Comparison of open and endoscopic posterior component separation with transversus abdominis release: a propensity score-matched study

Background Posterior component separation with transversus abdominis release (TAR) is considered to be the optimal technique for large incisional ventral hernia repair. Endoscopic TAR (eTAR) that gets all the benefits of minimally invasive surgery (MIS) gives a possibility to enhance results of the...

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Published in:Hernia : the journal of hernias and abdominal wall surgery 2024-12, Vol.28 (6), p.2145-2150
Main Authors: Ivakhov, G. B., Kalinina, A. A., Andriyashkin, A. V., Titkova, S. M., Loban, K. M., Glagolev, N. S., Sazhin, A. V.
Format: Article
Language:English
Subjects:
Abdominal Muscles - surgery
Abdominal Surgery
Adult
Aged
Complications
Endoscopy
Endoscopy - methods
Female
Hernia
Hernia, Ventral - surgery
Hernias
Herniorrhaphy - adverse effects
Herniorrhaphy - methods
Humans
Incisional Hernia - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Minimally invasive surgery
Morbidity
Original Article
Patients
Postoperative
Postoperative Complications
Propensity Score
Retrospective Studies
Surgery
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Summary:Background Posterior component separation with transversus abdominis release (TAR) is considered to be the optimal technique for large incisional ventral hernia repair. Endoscopic TAR (eTAR) that gets all the benefits of minimally invasive surgery (MIS) gives a possibility to enhance results of the treatment. The aim of our study was to make the comparison between open and endoscopic TAR procedures with an emphasis on frequency and severity of postoperative complications in comparable groups. Materials and methods All patients had midline incisional hernia and underwent either open (open TAR group) or endoscopic (eTAR group) Rives-Stoppa repair in combination with bilateral transversus abdominis release in Moscow City Hospital №1 from January 2018 to December 2022. A propensity score matching (PSM) was used to make groups comparable. Postoperative complications were classified according to Clavien-Dindo Classification, and Comprehensive complication index was calculated. Results We performed 133 open and endoscopic TAR separation for midline incisional hernia. After PSM analysis 51 patients were matched to each group. Overall surgical morbidity in the open TAR group (56.9%) was statistically significantly higher than in the eTAR group (29.4%) ( p  = 0.009). There were more severe complications (Clavien IIIa-V) in the open TAR group (11.8% vs. 0%, p  = 0.027). Length of hospital stay after surgery was shorter in eTAR group ( p  
ISSN:1248-9204
1265-4906
1248-9204
DOI:10.1007/s10029-024-02964-7