Short-Term Outcomes and Quality-of-Life Assessment Following Rives-Stoppa and Transversus Abdominis Release Procedures of Open Ventral Hernia Repair

Rajiv Kumar; Prem Prakash; Seema R Sinha; Nadeem Ahmad; Kanchan S Baitha

doi:10.7759/cureus.41637

Short-Term Outcomes and Quality-of-Life Assessment Following Rives-Stoppa and Transversus Abdominis Release Procedures of Open Ventral Hernia Repair

Cureus. 2023 Jul 10;15(7):e41637. doi: 10.7759/cureus.41637. eCollection 2023 Jul.

Authors

Rajiv Kumar¹, Prem Prakash¹, Seema R Sinha², Nadeem Ahmad¹, Kanchan S Baitha¹

Affiliations

¹ General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, IND.
² Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, IND.

Abstract

Introduction: Ventral hernia is one of the common surgical conditions that can significantly impact a patient's quality of life (QoL). Open ventral hernia repair using the Rives-Stoppa (RS) and Transversus Abdominis Release (TAR) procedures has gained recognition for its effectiveness in achieving hernia repair and reducing the risk of further recurrence. However, limited research has been performed to explore the short-term outcomes and QoL assessment following these two surgical techniques. The aim of this study was to know the result after RS and TAR methods of hernia repair in terms of short-term recurrences, pain, postoperative complications, and QoL.

Methods: This was a prospective, interventional study, which included 30 patients fulfilling the inclusion criteria. The study group was subjected to posterior component separation (PCS)-TAR and RS repair as per surgical indication (RS if defect size 4-10cm; PCS-TAR if defect size >10cm and </= 15cm). All post-operative patients were followed up at postoperative day (POD) seven, POD 30, and POD 90 for postoperative pain, complications, and QoL using the hernia-specific Carolina Comfort Scale (CCS). At the same time, recurrence was studied till POD 180.

Results: Not a single recurrence was observed till POD 180 in either of the repair methods. The mean operative time for RS repair was 170.47 ± 15.08 minutes while for TAR repair was 188.8 ± 22.04 (p-value= 0.013). Surgical site infection (SSI) was reported in 14.28% of RS repair cases and 11.11% of TAR repair cases. Seroma formation was observed in 9.5% of RS repair cases. RS repair has less mean CCS score than TAR. The one-way ANOVA showed f-ratio=421.43 and p-value=0.00001 for RS repair while f-ratio= 298.05 and p-value=0 .00001 for TAR repair at POD seven, POD 30, and POD 90. Both RS and TAR repair markedly reduced mean scores in all three domains on POD 90.

Conclusion: Both RS and TAR had no recurrence in a short period of six months. The intraoperative time taken in TAR was less than in earlier studies. QoL improved postoperatively in both the repairs with RS repair having better QoL than TAR repair.

Keywords: carolina comfort scale; quality of life; recurrence; rives-stoppa; tar; ventral hernia.