Early complications due to incisional herniorrhaphy with the posterior component separation technique. Cross-sectional study

Abstract

Introduction: Associated factors with postoperative complications are not completely known after the posterior component separation techniques in patients with incisional hernias. Objective: Determinating the association between some factors and postoperative global and specific complications as seroma, hematoma and surgical site infection in patient that underwent a posterior component separation surgery. Methods: Cross-sectional analytical study with records from patients that underwent elective surgery by transversus abdominis reléase (TAR) o Rives Stoppa technique between the years 2015 and 2019. Results: Of the population studied, 51.1 % were male, the median age and body mass index (BMI) were 56.5 years and 28 kg/m2 respectively. The 55.1 % had a recurrence of a previous herniorrhaphy, the median of diastasis of the rectal muscle was 12 cm (10-15 cm). We found that 59 patients were affected at least with one complication (33.5 %), the most frequent were surgical site infection in 19.3 %, seroma in 4 %, hematoma in 8 %, and reinterventions 5.3 %. After performing multivariate analysis, the history of 4 or more surgeries (RP: 2.06, IC 95 %, 1.02-16.68, p = 0,045) and diabetes (RP: 1.73, IC 95 %, 1.02-6.23 p = 0.041) was associated with global complications and ASA (American Society of Anesthesiologist) class 2 with respect to ASA 3 with a minor prevalence of complications (RP: 0.62, IC 95 % ,0.21-0.98, p = 0.044). Conclusions: The component separation technique is associated with a morbidity of 33.5 %. The factors that are associated with this morbidity are the presence of diabetes and multirecurrence, so prevention measures are necessary in patients with risk factors associated with early complications in subsequent component separation surgery.