Complex abdomen: a scoping review
- 01.12.2025
- Review
Erschienen in:
- Verfasst von
- C. Stabilini
- S. Capoccia Giovannini
- G. Campanelli
- G. Cavallaro
- U. Bracale
- G. Soliani
- F. Pecchini
- M. Frascio
- F. Carlini
- G. Longo
- A. Rubartelli
- G. Camerini
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
This scoping review aimed to systematically map the existing evidence on the surgical management of complex abdominal wall hernias (CA), focusing on patient-specific factors, hernia characteristics, contamination and operative strategies to their management, in order to identify research gaps and areas for clinical improvement.
Methods
A comprehensive literature search was conducted in PubMed and Scopus, covering publications from January 2015 to June 2024. A total of 6,445 articles were identified, of which 357 met inclusion criteria (303 primary studies and 54 systematic reviews). Studies were classified into three categories: patient-related factors (P), hernia-specific features (H), and contamination (W).
Results
Patient-related factors, particularly obesity and associated comorbidities, were consistently related to higher rates of morbidity and hernia recurrence despite prehabilitation and bariatric surgery were evaluated, results were inconclusive. Hernia-specific features, including large defect size and loss of domain, were associated with increased complication rates. Midline restoration and its achievement with component separation or preoperative botulinum toxin injections, were extensively studied, showing potential benefits. In contaminated settings, synthetic meshes outperformed biologic alternatives, demonstrating lower recurrence and morbidity rates in recent trials. Research in biosynthetic mesh is still needed.
Conclusion
Surgical management of CA remains a highly demanding clinical scenario with significant variability in outcomes influenced by patient factors and hernia characteristics. Techniques such as component separation and the use of synthetic meshes hold promise, but further high-quality, randomized trials are required to establish standardized protocols and optimize clinical outcomes in this challenging patient population.
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- Titel
- Complex abdomen: a scoping review
- Verfasst von
-
C. Stabilini
S. Capoccia Giovannini
G. Campanelli
G. Cavallaro
U. Bracale
G. Soliani
F. Pecchini
M. Frascio
F. Carlini
G. Longo
A. Rubartelli
G. Camerini
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03270-6
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