Complex abdomen: a scoping review
C Stabilini1, S Capoccia Giovannini2, G Campanelli3
1Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Policlinico San Martino Hospital, Genoa, Italy.
This review maps surgical management for complex abdominal wall hernias (CA), finding patient factors and hernia size impact outcomes. Synthetic meshes show promise in contaminated cases, but more research is needed.
Area of Science:
- Abdominal Wall Surgery
- Hernia Repair
- Surgical Management
Background:
- Complex abdominal wall hernias (CA) present significant surgical challenges.
- Outcomes are influenced by patient-specific factors and hernia characteristics.
Purpose of the Study:
- To systematically review evidence on surgical management of CA.
- To identify research gaps and areas for clinical improvement in CA repair.
Main Methods:
- Scoping review of PubMed and Scopus (Jan 2015 - June 2024).
- Included 357 articles (303 primary studies, 54 systematic reviews).
- Classified studies by patient factors (P), hernia features (H), and contamination (W).
Main Results:
- Obesity and comorbidities correlate with higher morbidity and recurrence.
- Large defects and loss of domain increase complication rates.
- Component separation and botulinum toxin show potential; synthetic meshes outperform biologics in contaminated settings.
Conclusions:
- CA surgery is complex with variable outcomes.
- Component separation and synthetic meshes are promising.
- High-quality randomized trials are needed for standardized protocols.
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