Large and complex ventral hernia repair using "components separation technique" without mesh results in a high recurrence rate

Am J Surg. 2015 Jan;209(1):170-9. doi: 10.1016/j.amjsurg.2014.02.013. Epub 2014 Apr 28.

Abstract

Background: Recurrence rates after component separation technique (CST) are low in the literature but may be underestimated because of inadequate follow-up methods.

Methods: Prospective patient follow-up was performed of consecutive patients who underwent repair of large and complex ventral hernias using CST without mesh utilization. Primary outcome was recurrent hernia determined by clinical examination at least 1 year after surgery in all living patients. Current literature underwent meta-analysis regarding outcomes and mode of follow-up.

Results: Seventy-five patients were included with a mean age of 52.2 years and a mean defect size of 214.9 cm(2), respectively. Twenty-nine patients (38.7%) had a recurrent hernia after a mean of 40.9-month follow-up, and this was significantly higher than in the literature (14.0%, P < .01). Sixty-four percent of studies in the literature were unclear about the method of determining recurrent hernia or included telephone follow-up and questionnaires.

Conclusions: CST coincides with a high recurrence rate when clinical follow-up is longer than a year. Reported recurrence rates are probably underestimated because the method and duration of follow-up are inadequate.

Keywords: Complex hernia; Component separation technique; Incisional hernia; Mesh; Ventral hernia.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh
  • Treatment Outcome
  • Young Adult