Early outcomes of component separation techniques : an analysis of the Spanish registry of incisional Hernia (EVEREG)
Pereira-Rodríguez, José Antonio (Parc de Salut MAR de Barcelona)
Bravo-Salva, Alejandro (Parc de Salut MAR de Barcelona)
Montcusí-Ventura, B. (Parc de Salut MAR de Barcelona)
Hernández Granados, Pilar (Hospital Universitario Fundación Alcorcón)
Rodrigues-Gonçalves, V. (Hospital Universitari Vall d'Hebron)
López Cano, Manuel (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Data:	2021
Resum:	To analyze the outcomes of component separation techniques (CST) to treat incisional hernias (IH) in a large multicenter cohort of patients. All IH repair using CST, registered in EVEREG from July 2012 to December 2019, were included. Data on the pre-operative patient characteristics and comorbidities, IH characteristics, surgical technique, complications, and recurrence were collected. Outcomes between anterior (ACS) and posterior component separation (PCS) techniques were compared. Risk factors for complications and recurrences were analyzed. During the study period, 1536 patients underwent CST (45. 5% females) with a median age of 64. 0 years and median body mass index (BMI) of 29. 7 kg/m 2. ACS was the most common technique (77. 7%). Overall complications were frequent in both ACS and PCS techniques (36. 5%), with a higher frequency of wound infection (10. 6% vs. 7. 0%; P = 0. 05) and skin necrosis (4. 4% vs. 0. 1%; P < 0. 0001) with the ACS technique. Main factors leading to major complications were mesh explant (OR 1. 72; P = 0. 001), previous repair (OR 0. 75; P = 0. 038), morbid obesity (OR 0. 67; P = 0. 015), ASA grade (OR 0. 62; P < 0. 0001), COPD (OR 0. 52; P < 0. 0001), and longitudinal diameter larger than 10 cm (OR 0. 58; P = 0. 001). After a minimum follow-up of 6 months (median 15 months; N = 590), 59 (10. 0%) recurrences were diagnosed. Operations performed in a non-specialized unit were significantly associated with recurrences (HR 4. 903, CI 1. 64-14. 65; P = 0. 004). CST is a complex procedure with a high rate of complications. Both ACS and PCS techniques have similar complication and recurrence rates. Operations performed in a specialized unit have better outcomes.
Nota:	Altres ajuts: Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.
Nota:	Altres ajuts: B. Braun Melsungen https://doi.org/10.13039/100007534
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Incisional hernia ; Component separation technique (CST) ; Hernia registry ; Abdominal wall surgery specialization
Publicat a:	Hernia, Vol. 25 (july 2021) , p. 1573-1580, ISSN 1248-9204

DOI: 10.1007/s10029-021-02449-x
PMID: 34213681

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