%0 Journal Article
%T Outcomes of complex abdominal wall reconstruction in patients with connective tissue disorders: a single center experience.
%A Messer N
%A Prabhu AS
%A Miller BT
%A Krpata DM
%A Beffa LRA
%A Phillips SE
%A Petro CC
%A Maskal SM
%A Ellis RC
%A Figueiredo S
%A Fafaj A
%A Rosen MJ
%J Hernia
%V 28
%N 3
%D 2024 Jun 1
%M 38427113
%F 2.92
%R 10.1007/s10029-023-02957-y
%X <B>BACKGROUND: </B>Individuals diagnosed with connective tissue disorders (CTD) are known to be predisposed to incisional hernia formation. However, there is a scarcity of data on outcomes for these patients undergoing hernia repair. We sought to describe our outcomes in performing abdominal wall reconstructions in these complex patients.<BR><B>METHODS: </B>Adult patients with CTD undergoing open, elective, posterior component separation with permanent synthetic mesh at our institution from January 2018 to October 2022 were queried from a prospectively collected database in the Abdominal Core Health Quality Collaborative. We evaluated 30-day wound morbidity, perioperative complications, long-term hernia recurrence, and patient-reported quality of life.<BR><B>RESULTS: </B>Twelve patients were identified. Connective tissue disorders included Marfan's n = 7 (58.3%), Loeys-Dietz syndrome n = 2 (16.7%), Systemic Lupus Erythematosus n = 2 (16.7%), and Scleroderma n = 1 (8.3%). Prior incisions included three midline laparotomies and nine thoracoabdominal, mean hernia width measured 14 cm, and 9 were recurrent hernias. Surgical site occurrences (SSOs) were observed in 25% of cases, and 16.7% necessitated procedural intervention. All twelve patients were available for long-term follow-up, with a mean of 34 (12-62) months. There were no instances of reoperation or mesh excision related to the TAR procedure. One patient developed a recurrence after having his mesh violated for repair of a new visceral aneurysm. Mean HerQLes scores at 1 year were 70 and 89 at ≥ 2 years; Mean scaled PROMIS scores were 30.7 at 1 year and 36.3 at ≥ 2 years.<BR><B>CONCLUSIONS: </B>Ventral hernia repair with TAR is feasible in patients with connective tissue disorder and can be a suitable alternative in patients with large complex hernias.