Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias

OBJECTIVES To evaluate and compare the outcomes of the Posterior Component Separation (PCS) technique with and without Transversus Abdominis Release (TAR) in the management of complex abdominal hernias, focusing on recurrence rates, complications, and overall surgical effectiveness. METHODOLOGY...

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Main Authors: Siddique Ahmad, Saadia Muhammad, Muhammad Iftikhar, Muhammad Alam, Rashid Aslam, Muhammad Bilawal Khan
Format: Article
Language:English
Published: Gandhara University 2025-03-01
Series:Journal of Gandhara Medical and Dental Sciences
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Online Access:http://jgmds.org.pk/index.php/JGMDS/article/view/638
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author Siddique Ahmad
Saadia Muhammad
Muhammad Iftikhar
Muhammad Alam
Rashid Aslam
Muhammad Bilawal Khan
author_facet Siddique Ahmad
Saadia Muhammad
Muhammad Iftikhar
Muhammad Alam
Rashid Aslam
Muhammad Bilawal Khan
author_sort Siddique Ahmad
collection DOAJ
description OBJECTIVES To evaluate and compare the outcomes of the Posterior Component Separation (PCS) technique with and without Transversus Abdominis Release (TAR) in the management of complex abdominal hernias, focusing on recurrence rates, complications, and overall surgical effectiveness. METHODOLOGY This retrospective cohort study was conducted at Hayatabad Medical Complex, Peshawar, from January 2020 to April 2023. A total of 87 patients with complex midline and lateral hernias were included. Complex hernias had defects >8 cm, >20% abdominal domain loss, multiple defects, or recurrence. Lateral hernias were post-open cholecystectomy incisional hernias. Data on demographics, comorbidities, and surgical details were analysed using SPSS v20. Chi-square and Fisher’s exact tests were applied for categorical variables, and an independent t-test was used for continuous variables (p<0.05 considered significant). RESULTS Of 87 patients, 42 (48.3%) underwent PCS-TAR, while 45 (51.7%) had PCS without TAR. The mean operative time was 120 ± 10.6 minutes. Complications occurred in 24 (27.6%) patients, significantly higher in the TAR group (38.1% vs. 17.8%, p=0.034). Recurrence was observed in 7 (8%) patients. Seroma formation was more common in the TAR group (16.7% vs. 2.2%, p=0.009). Mortality occurred in one patient due to pulmonary embolism. CONCLUSION Posterior component separation technique with or without transversus abdominis release is a neoteric surgical procedure for managing large complex hernias. It has an excellent outcome with minimal complications, resulting in improved quality of life for the patients.
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spelling doaj-art-1321a7eccf14440fb19a9ff22dac7bb32025-08-20T01:50:45ZengGandhara UniversityJournal of Gandhara Medical and Dental Sciences2312-94332618-14522025-03-01122Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall HerniasSiddique Ahmad0Saadia Muhammad1Muhammad Iftikhar2Muhammad Alam3Rashid Aslam4Muhammad Bilawal Khan5Hayatabad Medical Complex, PeshawarHayatabad Medical Complex PeshawarAssociate Professor of Surgery Hayatabad Medical Complex PeshawarHayatabad Medical Complex, PeshawarHayatabad Medical Complex, PeshawarHayatabad Medical Complex, Peshawar OBJECTIVES To evaluate and compare the outcomes of the Posterior Component Separation (PCS) technique with and without Transversus Abdominis Release (TAR) in the management of complex abdominal hernias, focusing on recurrence rates, complications, and overall surgical effectiveness. METHODOLOGY This retrospective cohort study was conducted at Hayatabad Medical Complex, Peshawar, from January 2020 to April 2023. A total of 87 patients with complex midline and lateral hernias were included. Complex hernias had defects >8 cm, >20% abdominal domain loss, multiple defects, or recurrence. Lateral hernias were post-open cholecystectomy incisional hernias. Data on demographics, comorbidities, and surgical details were analysed using SPSS v20. Chi-square and Fisher’s exact tests were applied for categorical variables, and an independent t-test was used for continuous variables (p<0.05 considered significant). RESULTS Of 87 patients, 42 (48.3%) underwent PCS-TAR, while 45 (51.7%) had PCS without TAR. The mean operative time was 120 ± 10.6 minutes. Complications occurred in 24 (27.6%) patients, significantly higher in the TAR group (38.1% vs. 17.8%, p=0.034). Recurrence was observed in 7 (8%) patients. Seroma formation was more common in the TAR group (16.7% vs. 2.2%, p=0.009). Mortality occurred in one patient due to pulmonary embolism. CONCLUSION Posterior component separation technique with or without transversus abdominis release is a neoteric surgical procedure for managing large complex hernias. It has an excellent outcome with minimal complications, resulting in improved quality of life for the patients. http://jgmds.org.pk/index.php/JGMDS/article/view/638ObesityAbdominal MusclesProcedureManagementHernia
spellingShingle Siddique Ahmad
Saadia Muhammad
Muhammad Iftikhar
Muhammad Alam
Rashid Aslam
Muhammad Bilawal Khan
Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias
Journal of Gandhara Medical and Dental Sciences
Obesity
Abdominal Muscles
Procedure
Management
Hernia
title Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias
title_full Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias
title_fullStr Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias
title_full_unstemmed Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias
title_short Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias
title_sort outcomes of posterior component separation technique with and without transverse abdominus release in the management of complex abdominal wall hernias
topic Obesity
Abdominal Muscles
Procedure
Management
Hernia
url http://jgmds.org.pk/index.php/JGMDS/article/view/638
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