Anterior Component Separation Versus Posterior Component Separation for Repair of Large Ventral Hernias

Study Overview
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Brief Summary
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This study evaluates effect of anterior component separation and posterior component separation and transversus abdominis muscle release methods for treatment of midline ventral hernias.

Detailed Description
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The anterior component separation technique requires an extensive subcutaneous flap elevation, incision of the external oblique aponeurosis, and incision of the posterior rectus sheath. The posterior component separation technique utilized the retromuscular space, accessed by incising the posterior rectus sheath and dissecting the posterior sheath between the internal oblique and transversus abdominis muscles. Transversus abdominis muscle release dissected the posterior sheath back to the transversus abdominal muscle and accessed the space between muscle and trasversalis fascia.

Official Title
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Anterior Component Separation Versus Posterior Component Separation for Repair of Large Ventral Hernias: a Prospective Cohort Study

Conditions
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Large Midline Ventral Hernia

Intervention / Treatment
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* Procedure: Anterior component separation
* Procedure: Posterior component separation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: subject has midline ventral hernia patient's approval to participate in the study Exclusion Criteria: strangulated hernia patient's preference for either operative technique patient's refusal to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: anterior component separation<br>The anterior component separation technique requires an extensive subcutaneous flap elevation, incision of the external oblique aponeurosis, and incision of the posterior rectus sheath. | Procedure: Anterior component separation<br> <br> |
| Active Comparator: posterior component separation<br>The posterior component separation technique utilized the retromuscular space, accessed by incising the posterior rectus sheath and dissecting the posterior sheath between the internal oblique and transversus abdominis muscles. | Procedure: Posterior component separation<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hernia recurrence | Develop of ventral hernia recurrence | during 3 year after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wound complications | Develop of wound complications (seroma, hematoma, surgical site infection) | 30 day after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anterior component separation, TAR