Outcomes of Posterior Component Separation Technique with and Without Transverse Abdominus Release in the Management of Complex Abdominal Wall Hernias
Keywords:
Obesity, Abdominal Muscles, Procedure, Management, HerniaAbstract
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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Copyright (c) 2025 Siddique Ahmad, Saadia Muhammad, Muhammad Iftikhar, Muhammad Alam, Rashid Aslam, Muhammad Bilawal Khan
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