh was not significantly reduced by the use of PCSTAR (3.1%) when compared to ACS (7.5%) (p = 0.22). No significant difference was found in wound complication rates between PCSTAR and OACS, respectively, ‘superficial’ 10.9 vs 21.6% (p = 0.15); and ‘deep’ 9.5 vs 12.7% (p = 0.53). These data suggest PCSTAR have comparable outcomes to OACS. This analysis is limited by the lack of comparative studies and heterogenicity in the OACS group. |
Databáze: | OpenAIRE |
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