Introduction
Abdominal wall reconstruction can be a challenging procedure especially in case of large sized defects. Previous studies suggest that primary fascial closure with mesh reinforcement improves outcomes reducing hernia recurrence rate. [1-5] To date, only few studies have compared bridged and mesh reinforced repairs with significant differences among study groups concerning defect sizes. [1, 3, 4] Indeed, the comparison of these two repair techniques in randomized controlled trials is difficult due to problems of forming comparable groups. [6]
To overcome this issue, we have analyzed our long term results of bridged and mesh reinforced abdominal wall reconstruction by adjusting the difference between the two treatment arms using propensity score analysis. [7]
Methods
A retrospective cohort study evaluating all consecutive patients underwent midline AWR with underlay (preperitoneal or intraperitoneal) mesh for an abdominal wall hernia or oncologic defect for which the fascia could or could not be primarily closed without undue tension was performed at The University of Texas MD Anderson Cancer Center between March 2005 and October 2015. When the fascial defect could not be closed primarily over the underlay mesh, the prosthesis was left in place as a …show more content…
[10] Our surgeons used a similar general technique for all AWRs. Briefly, reconstruction began by defining the defect, including excision of the hernia sac and debridement of devitalized tissue and fascia, and determining whether lateral release was necessary to medialize the rectus muscles. Anterior open or minimally invasive [11, 12] component separation (CS), including release of the external oblique aponeurosis from pubis to the costal margin, was performed to provide lateral release and to reduce tension from the midline fascial closure.
Abdominal wall reconstruction can be a challenging procedure especially in case of large sized defects. Previous studies suggest that primary fascial closure with mesh reinforcement improves outcomes reducing hernia recurrence rate. [1-5] To date, only few studies have compared bridged and mesh reinforced repairs with significant differences among study groups concerning defect sizes. [1, 3, 4] Indeed, the comparison of these two repair techniques in randomized controlled trials is difficult due to problems of forming comparable groups. [6]
To overcome this issue, we have analyzed our long term results of bridged and mesh reinforced abdominal wall reconstruction by adjusting the difference between the two treatment arms using propensity score analysis. [7]
Methods
A retrospective cohort study evaluating all consecutive patients underwent midline AWR with underlay (preperitoneal or intraperitoneal) mesh for an abdominal wall hernia or oncologic defect for which the fascia could or could not be primarily closed without undue tension was performed at The University of Texas MD Anderson Cancer Center between March 2005 and October 2015. When the fascial defect could not be closed primarily over the underlay mesh, the prosthesis was left in place as a …show more content…
[10] Our surgeons used a similar general technique for all AWRs. Briefly, reconstruction began by defining the defect, including excision of the hernia sac and debridement of devitalized tissue and fascia, and determining whether lateral release was necessary to medialize the rectus muscles. Anterior open or minimally invasive [11, 12] component separation (CS), including release of the external oblique aponeurosis from pubis to the costal margin, was performed to provide lateral release and to reduce tension from the midline fascial closure.