Outcomes after open posterior component separation via transversus abdominis release (TAR) for incisional hernia repair. A systematic review and meta-analysis
- 27.08.2024
- Review
Erschienen in:
- Verfasst von
- Emmanuel E. Sadava
- Francisco Laxague
- Agustin C. Valinoti
- Cristian A. Angeramo
- Francisco Schlottmann
- Erschienen in
- Hernia | Ausgabe 6/2024
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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- Titel
- Outcomes after open posterior component separation via transversus abdominis release (TAR) for incisional hernia repair. A systematic review and meta-analysis
- Verfasst von
-
Emmanuel E. Sadava
Francisco Laxague
Agustin C. Valinoti
Cristian A. Angeramo
Francisco Schlottmann
- Publikationsdatum
- 27.08.2024
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 6/2024
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03142-5
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