Abstract：
BACKGROUND: Transversus abdominis release (TAR) is increasingly being performed for reconstruction of complex incisional and recurrent ventral hernias, with complication rates ranging from 17.4% to 33.3% after open TAR (oTAR) or robotic TAR (rTAR). The purpose of this study was to describe the outcomes of patients undergoing TAR with macroporous polypropylene mesh (MPM) and to compare outcomes between oTAR and rTAR.
METHODS: A retrospective review of 183 consecutive patients undergoing TAR with MPM performed by a single surgeon at a single institution from 2015 to 2021 was performed. Patients with less than one year of follow-up were excluded. Univariate analysis was performed to compare outcomes between oTAR and rTAR patients.
RESULTS: Average patient age was 59.4 y, median body mass index was 33.2 kg/m2, and median hernia width was 12.0 cm. Forty 2 (23%) patients underwent oTAR, 127 (69%) underwent rTAR, and 14 (8%) underwent laparoscopic TAR. Patients experienced 16.4%, 10.4%, 3.8%, and 6.0% rates of overall complications, surgical site occurrences, surgical site infections, and other complications, respectively. At average follow-up of 2.3 y, a 2.7% hernia recurrence rate was observed. In comparison to patients undergoing oTAR, rTAR patients required shorter operative times and length of stay, and were less likely to experience postoperative complications overall, and other complications. Recurrence rates were similar between oTAR and rTAR.
CONCLUSIONS: Patients undergoing TAR with MPM experienced complication and recurrence rates in alignment with previously published results. In comparison to oTAR, rTAR was associated with more favorable perioperative outcomes and complication rates, but similar recurrence rates.
METHODS: A retrospective review of 183 consecutive patients undergoing TAR with MPM performed by a single surgeon at a single institution from 2015 to 2021 was performed. Patients with less than one year of follow-up were excluded. Univariate analysis was performed to compare outcomes between oTAR and rTAR patients.
RESULTS: Average patient age was 59.4 y, median body mass index was 33.2 kg/m2, and median hernia width was 12.0 cm. Forty 2 (23%) patients underwent oTAR, 127 (69%) underwent rTAR, and 14 (8%) underwent laparoscopic TAR. Patients experienced 16.4%, 10.4%, 3.8%, and 6.0% rates of overall complications, surgical site occurrences, surgical site infections, and other complications, respectively. At average follow-up of 2.3 y, a 2.7% hernia recurrence rate was observed. In comparison to patients undergoing oTAR, rTAR patients required shorter operative times and length of stay, and were less likely to experience postoperative complications overall, and other complications. Recurrence rates were similar between oTAR and rTAR.
CONCLUSIONS: Patients undergoing TAR with MPM experienced complication and recurrence rates in alignment with previously published results. In comparison to oTAR, rTAR was associated with more favorable perioperative outcomes and complication rates, but similar recurrence rates.
摘要：
背景：腹横肌松解术（TAR）越来越多地用于复杂的切口性和复发性腹侧疝的重建，开放TAR（oTAR）或机器人TAR（rTAR）后的并发症发生率为17.4％至33.3％。这项研究的目的是描述使用大孔聚丙烯网（MPM）进行TAR的患者的结果，并比较oTAR和rTAR之间的结果。
方法：回顾性分析了从2015年至2021年，由单个外科医生在单个机构进行的连续183例TAR合并MPM患者。随访少于一年的患者被排除在外。进行单因素分析以比较oTAR和rTAR患者之间的结果。
结果：患者平均年龄为59.4岁，中位体重指数为33.2kg/m2,中位疝宽度为12.0cm.42例（23%）患者接受了OTAR，127（69%）接受了rTAR，14例（8%）接受了腹腔镜TAR。患者经历了16.4%，10.4%,3.8%,总体并发症发生率为6.0%，手术部位的发生，手术部位感染,和其他并发症，分别。平均随访2.3年，观察到2.7%的疝复发率.与接受oTAR的患者相比，rTAR患者需要更短的手术时间和住院时间，总体上不太可能出现术后并发症，和其他并发症。oTAR和rTAR的复发率相似。
结论：接受TAR合并MPM的患者出现并发症和复发率，与先前发表的结果一致。与OTAR相比，rTAR与更有利的围手术期结局和并发症发生率相关，但复发率相似。
方法：回顾性分析了从2015年至2021年，由单个外科医生在单个机构进行的连续183例TAR合并MPM患者。随访少于一年的患者被排除在外。进行单因素分析以比较oTAR和rTAR患者之间的结果。
结果：患者平均年龄为59.4岁，中位体重指数为33.2kg/m2,中位疝宽度为12.0cm.42例（23%）患者接受了OTAR，127（69%）接受了rTAR，14例（8%）接受了腹腔镜TAR。患者经历了16.4%，10.4%,3.8%,总体并发症发生率为6.0%，手术部位的发生，手术部位感染,和其他并发症，分别。平均随访2.3年，观察到2.7%的疝复发率.与接受oTAR的患者相比，rTAR患者需要更短的手术时间和住院时间，总体上不太可能出现术后并发症，和其他并发症。oTAR和rTAR的复发率相似。
结论：接受TAR合并MPM的患者出现并发症和复发率，与先前发表的结果一致。与OTAR相比，rTAR与更有利的围手术期结局和并发症发生率相关，但复发率相似。
