OC-121 TRANSVERSUS ABDOMINIS RELEASE (TAR) IN CONTAMINATED FIELDS

Abstract

Abstract Aim Complex abdominal wall reconstructions in contaminated fields is a controversial topic. Although some prefer a staged approach, others advocate performing a single surgery even associating bowel and colon resections with synthetic mesh reinforcement. We aimed to evaluate and compare results of Transversus Abdominis Release (TAR) in clean and contaminated fields. Material & Methods A consecutive series of patients undergoing TAR for complex incisional hernias between 2014 and 2022 with a minimum of 6-month follow-up was included. The cohort was divided into 2 groups according to the Modified Hernia Grading System of the Ventral Hernia Working Group (VHWG): G1, Grade 1 (low risk) and Grade 2 (comorbid); and G2: Grade 3 (contaminated). Demographics, operative and postoperative variables were analyzed and compared. Results A total of 69 TAR repairs were performed; 54 (78,3%) were included in G1 and 15 (21,7%) in G2. There were no differences in overall morbidity at 30 postoperative days (G1 19% vs G2 27%; p=NS). Surgical Site Infection (SSI) was significantly higher in G2 (G1 11,1% vs G2 46,6%; p=0,01), however Surgical Site Occurrence Requiring Procedural Intervention (SSOPI) was similar in both groups (G1 5,5% vs G2 11,1%; p=NS). No mesh removal was recorded. After 31 ± 10 months follow-up, the recurrence rate was 2.9% (2 patients). Conclusions TAR technique is feasible and safe for the treatment of complex hernias in contaminated fields. Although an increase in SSI rate might be observed, most cases are superficial without the need for invasive procedures.