title: Large and complex ventral hernia repair using "components separation technique" without mesh results in a high recurrence rate.
abstract: BACKGROUND
  Recurrence rates after component separation technique (CST) are low in the literature but may be underestimated because of inadequate follow-up methods.
  
  
  METHODS
  Prospective patient follow-up was performed of consecutive patients who underwent repair of large and complex ventral hernias using CST without mesh utilization. Primary outcome was recurrent hernia determined by clinical examination at least 1 year after surgery in all living patients. Current literature underwent meta-analysis regarding outcomes and mode of follow-up.
  
  
  RESULTS
  Seventy-five patients were included with a mean age of 52.2 years and a mean defect size of 214.9 cm(2), respectively. Twenty-nine patients (38.7%) had a recurrent hernia after a mean of 40.9-month follow-up, and this was significantly higher than in the literature (14.0%, P < .01). Sixty-four percent of studies in the literature were unclear about the method of determining recurrent hernia or included telephone follow-up and questionnaires.
  
  
  CONCLUSIONS
  CST coincides with a high recurrence rate when clinical follow-up is longer than a year. Reported recurrence rates are probably underestimated because the method and duration of follow-up are inadequate.
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: n.slater.md@gmail.com.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Slater
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Bleichrodt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D055815:Young Adult
keywords: Complex hernia; Component separation technique; Incisional hernia; Mesh; Ventral hernia