Endoscopic versus open component separation in complex abdominal wall reconstruction.
BACKGROUND
Open component separation has a high wound complication rate. Newer endoscopic approaches are described with no comparative trials.


METHODS
A retrospective review (2005-2009) of patients undergoing open or endoscopic component separation was performed.


RESULTS
Forty-four cases were identified (22 endoscopic; 22 open). All perioperative variables were the same except age (65 open vs 55 endoscopic; P<.05). Hospital length of stay was 11 days in the open group versus 8 days in the endoscopic group (P=.09). Wound complications were 52% in the open group versus 27% in the endoscopic group (P=.09). Wound-related interventions occurred in 45% of the open group and 33% of the endoscopic group. Hernia recurrences rates were similar (open, 32%; endoscopic, 27%; P=.99).


CONCLUSIONS
Open and endoscopic components separation have similar rates of recurrence. The endoscopic group had shorter lengths of stay and less major wound complications. The endoscopic approach may be the ideal technique for complex abdominal wall reconstruction.
Harth
Karem C
KC
Department of General Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., Mail Stop 5047, Room 7110, Cleveland, OH 44106-5047, USA.
Rosen
Michael J
MJ
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies