Abstract：
OBJECTIVE: Undeniably, in the last 2 decades, surgical approaches in the field of abdominal wall repair have notably improved. However, the best approach to provide a durable repair with low morbidity rate has yet to be determined. The purpose of this study is to outline our long-term results following the Transverse Abdominis Release (TAR) approach in patients with complex ventral hernias, focusing on the incidence of recurrence and overall patient satisfaction following surgery.
METHODS: This is a retrospective study on 167 consecutive patients who underwent TAR between January 2015 and December 2021 for primary or recurrent complex abdominal hernias. Of these, 117 patients who underwent the open Madrid approach with the use of a double mesh (absorbable and permanent synthetic mesh) were selected and analyzed. A quality of life questionnaire (EuraHS QoL) comparing the preoperative and the postoperative status was administered.
RESULTS: Between January 2015 and December 2021, we successfully treated 117 patients presenting with complex ventral defects using the double mesh technique (absorbable and permanent synthetic mesh). Of these, 26 (22.2%) were recurrent cases. At a median follow-up period of 37.7 months, there had been 1 (0.8%) case of recurrence and 8 cases (6.8%) of bulging. The QoL score was significantly improved when compared to the preoperative status in terms of cosmesis, body perception, and physical discomfort.
CONCLUSIONS: The Madrid approach for posterior component separation is associated with both a low perioperative morbidity and recurrence rate. In accordance with other studies, we demonstrated that the TAR with reconstruction according to the Madrid approach provides excellent results in the treatment of complex abdominal wall hernias, even at long-term follow-up.
METHODS: This is a retrospective study on 167 consecutive patients who underwent TAR between January 2015 and December 2021 for primary or recurrent complex abdominal hernias. Of these, 117 patients who underwent the open Madrid approach with the use of a double mesh (absorbable and permanent synthetic mesh) were selected and analyzed. A quality of life questionnaire (EuraHS QoL) comparing the preoperative and the postoperative status was administered.
RESULTS: Between January 2015 and December 2021, we successfully treated 117 patients presenting with complex ventral defects using the double mesh technique (absorbable and permanent synthetic mesh). Of these, 26 (22.2%) were recurrent cases. At a median follow-up period of 37.7 months, there had been 1 (0.8%) case of recurrence and 8 cases (6.8%) of bulging. The QoL score was significantly improved when compared to the preoperative status in terms of cosmesis, body perception, and physical discomfort.
CONCLUSIONS: The Madrid approach for posterior component separation is associated with both a low perioperative morbidity and recurrence rate. In accordance with other studies, we demonstrated that the TAR with reconstruction according to the Madrid approach provides excellent results in the treatment of complex abdominal wall hernias, even at long-term follow-up.
摘要：
目标：不可否认，在过去的20年里，腹壁修复领域的手术方法有了显著改善。然而,提供低发病率的持久修复的最佳方法尚未确定。这项研究的目的是概述我们在复杂腹侧疝患者的横向腹肌释放（TAR）方法后的长期结果，关注术后复发率和患者总体满意度。
方法：这是一项回顾性研究，研究对象是在2015年1月至2021年12月期间因原发性或复发性复杂性腹部疝接受TAR的167例连续患者。其中,选择并分析了117例使用双网（可吸收和永久性合成网）进行开放式马德里入路的患者。使用生活质量问卷（EuraHSQoL）比较术前和术后状态。
结果：在2015年1月至2021年12月之间，我们使用双网状技术（可吸收和永久性合成网状物）成功治疗了117例表现为复杂腹侧缺损的患者。其中,26例（22.2%）为复发病例。中位随访期为37.7个月，有1例(0.8%)复发和8例(6.8%)隆起。在美容方面，与术前状态相比，QoL评分显着提高，身体感知，和身体不适。
结论：马德里入路的后部组件分离与低的围手术期发病率和复发率相关。根据其他研究，我们证明了根据马德里方法进行重建的TAR在治疗复杂的腹壁疝方面提供了出色的结果，即使是长期随访。
方法：这是一项回顾性研究，研究对象是在2015年1月至2021年12月期间因原发性或复发性复杂性腹部疝接受TAR的167例连续患者。其中,选择并分析了117例使用双网（可吸收和永久性合成网）进行开放式马德里入路的患者。使用生活质量问卷（EuraHSQoL）比较术前和术后状态。
结果：在2015年1月至2021年12月之间，我们使用双网状技术（可吸收和永久性合成网状物）成功治疗了117例表现为复杂腹侧缺损的患者。其中,26例（22.2%）为复发病例。中位随访期为37.7个月，有1例(0.8%)复发和8例(6.8%)隆起。在美容方面，与术前状态相比，QoL评分显着提高，身体感知，和身体不适。
结论：马德里入路的后部组件分离与低的围手术期发病率和复发率相关。根据其他研究，我们证明了根据马德里方法进行重建的TAR在治疗复杂的腹壁疝方面提供了出色的结果，即使是长期随访。
