Complex Abdominal Wall Hernias: A Multicenter Cohort Study

Abstract Introduction The TAR description has revolutionized complex abdominal wall surgery, providing solutions to previously challenging issues. We acknowledge its associated morbidity, low recurrence rates, and short-term improvement in quality of life. However, its long-term impact on patients' quality of life remains unknown. Material and Methods prospective study of consecutive patients undergoing transverse abdominis release (TAR) for complex abdominal hernias between 2014 and 2017 in four different centers with a minimum of 5-year follow-up. Demographics, operative and postoperative variables were analyzed. Preoperative quality of life assessments (EuraHS QoL) was conducted, along with follow-ups at one and two years postoperatively. A fourth assessment was performed more than five years after the intervention, incorporating the use of the Carolina's Comfort Scale on this occasion. Results A total of 60 patients undergoing TAR were included. The mean follow-up was 82 months. Of them, 59,6% were men and 40,4% women. The mean age was 61 (52–69) years. The EuraHS QoL score significantly improved compared to the preoperative score in terms of pain, aesthetic perception and physical functioning (p 0,0001). The Carolina’s Comfort Scale after 5 years showed a low incidence of mesh sensation, pain related to mesh and limitation for movements or physical exercise. Conclusions The TAR technique for complex abdominal wall hernias improves long-term quality of life after surgery with a low incidence of postoperative chronic pain and functional impairment.