OC-060 PREDICTING FACTORS OF RECURRENCE AFTER TRANSVERSUS ABDOMINIS MUSCLE RELEASE (TAR) FOR COMPLEX INCISIONAL HERNIAS. RETROSPECTIVE ANALYZE OF A COHORT

Abstract

Abstract Background Transversus Abdominis Muscle Release (TAR) is used to provide adequate coverage for large abdominal wall defects and appears to be more advantageous compared to Anterior Component Separation concerning complications and recurrence rates. The aim of this study was to identify the independent predictors associated with hernia recurrence after TAR in the treatment of complex incisional hernias. Methods This is a retrospective observational study of 191 patients who underwent TAR between November 2014 and December 2021. The main inclusion criteria were adults with large complex incisional hernias larger than 10 cm in transverse diameter. The recurrence rate was determined by clinical examination and by abdominal CT scan. Results At a median of 49.6 months (range 36–75 months) of postoperative follow-up, we reported 19 cases of recurrence (9.94%). Recurrences occurred after a mean period of 12.4 months (range 10–49 months). On multivariate analysis, the development of postoperative hematoma (OR 2.9; CI 1.55–4.10, p = 0.001), and needing surgery for the hematoma (OR 2.1; CI 1.21–3.29, p = 0.004), obesity and chronic pulmonary disease (COPD) were predictors of recurrence after TAR. The area under Curve (AUC) was highly specific for all these independent factors (AUC = 0.842). There was no significant difference in recurrence rate among obesity, smoking, urgent repair, type of mesh fixation, operative time, type of prosthesis, or concomitant procedures. Conclusions In our current study, the development of postoperative hematoma and needing surgery for the hematoma, and obesity were associated with an increased risk of hernia recurrence after RSR.