A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias
Purpose This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519–526, 1990 ), has become an established tec...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2018-08, Vol.22 (4), p.617-626 |
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| creator | Hodgkinson, J. D. Leo, C. A. Maeda, Y. Bassett, P. Oke, S. M. Vaizey, C. J. Warusavitarne, J. |
| description | Purpose
This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519–526,
1990
), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709–716,
2012
), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair.
Methods
Analysis was conducted according to PRISMA guidelines. A systematic search of the MEDLINE, EMBASE and Pubmed databases was performed. Studies reporting exclusively on midline ventral hernia repair were reviewed. Studies describing PCSTAR were selected and compared to matched studies describing OACS. Meta-analysis was used to compare outcomes between the two-pooled groups.
Results
Seven studies describing 281 cases of PCSTAR for midline incisional hernia using a retromuscular mesh placement were identified. Six comparable studies describing 285 cases of OACS and retromuscular mesh placement were identified from the same search. Pooled analysis demonstrated a hernia recurrence rate of 5.7% (3.0–8.5) for PCSTAR and 9.5% (4.0–14.9) for OACS. Comparative analysis demonstrated no significant difference between hernia recurrence rate (
p
= 0.23). The use of bridging mesh was not significantly reduced by the use of PCSTAR (3.1%) when compared to ACS (7.5%) (
p
= 0.22). No significant difference was found in wound complication rates between PCSTAR and OACS, respectively, ‘superficial’ 10.9 vs 21.6% (
p
= 0.15); and ‘deep’ 9.5 vs 12.7% (
p
= 0.53).
Conclusions
These data suggest PCSTAR have comparable outcomes to OACS. This analysis is limited by the lack of comparative studies and heterogenicity in the OACS group. |
| doi_str_mv | 10.1007/s10029-018-1757-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2012115024</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2015461181</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-356a3f3bf60db8b21e63f6ef551943315a858118576f47112b9dedf1eca4fd003</originalsourceid><addsrcrecordid>eNp9kctu1TAQhiMEotcHYIMssWET6nFsJ1lWFVCkSmzKOpokY46rxA6epKjPxEvi01NAQoKNb_rm_yV_RfEK5DuQsr7gvKq2lNCUUJu6NM-KY1C6KVsl9fP92ZpSt9IeFSfMd1LKRtvmZXGkWgNWtfq4-HEpZlqxxIDTA3sWQ5wXTD58FXGhIDCslHxMj-8xUFgFUwZw9TGI737diSXy_xgMo1gTBr6nxBsL7Mc4-5CrEk2ETMIHse4oXxf0SUQnZj9OPpC4z1EJJ7GjFDzyWfHC4cR0_rSfFl8-vL-9ui5vPn_8dHV5Uw5VrdayMhYrV_XOyrFvegVkK2fJGQOtriow2JgGoDG1dboGUH070uiABtRulLI6Ld4ecpcUv23Eazd7HmiaMFDcuFMSFICRSmf0zV_oXdxS_stHymibeyBTcKCGFJkTuW5Jfsb00IHs9ia7g8kum-z2JjuTZ14_JW_9TOPviV_qMqAOAC97XZT-VP879Sf-I60n</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2015461181</pqid></control><display><type>article</type><title>A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias</title><source>Springer Nature - Complete Springer Journals</source><creator>Hodgkinson, J. D. ; Leo, C. A. ; Maeda, Y. ; Bassett, P. ; Oke, S. M. ; Vaizey, C. J. ; Warusavitarne, J.</creator><creatorcontrib>Hodgkinson, J. D. ; Leo, C. A. ; Maeda, Y. ; Bassett, P. ; Oke, S. M. ; Vaizey, C. J. ; Warusavitarne, J.</creatorcontrib><description>Purpose
This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519–526,
1990
), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709–716,
2012
), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair.
Methods
Analysis was conducted according to PRISMA guidelines. A systematic search of the MEDLINE, EMBASE and Pubmed databases was performed. Studies reporting exclusively on midline ventral hernia repair were reviewed. Studies describing PCSTAR were selected and compared to matched studies describing OACS. Meta-analysis was used to compare outcomes between the two-pooled groups.
Results
Seven studies describing 281 cases of PCSTAR for midline incisional hernia using a retromuscular mesh placement were identified. Six comparable studies describing 285 cases of OACS and retromuscular mesh placement were identified from the same search. Pooled analysis demonstrated a hernia recurrence rate of 5.7% (3.0–8.5) for PCSTAR and 9.5% (4.0–14.9) for OACS. Comparative analysis demonstrated no significant difference between hernia recurrence rate (
p
= 0.23). The use of bridging mesh was not significantly reduced by the use of PCSTAR (3.1%) when compared to ACS (7.5%) (
p
= 0.22). No significant difference was found in wound complication rates between PCSTAR and OACS, respectively, ‘superficial’ 10.9 vs 21.6% (
p
= 0.15); and ‘deep’ 9.5 vs 12.7% (
p
= 0.53).
Conclusions
These data suggest PCSTAR have comparable outcomes to OACS. This analysis is limited by the lack of comparative studies and heterogenicity in the OACS group.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-018-1757-5</identifier><identifier>PMID: 29516294</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdominal Surgery ; Hernia ; Hernias ; Medicine ; Medicine & Public Health ; Meta-analysis ; Review ; Surgery ; Surgical mesh ; Wounds</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2018-08, Vol.22 (4), p.617-626</ispartof><rights>Springer-Verlag France SAS, part of Springer Nature 2018</rights><rights>Hernia is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-356a3f3bf60db8b21e63f6ef551943315a858118576f47112b9dedf1eca4fd003</citedby><cites>FETCH-LOGICAL-c372t-356a3f3bf60db8b21e63f6ef551943315a858118576f47112b9dedf1eca4fd003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-018-1757-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-018-1757-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29516294$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hodgkinson, J. D.</creatorcontrib><creatorcontrib>Leo, C. A.</creatorcontrib><creatorcontrib>Maeda, Y.</creatorcontrib><creatorcontrib>Bassett, P.</creatorcontrib><creatorcontrib>Oke, S. M.</creatorcontrib><creatorcontrib>Vaizey, C. J.</creatorcontrib><creatorcontrib>Warusavitarne, J.</creatorcontrib><title>A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Purpose
This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519–526,
1990
), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709–716,
2012
), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair.
Methods
Analysis was conducted according to PRISMA guidelines. A systematic search of the MEDLINE, EMBASE and Pubmed databases was performed. Studies reporting exclusively on midline ventral hernia repair were reviewed. Studies describing PCSTAR were selected and compared to matched studies describing OACS. Meta-analysis was used to compare outcomes between the two-pooled groups.
Results
Seven studies describing 281 cases of PCSTAR for midline incisional hernia using a retromuscular mesh placement were identified. Six comparable studies describing 285 cases of OACS and retromuscular mesh placement were identified from the same search. Pooled analysis demonstrated a hernia recurrence rate of 5.7% (3.0–8.5) for PCSTAR and 9.5% (4.0–14.9) for OACS. Comparative analysis demonstrated no significant difference between hernia recurrence rate (
p
= 0.23). The use of bridging mesh was not significantly reduced by the use of PCSTAR (3.1%) when compared to ACS (7.5%) (
p
= 0.22). No significant difference was found in wound complication rates between PCSTAR and OACS, respectively, ‘superficial’ 10.9 vs 21.6% (
p
= 0.15); and ‘deep’ 9.5 vs 12.7% (
p
= 0.53).
Conclusions
These data suggest PCSTAR have comparable outcomes to OACS. This analysis is limited by the lack of comparative studies and heterogenicity in the OACS group.</description><subject>Abdominal Surgery</subject><subject>Hernia</subject><subject>Hernias</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Review</subject><subject>Surgery</subject><subject>Surgical mesh</subject><subject>Wounds</subject><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kctu1TAQhiMEotcHYIMssWET6nFsJ1lWFVCkSmzKOpokY46rxA6epKjPxEvi01NAQoKNb_rm_yV_RfEK5DuQsr7gvKq2lNCUUJu6NM-KY1C6KVsl9fP92ZpSt9IeFSfMd1LKRtvmZXGkWgNWtfq4-HEpZlqxxIDTA3sWQ5wXTD58FXGhIDCslHxMj-8xUFgFUwZw9TGI737diSXy_xgMo1gTBr6nxBsL7Mc4-5CrEk2ETMIHse4oXxf0SUQnZj9OPpC4z1EJJ7GjFDzyWfHC4cR0_rSfFl8-vL-9ui5vPn_8dHV5Uw5VrdayMhYrV_XOyrFvegVkK2fJGQOtriow2JgGoDG1dboGUH070uiABtRulLI6Ld4ecpcUv23Eazd7HmiaMFDcuFMSFICRSmf0zV_oXdxS_stHymibeyBTcKCGFJkTuW5Jfsb00IHs9ia7g8kum-z2JjuTZ14_JW_9TOPviV_qMqAOAC97XZT-VP879Sf-I60n</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Hodgkinson, J. D.</creator><creator>Leo, C. A.</creator><creator>Maeda, Y.</creator><creator>Bassett, P.</creator><creator>Oke, S. M.</creator><creator>Vaizey, C. J.</creator><creator>Warusavitarne, J.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20180801</creationdate><title>A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias</title><author>Hodgkinson, J. D. ; Leo, C. A. ; Maeda, Y. ; Bassett, P. ; Oke, S. M. ; Vaizey, C. J. ; Warusavitarne, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-356a3f3bf60db8b21e63f6ef551943315a858118576f47112b9dedf1eca4fd003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Hernia</topic><topic>Hernias</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Review</topic><topic>Surgery</topic><topic>Surgical mesh</topic><topic>Wounds</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hodgkinson, J. D.</creatorcontrib><creatorcontrib>Leo, C. A.</creatorcontrib><creatorcontrib>Maeda, Y.</creatorcontrib><creatorcontrib>Bassett, P.</creatorcontrib><creatorcontrib>Oke, S. M.</creatorcontrib><creatorcontrib>Vaizey, C. J.</creatorcontrib><creatorcontrib>Warusavitarne, J.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hodgkinson, J. D.</au><au>Leo, C. A.</au><au>Maeda, Y.</au><au>Bassett, P.</au><au>Oke, S. M.</au><au>Vaizey, C. J.</au><au>Warusavitarne, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>22</volume><issue>4</issue><spage>617</spage><epage>626</epage><pages>617-626</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Purpose
This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519–526,
1990
), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709–716,
2012
), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair.
Methods
Analysis was conducted according to PRISMA guidelines. A systematic search of the MEDLINE, EMBASE and Pubmed databases was performed. Studies reporting exclusively on midline ventral hernia repair were reviewed. Studies describing PCSTAR were selected and compared to matched studies describing OACS. Meta-analysis was used to compare outcomes between the two-pooled groups.
Results
Seven studies describing 281 cases of PCSTAR for midline incisional hernia using a retromuscular mesh placement were identified. Six comparable studies describing 285 cases of OACS and retromuscular mesh placement were identified from the same search. Pooled analysis demonstrated a hernia recurrence rate of 5.7% (3.0–8.5) for PCSTAR and 9.5% (4.0–14.9) for OACS. Comparative analysis demonstrated no significant difference between hernia recurrence rate (
p
= 0.23). The use of bridging mesh was not significantly reduced by the use of PCSTAR (3.1%) when compared to ACS (7.5%) (
p
= 0.22). No significant difference was found in wound complication rates between PCSTAR and OACS, respectively, ‘superficial’ 10.9 vs 21.6% (
p
= 0.15); and ‘deep’ 9.5 vs 12.7% (
p
= 0.53).
Conclusions
These data suggest PCSTAR have comparable outcomes to OACS. This analysis is limited by the lack of comparative studies and heterogenicity in the OACS group.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>29516294</pmid><doi>10.1007/s10029-018-1757-5</doi><tpages>10</tpages></addata></record> |
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| ispartof | Hernia : the journal of hernias and abdominal wall surgery, 2018-08, Vol.22 (4), p.617-626 |
| issn | 1265-4906 1248-9204 |
| language | eng |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Hernia Hernias Medicine Medicine & Public Health Meta-analysis Review Surgery Surgical mesh Wounds |
| title | A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias |
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