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- Title
Narbenhernien: offene Operationsverfahren und Ergebnisse einer Kohortenstudie mit 343 Patienten.
- Authors
Garcia Ureña, Miguel Ángel; López-Monclús, Javier; Hernando, Luis Alberto Blázquez; Munoz-Rodriguez, Joaquín; García de León, Laura Roman; Avilés Oliveros, Adriana; Pedrique, Manuel Medina; de Luca, Marcelo; Valle de Lersundi, Alvaro Robin
- Abstract
The treatment of complex midline hernias remains a particular challenge. The currently refined knowledge of the anatomy in the cadaver laboratory and advancing clinical experience have changed our present approach. The aim of this review is to present a description of the updated surgical procedures and outcomes. We favor the retromuscular or preperitoneal layer for mesh implantation, including the Rives-Stoppa procedure (sublay mesh) and posterior component separation with the Madrid modification. We operated on 334 complex midline incisional hernias: 6.3% retromuscular preperitoneal, 15% after Rives-Stoppa, 2.4% anterior component separation and 76% posterior component separation. A bridging procedure was used in 31%. A complication occurred in 35.3%, most of which were wound healing disorders (SSO). The average length of hospital stay was 7.2 days. We recorded a very low incidence of long-term complications: 3.3% recurrence, 0.9% chronic pain (daily use of pain medication), 6% bulging, 1.8% chronic seroma and 2.6% chronic mesh infection. Despite the associated morbidity, retromuscular/preperitoneal treatment offers excellent long-term results.
- Subjects
MADRID (Spain)
- Publication
Chirurgie (2731-6971), 2024, Vol 95, Issue 1, p10
- ISSN
2731-6971
- Publication type
Article
- DOI
10.1007/s00104-023-02005-6