Abstract：
OBJECTIVE: Posterior component separation with transversus abdominis release (TAR) enables medial myofascial flap advancement in complex abdominal wall reconstruction. Here, we add to a growing body of literature on TAR by assessing longitudinal clinical and patient-reported outcomes (PROs) after complex ventral hernia repair (VHR) with TAR.
METHODS: Adult patients undergoing VHR with TAR between 10/15/2015 and 1/15/2020 were retrospectively identified. Patients with parastomal hernias and <12 months of follow-up were excluded. Clinical outcomes and PROs were assessed.
RESULTS: Fifty-six patients were included with a median age and body mass index of 60 and 30.8 kg/m2, respectively. The average hernia defect was 384 cm2 [IQR 205-471], and all patients had retromuscular mesh placed. The most common complications were delayed healing (19.6%) and seroma (14.3%). There were no cases of mesh infection or explantation. Previous hernia repair and concurrent panniculectomy were risk factors for developing complications (P < .05). One patient (1.8%) recurred at a median follow-up of 25.2 months [IQR 18.2-42.4]. Significant improvement in disease-specific PROs was maintained throughout the follow-up period (before to after P < .05).
CONCLUSIONS: Transversus abdominis release is a safe and efficacious technique to achieve fascial closure and retromuscular mesh in the repair of complex hernia defects.
METHODS: Adult patients undergoing VHR with TAR between 10/15/2015 and 1/15/2020 were retrospectively identified. Patients with parastomal hernias and <12 months of follow-up were excluded. Clinical outcomes and PROs were assessed.
RESULTS: Fifty-six patients were included with a median age and body mass index of 60 and 30.8 kg/m2, respectively. The average hernia defect was 384 cm2 [IQR 205-471], and all patients had retromuscular mesh placed. The most common complications were delayed healing (19.6%) and seroma (14.3%). There were no cases of mesh infection or explantation. Previous hernia repair and concurrent panniculectomy were risk factors for developing complications (P < .05). One patient (1.8%) recurred at a median follow-up of 25.2 months [IQR 18.2-42.4]. Significant improvement in disease-specific PROs was maintained throughout the follow-up period (before to after P < .05).
CONCLUSIONS: Transversus abdominis release is a safe and efficacious technique to achieve fascial closure and retromuscular mesh in the repair of complex hernia defects.
摘要：
目的：腹横肌释放（TAR）后组件分离可在复杂的腹壁重建中推进内侧肌筋膜瓣。这里,通过评估使用TAR进行复杂腹侧疝修补术(VHR)后的纵向临床和患者报告结局(PRO),我们增加了越来越多关于TAR的文献.
方法：对2015年10月15日至2020年1月15日期间接受TARVHR的成年患者进行回顾性分析。排除造口旁疝和<12个月随访的患者。评估临床结果和PRO。
结果：纳入56例患者，中位年龄和体重指数分别为60和30.8kg/m2。平均疝缺损为384cm2[IQR205-471]，所有患者都放置了后肌网。最常见的并发症是延迟愈合(19.6%)和血清肿(14.3%)。无网片感染或移植病例。既往疝修补术和同时行膜膜切除术是发生并发症的危险因素（P<0.05）。一名患者（1.8%）在中位随访25.2个月时复发[IQR18.2-42.4]。在整个随访期间（P<0.05前后），疾病特异性PRO的显着改善得以维持。
结论：腹横肌松解术是一种在复杂疝缺损修复中实现筋膜闭合和肌后补片的安全有效的技术。
方法：对2015年10月15日至2020年1月15日期间接受TARVHR的成年患者进行回顾性分析。排除造口旁疝和<12个月随访的患者。评估临床结果和PRO。
结果：纳入56例患者，中位年龄和体重指数分别为60和30.8kg/m2。平均疝缺损为384cm2[IQR205-471]，所有患者都放置了后肌网。最常见的并发症是延迟愈合(19.6%)和血清肿(14.3%)。无网片感染或移植病例。既往疝修补术和同时行膜膜切除术是发生并发症的危险因素（P<0.05）。一名患者（1.8%）在中位随访25.2个月时复发[IQR18.2-42.4]。在整个随访期间（P<0.05前后），疾病特异性PRO的显着改善得以维持。
结论：腹横肌松解术是一种在复杂疝缺损修复中实现筋膜闭合和肌后补片的安全有效的技术。
