ArticleFrontiers in surgery2026
Anterior component separation for complex ventral hernias: outcomes of a tailored reconstruction strategy.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To evaluate the outcomes of two open ventral hernia reconstruction strategies selected according to defect complexity, with particular emphasis on postoperative morbidity and recurrence-related reoperations. Methods: This retrospective cohort study included 266 patients who underwent elective ventral hernia repair between 2020 and 2024. Patients underwent either anterior component separation or primary fascial closure with onlay polypropylene mesh reinforcement according to defect complexity and the feasibility of achieving tension-free midline fascial closure. Postoperative complications occurring within 30 days and recurrence-related reoperations during follow-up were analyzed. Results: A total of 266 patients were included, comprising 90 patients in the component separation group and 176 patients in the primary closure group. Patients undergoing component separation had substantially larger fascial defects (median 150 cm Conclusions: Anterior component separation was preferentially used in patients with larger and more complex ventral hernias. Although early wound morbidity was more frequent in these patients, recurrence-related reoperation rates remained comparable to those achieved with primary fascial closure and onlay mesh reinforcement. These findings support anterior component separation as an effective reconstructive option for achieving durable tension-free midline closure in selected patients with complex ventral hernias.
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