Anterior Component Separation Technique Is Efficient Enough in Loss of Domain Hernia Treatment

Abstract

Repair of loss of domain hernia (LODH) has many related postoperative complications and abdominal separation techniques are well-accepted methods for avoiding abdominal compartment syndrome. The purpose of our study was to evaluate the effectiveness of anterior component separation technique and method of the patient selection for this technique in LODH. Between 2016 and 2019, 40 consecutive patients operated for LODH with over 10-cm fascial defect were analyzed prospectively. Patients were divided into two groups according to the hernia volume/abdominal volume ratio. Group 1 included patients less than 0.25 ratio and group 2 over 0.25. Bladder pressure, length of hospital stay, pain, bleeding, wound infection, and the duration of drainage tube were compared between groups. Average operation time, hospital stay, and wound drainage time was similar in both groups. In group 1, postoperative intra-abdominal hypertension was detected in 5 patients, whereas there was none in group 2. The rating of the individual measurement and sum of the defects will give proper results in multiple hernia defects. The properly performed anterior component separation alone would be an effective method on patients with LODH in order to avoid abdominal compartment syndrome.