• RCCSE中国核心学术期刊（A+）
  • 中国百强报刊
  • 百种中国杰出学术期刊
  • 中国精品科技期刊
  • 中国高校百佳科技期刊
  • 中国自然科学类核心期刊
  • 中国科技论文统计源期刊
  • 中华医学会优秀期刊
  • 中国精品科技期刊顶尖学术论文（5000）项目来源期刊
  • 入选中国高质量科技期刊分级目录（消化病学）T1级
  • 入选《中国学术期刊影响因子年报（自然科学与工程技术）》Q1区
  • 入选《科技期刊世界影响力指数（WJCI）报告（2022）》
  • RCCSE中国核心学术期刊（A+）
  • 中国百强报刊
  • 百种中国杰出学术期刊
  • 中国精品科技期刊
  • 中国高校百佳科技期刊
  • 中国自然科学类核心期刊
  • 中国科技论文统计源期刊
  • 中华医学会优秀期刊
  • 中国精品科技期刊顶尖学术论文（5000）项目来源期刊
  • 入选中国高质量科技期刊分级目录（消化病学）T1级
  • 入选《中国学术期刊影响因子年报（自然科学与工程技术）》Q1区
  • 入选《科技期刊世界影响力指数（WJCI）报告（2022）》
Jin Cuihong, Wang Fan, Wang Baoshan, et al. Application value of transversus abdominis muscle release technique in giant ventral hernia repair[J]. Chinese Journal of Digestive Surgery, 2021, 20(7): 805-809. DOI: 10.3760/cma.j.cn115610-20210519-00241
Citation: Jin Cuihong, Wang Fan, Wang Baoshan, et al. Application value of transversus abdominis muscle release technique in giant ventral hernia repair[J]. Chinese Journal of Digestive Surgery, 2021, 20(7): 805-809. DOI: 10.3760/cma.j.cn115610-20210519-00241
shu

Application value of transversus abdominis muscle release technique in giant ventral hernia repair

  • Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing100043, China

Funds: 

High-level Health Technicians Training Program of Beijing Health System 2015-3-031

More Information
  • Corresponding author:

    Wang Fan, Email: wolf_ie@126.com

  • Received Date: May 18, 2021
  • Available Online: July 18, 2024
    Graphical Abstract
    • Abstract
  • Objective 

    To investigate the application value of transversus abdominis muscle release technique in giant ventral hernia repair.

    Methods 

    The retrospective and descriptive study was conducted. The clinical data of 72 patients with giant ventral hernia who were admitted to Beijing Chaoyang Hospital of Capital Medical University from January 2017 to January 2020 were collected. There were 47 males and 25 females, aged from 29 to 79 years, with a median age of 56 years. All patients underwent ventral hernia repair with transversus abdominis muscle release technique and preperitoneal/retro-muscular polypropylene mesh reinforcement. Observation indicators: (1) surgical situations; (2) postoperative complications; (3) hernia-related quality of life. Follow-up was conducted using outpatient examination and telephone interview to detect postoperative complications at postoperative 1, 6 and 12 months. Follow-up was up to January 2021. Measurement data with normal distribution were represented as Mean±SD, and comparison within groups was analyzed using the paired t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers.

    Results 

    (1) Surgical situations: all 72 patients underwent ventral hernia repair with transversus abdominis muscle release technique and preperitoneal/retro-muscular polypropylene mesh reinforcement successfully. The operation time, volume of intraoperative blood loss and mesh size of the 72 patients were (105±46)minutes, (55±15)mL and (680±225)cm2, respectively. (2) Postoperative complications: 72 patients were followed up for 12 to 48 months, with a median follow-up time of 16 months. During the follow-up, 7 of the 72 patients were diagnosed with seroma by abdominal computed tomography (CT) scan at postoperative 1 week, the size of which was (460±130)mm2. The 7 patients with seroma were followed up and results of abdominal CT scan at postoperative 6 months showed that the seroma was completely absorbed. Two of the 72 patients had postoperative intestinal obstruction, which was considered as postoperative paralytic ileus. After conservative treatment, the 2 patients were improved 2 weeks after operation. None of the 72 patients had surgical site infection, intestinal fistula or hernia recurrence. (3) Hernia-related quality of life: the score of hernia-related quality of life of 72 patients before operation and at postoperative 12 months were 40±12 and 73±17, respectively, showing a significant difference (t=12.527, P<0.05).

    Conclusion 

    Transversus abdominis muscle release technique in the giant ventral hernia repair is safe and effective, which can improve hernia-related quality of life of patients.

    • FullText(HTML)
    • References (35)
  • [1]
    MathesSJ, SteinwaldPM, FosterRD, et al. Complex abdominal wall reconstruction: a comparison of flap and mesh closure[J]. Ann Surg,2000,232(4):586‑596. DOI:10. 1097/00000658-200010000-00014.
    [2]
    王平,黄永刚,高国栋,等.国际内镜疝学会腹壁疝和切口疝腹腔镜治疗指南更新解读(五)[J/CD].中华疝和腹壁外科杂志:电子版,2019,13(6):492‑496. DOI:10.3877/cma.j.issn. 1674-392X.2019.06.002.
    [3]
    BathAS, PatnaikPK, BhandariPS. Reconstruction of complex abdominal wall defects[J]. Med J Armed Forces India,2007,63(2):123‑126. DOI: 10.1016/S0377-1237(07)80053-0.
    [4]
    NovitskyYW, ElliottHL, OrensteinSB, et al. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction[J]. Am J Surg,2012,204(5):709‑716. DOI: 10.1016/j.amjsurg.2012.02.008.
    [5]
    KoJH, WangEC, SalvayDM, et al. Abdominal wall recons-truction: lessons learned from 200 "components separation" procedures[J]. Arch Surg,2009,144(11):1047-1055. DOI: 10.1001/archsurg.2009.192.
    [6]
    AliottaRE, GatherwrightJ, KrpataD, et al. Complex abdominal wall reconstruction, harnessing the power of a specialized multidisciplinary team to improve pain and quality of life[J]. Hernia,2019,23(2):205‑215. DOI:10.1007/ s10029-019-01916-w.
    [7]
    SoodRF, LipiraAB, NeliganPC, et al. Respiratory failure following abdominal wall reconstruction: an analysis of the nationwide inpatient sample[J]. Plast Reconstr Surg,2019,143(1):165e‑171e. DOI:10.1097/PRS.0000000000 005115.
    [8]
    AraiM, KimS, IshiiH, et al. The long‑term outcomes of early abdominal wall reconstruction by bilateral anterior rectus abdominis sheath turnover flap method in criti-cally ill patients requiring open abdomen[J]. World J Emerg Surg,2018,13:39. DOI: 10.1186/s13017-018-0200-7.
    [9]
    SaourS, FloydD. Incision planning in complex abdominal wall reconstruction[J]. JPRAS Open,2021,28:43‑51. DOI: 10.1016/j.jpra.2020.11.012.
    [10]
    DiazJJ, CullinaneDC, KhwajaKA, et al. Eastern Associa-tion for the Surgery of Trauma: management of the open abdomen, part Ⅲ‒review of abdominal wall reconstruc-tion[J]. J Trauma Acute Care Surg,2013,75(3):376-386. DOI: 10.1097/TA.0b013e318294bee3.
    [11]
    DraguA, KleinP, UnglaubF, et al. Tensiometry as a decision tool for abdominal wall reconstruction with component separation[J]. World J Surg,2009,33(6):1174-1180. DOI: 10.1007/s00268-009-9991-8.
    [12]
    Norwich‑CavanaughA, KimS, PanseG, et al. Prelamina-tion of vascularized tensor fascia lata for complex abdo-minal wall reconstruction[J]. Ann Plast Surg,2021,86(3S Suppl 2):S332‑S335. DOI: 10.1097/SAP.0000000000002690.
    [13]
    ElhageSA, MarturanoMN, PrasadT, et al. Impact of perforator sparing on anterior component separation outcomes in open abdominal wall reconstruction[J]. Surg Endosc,2020[Online ahead of print]. DOI: 10.1007/s00464-020-07888-8.
    [14]
    BlackCK, ZolperEG, WaltersET, et al. Utility of a modified components separation for abdominal wall reconstruc-tion in the liver and kidney transplant population[J]. Arch Plast Surg,2019,46(5):462‑469. DOI:10.5999/aps.2018. 01361.
    [15]
    NaranS, ShakirS, ShestakKC, et al. Components separa-tion for abdominal wall reconstruction in the recalcitrant, high‑comorbidity patient: a review of 311 single-surgeon cases[J]. Ann Plast Surg,2018,80(3):262‑267. DOI: 10.1097/SAP.0000000000001275.
    [16]
    杜宇,侯清.巨大腹壁疝修补术中应用主动减容手术对腹腔内高压及预后的影响[J/CD].中华疝和腹壁外科杂志:电子版,2019,13(4):365‑368. DOI:10.3877/cma.j.issn.1674-39 2X.2019.04.021.
    [17]
    AlleyneB, OzturkCN, RampazzoA, et al. Combined submuscular tissue expansion and anterior component separation technique for abdominal wall reconstruction: Long‑term outcome analysis[J]. J Plast Reconstr Aesthet Surg,2017,70(6):752‑758. DOI: 10.1016/j.bjps.2017.01.018.
    [18]
    Espinosa‑de‑Los‑MonterosA, de la Torre JI, AhumadaLA, et al. Reconstruction of the abdominal wall for incisional hernia repair[J]. Am J Surg,2006,191(2):173‑177. DOI:10. 1016/j.amjsurg.2005.07.037.
    [19]
    RoubaudMS, BaumannDP. Flap Reconstruction of the Abdominal Wall[J]. Semin Plast Surg,2018,32(3):133-140. DOI: 10.1055/s-0038-1661381.
    [20]
    杨董超,宋致成,杨建军,等.前入路组织结构分离技术和腹横肌分离技术在腹壁正中巨大切口疝治疗中的应用价值[J].中华消化外科杂志,2016,15(10):1012‑1017. DOI:10. 3760/cma.j.issn.1673-9752.2016.10.014
    [21]
    LodeL, OmaE, HenriksenNA, et al. Enhanced recovery after abdominal wall reconstruction: a systematic review and meta‑analysis[J]. Surg Endosc,2021,35(2):514‑523. DOI: 10.1007/s00464-020-07995-6.
    [22]
    WegdamJA, ThoolenJ, NienhuijsSW, et al. Systematic review of transversus abdominis release in complex abdominal wall reconstruction[J]. Hernia,2019,23(1):5-15. DOI: 10.1007/s10029-018-1870-5.
    [23]
    王平,黄永刚,叶静,等.腹横肌松解术在腹壁巨大切口疝修补中的临床应用[J/CD].中华疝和腹壁外科杂志:电子版,2018,12(3):194‑198. DOI:10.3877/cma.j.issn.1674-392X. 2018.03.009.
    [24]
    JonesCM, WinderJS, PotochnyJD, et al. Posterior com-ponent separation with transversus abdominis release: technique, utility, and outcomes in complex abdominal wall reconstruction[J]. Plast Reconstr Surg,2016,137(2):636-646. DOI: 10.1097/01.prs.0000475778.45783.e2.
    [25]
    CrissCN, PetroCC, KrpataDM, et al. Functional abdo-minal wall reconstruction improves core physiology and quality‑of‑life[J]. Surgery,2014,156(1):176‑182. DOI:10. 1016/j.surg.2014.04.010.
    [26]
    GazzolaR, LombardoM, RosatiR, et al. Posterior com-ponent separation with transversus abdominis release: technique, utility, and outcomes in complex abdominal wall reconstruction[J]. Plast Reconstr Surg,2016,138(3):562e‑563e. DOI: 10.1097/PRS.0000000000002453.
    [27]
    WinderJS, BeharBJ, JuzaRM, et al. Transversus abdo-minis release for abdominal wall reconstruction: early experience with a novel technique[J]. J Am Coll Surg,2016, 223(2):271‑278. DOI: 10.1016/j.jamcollsurg.2016.04.012.
    [28]
    RangwaniSM, KraftCT, SchneebergerSJ, et al. Strategies for mesh fixation in abdominal wall reconstruction: con-cepts and techniques[J]. Plast Reconstr Surg,2021,147(2):484‑491. DOI: 10.1097/PRS.0000000000007584.
    [29]
    DenneyB, de la Torre JI. Multipoint suture fixation tech-nique for abdominal wall reconstruction with component separation and onlay biological mesh placement[J]. Am Surg,2017,83(5):515‑521.
    [30]
    WeltzAS, SibiaUS, ZahiriHR, et al. Operative outcomes after open abdominal wall reconstruction with retromus-cular mesh fixation using fibrin glue versus transfascial sutures[J]. Am Surg,2017,83(9):937‑942.
    [31]
    KaoAM, ArnoldMR, AugensteinVA, et al. Prevention and treatment strategies for mesh infection in abdominal wall reconstruction[J]. Plast Reconstr Surg,2018,142(3Suppl):149S‑155S. DOI: 10.1097/PRS.0000000000004871.
    [32]
    Lopez‑MonclusJ, Muñoz‑RodríguezJ, San MiguelC, et al. Combining anterior and posterior component separation for extreme cases of abdominal wall reconstruction[J]. Hernia,2020,24(2):369‑379. DOI: 10.1007/s10029-020-02152-3.
    [33]
    ElhageSA, MarturanoMN, DeerenbergEB, et al. Impact of panniculectomy in complex abdominal wall reconstruc-tion: a propensity matched analysis in 624 patients[J]. Surg Endosc,2020[Online ahead of print]. DOI: 10.1007/s00464-020-08011-7.
    [34]
    ShaoJM, AlimiY, ConroyD, et al. Outcomes using indocy-anine green angiography with perforator‑sparing com-ponent separation technique for abdominal wall recon-struction[J]. Surg Endosc,2020,34(5):2227‑2236. DOI:10. 1007/s00464-019-07012-5.
    [35]
    ReinpoldW. Transversus abdominis muscle release: technique, indication, and results[J]. Int Abdom Wall Hernia Surg,2018,1(3):79-86. DOI: 10.4103/ijawhs.ijawhs_27_18.
    • Related Articles

Catalog

    Get Citation
    XML
    Article views (1774) PDF downloads (0) Cited by()
    Turn off MathJax
    Article Contents
    Abstract
    References

    Supported by: Beijing Renhe Information Technology Co., Ltd.  Baidu Analytics

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return