A COMPARATIVE STUDY BETWEEN ANTERIOR COMPONENT SEPARATION AND POSTERIOR COMPONENT SEPARATION IN VENTRAL HERNIA REPAIR

Abstract

Background: Component separation techniques are established methods for repairing large ventral abdominal hernias. Among them, anterior component separation (ACS) and posterior component separation with transversus abdominis release (PCS-TAR) are widely practiced. This study aimed to compare ACS and PCS-TAR in terms of operative parameters, postoperative complications, and recurrence.

Methods: A prospective comparative study was conducted on 40 patients with large midline ventral hernia (defect surface area 300–600 cm², width >10 cm) admitted between September 2019 and November 2021. Patients were randomized into two groups: ACS (n=20) and PCS-TAR (n=20). Preoperative, intraoperative, and postoperative variables were compared.

Results: Both groups were comparable in demographics. Mean operative time was longer in PCS-TAR (148 vs. 140 min, p=0.12). Wound-related complications (seroma, infection) were significantly higher in ACS (40% vs. 10%, p<0.001). Drain removal was earlier in PCS-TAR (13.6 vs. 14.9 days). Recurrence at 12 months was significantly lower in PCS-TAR (0% vs. 10%, p=0.02).

Conclusion: PCS-TAR offers superior outcomes in terms of wound morbidity and recurrence, though with slightly longer operative time. It should be considered the preferred option for large midline ventral hernia repair.