چکیده (انگلیسی):

Background: Components separation technique emerged several years ago as a novel procedure to
improve durability of repair for ventral abdominal hernias. Almost twenty-five years since its initial
description, little comprehensive risk adjusted data exists on the morbidity of this procedure. This study
is the largest analysis to date of short-term outcomes for these cases.
Methods: The ACS-NSQIP database identified open ventral or incisional hernia repairs with components
separation from 2005 to 2012. A data set of cohorts without this technique, matched for preoperative risk
factors and operative characteristics, was developed for comparison. A comprehensive risk-adjusted
analysis of outcomes and morbidity was performed.
Results: A total of 68,439 patients underwent open ventral hernia repair during the study period (2245
with components separation performed (3.3%) and 66,194 without). In comparison with risk-adjusted
controls, use of components separation increased operative duration (additional 83 min), length of
stay (6.4 days vs. 3.8 days, p < 0.001), return to the OR rate (5.9% vs. 3.6%, p < 0.001), and 30-day
morbidity (10.1% vs. 7.6%, p < 0.001) with no increase in mortality (0.0% in each group).
Conclusions: Components separation technique for large incisional hernias significantly increases length
of stay and postoperative morbidity. Novel strategies to improve short-term outcomes are needed with
continued use of this technique.