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Complex hernia

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https://www.readbyqxmd.com/read/28316313/flank-hernia-repair-with-suture-anchor-mesh-fixation-to-the-iliac-crest
#1
Kaushik Mukherjee, Richard S Miller
Traumatic or postsurgical flank hernias are complex and prone to recurrence, particularly at the border of the iliac crest. We reviewed our experience using suture anchors drilled into the iliac crest to fixate the mesh to bone. Our study of 10 repairs in eight patients was Institutional Review Board exempt. We obtained demographics, body mass index, diabetes, methicillin-resistant Staphylococcus aureus (MRSA) history, smoking status, steroid use, number of prior repairs, defect size, mesh size, number of anchors, and recurrence and infection at follow-up...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28314387/twin-pregnancy-complicated-by-esophageal-atresia-duodenal-atresia-gastric-perforation-and-hypoplastic-left-heart-structures-in-one-twin-a-case-report-and-review-of-the-literature
#2
Mohamad K Abou Chaar, Mariana L Meyers, Bethany D Tucker, Henry L Galan, Kenneth W Liechty, Timothy M Crombleholme, Ahmed I Marwan
BACKGROUND: The antenatal diagnosis of a combined esophageal atresia without tracheoesophageal fistula and duodenal atresia with or without gastric perforation is a rare occurrence. These diagnoses are difficult and can be suspected on ultrasound by nonspecific findings including a small stomach and polyhydramnios. Fetal magnetic resonance imaging adds significant anatomical detail and can aid in the diagnosis of these complicated cases. Upon an extensive literature review, there are no reports documenting these combined findings in a twin pregnancy...
March 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28303347/genome-wide-enrichment-of-damaging-de-novo-variants-in-patients-with-isolated-and-complex-congenital-diaphragmatic-hernia
#3
Mauro Longoni, Frances A High, Hongjian Qi, Maliackal P Joy, Regis Hila, Caroline M Coletti, Julia Wynn, Maria Loscertales, Linshan Shan, Carol J Bult, Jay M Wilson, Yufeng Shen, Wendy K Chung, Patricia K Donahoe
Congenital Diaphragmatic Hernia (CDH) is a common and often lethal birth defect characterized by diaphragmatic structural defects and pulmonary hypoplasia. CDH is isolated in 60% of newborns, but may also be part of a complex phenotype with additional anomalies. We performed whole exome sequencing (WES) on 87 individuals with isolated or complex CDH and on their unaffected parents, to assess the contribution of de novo mutations in the etiology of diaphragmatic and pulmonary defects and to identify new candidate genes...
March 16, 2017: Human Genetics
https://www.readbyqxmd.com/read/28303285/-evidence-based-tapp-technique
#4
R Bittner
Transabdominal preperitoneal patch plasty (TAPP) is the most frequently used surgical technique for repair of an inguinal hernia in German hospitals (Federal Statistical Office, Wiesbaden). Since its initial description in 1992 by Arregui the technique has been further developed and completely standardized, so that TAPP is now suitable as an operation performed by trainee surgeons despite the complex technique. The individual operation stages have been described by many experts mainly based on their own experiences, training with other experts, participation in meetings with live or video demonstrations and reports in the literature...
March 16, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28302520/complex-hernias-with-loss-of-domain-in-morbidly-obese-patients-role-of-laparoscopic-sleeve-gastrectomy-in-a-multi-step-approach
#5
Yves Borbély, Jens Zerkowski, Julia Altmeier, Anna Eschenburg, Dino Kröll, Philipp Nett
BACKGROUND: Morbid obesity and its associated co-morbidities are risk factors for the development of abdominal hernias, add complexity to their repair, and increase perioperative risk. Repair of hernias with loss of domain (LoD) is further complicated by risk of abdominal compartment syndrome. A staged concept with an initial weight loss procedure might enable a reposition of the herniated viscera, improve co-morbidities for, and prohibit abdominal compartment syndrome in the subsequent repair...
January 27, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28301893/congenital-diaphragmatic-hernia-the-side-of-diaphragmatic-defect-and-associated-nondiaphragmatic-malformations
#6
Ruža Grizelj, Katarina Bojanić, Jurica Vuković, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
Background Congenital diaphragmatic hernia (CDH) has different clinical presentations depending on whether it is right sided (R-CDH) or left sided (L-CDH). Some have suggested that L-CDH and R-CDH may represent different syndromic phenotypes. This theory would be indirectly supported if different nondiaphragmatic anomalies were associated with laterality. We assessed whether CDH laterality is associated with specific types of nondiaphragmatic anomalies. Methods Cases of CDH were retrospectively identified from five centers, and associated congenital anomalies, prenatal diagnosis, demographics, birth characteristics, and side of the CDH were analyzed...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28297581/systemic-delivery-of-bone-marrow-mesenchymal-stem-cells-for-in-situ-intervertebral-disc-regeneration
#7
Carla Cunha, Catarina R Almeida, Maria Inês Almeida, Andreia M Silva, Maria Molinos, Sofia Lamas, Catarina L Pereira, Graciosa Q Teixeira, António T Monteiro, Susana G Santos, Raquel M Gonçalves, Mário A Barbosa
Cell therapies for intervertebral disc (IVD) regeneration presently rely on transplantation of IVD cells or stem cells directly to the lesion site. Still, the harsh IVD environment, with low irrigation and high mechanical stress, challenges cell administration and survival. In this study, we addressed systemic transplantation of allogeneic bone marrow mesenchymal stem cells (MSCs) intravenously into a rat IVD lesion model, exploring tissue regeneration via cell signaling to the lesion site. MSC transplantation was performed 24 hours after injury, in parallel with dermal fibroblasts as a control; 2 weeks after transplantation, animals were killed...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28282003/complex-ventral-hernia-repair-with-acellular-dermal-matrices-clinical-and-quality-of-life-outcomes
#8
John Scott Roth, Amanda Zachem, Margaret A Plymale, Daniel L Davenport
Acellular dermal matrices (ADMs) are used in conjunction with complex hernia repair, but their efficacy is often debated. This study assesses clinical and quality of life (QOL) outcomes in multiply comorbid patients undergoing complex ventral hernia repair using ADMs. After obtaining institutional review board approval, a prospective study was conducted evaluating patients undergoing complex ventral incisional hernia repair with abdominal wall reconstruction (AWR) using either human (Flex HD) or porcine ADM (Strattice)...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28265733/major-complex-abdominal-wall-repair-in-contaminated-fields-with-use-of-a-non-cross-linked-biologic-mesh-a-dual-institutional-experience
#9
J J Atema, E J Furnée, Y Maeda, J Warusavitarne, P J Tanis, W A Bemelman, C J Vaizey, M A Boermeester
BACKGROUND: Data on the use of biologic mesh in abdominal wall repair in complex cases remain sparse. Aim of this study was to evaluate a non-cross-linked porcine acellular dermal matrix for repair of complex contaminated abdominal wall defects. METHODS: Retrospective observational cohort study of consecutive patients undergoing abdominal wall repair with use of Strattice™ Reconstructive Tissue Matrix (LifeCell Corporation, Oxford, UK) between January 2011 and February 2015 at two National Intestinal Failure Units...
March 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28255618/absent-external-oblique-musculo-aponeurotic-complex-during-inguinal-hernioplasty-a-case-report-and-review-of-literature
#10
Royson Dsouza, Nachiket Shankar, Rohin Gurubatham, Wesley Rajaleelan, Nandakumar Menon
The external oblique musculo-aponeurotic complex is an important contributor to the strength of the inguinal canal. The present case report describes the bilateral absence of the external oblique muscle in a patient. A 40-year-old male patient presented with a history of intermittent lower abdominal pain for 15 years which had increased over the past 2 years. Abdominal examination revealed bilateral reducible, incomplete, direct inguinal hernia. Elective bilateral Lichtenstein's mesh hernioplasty was planned for the patient...
March 3, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28251844/overview-of-pathophysiological-features-of-gerd
#11
Paolo Usai Satta, Francesco Oppia, Francesco Cabras
Gastro-esophageal reflux disease (GERD) is a very prevalent condition and has a high impact on the quality of life. Nevertheless, pathophysiology is complex and multi-factorial. Several mechanisms have been proposed: decreased salivation, decreased lower esophageal sphincter pressure resting tone, presence of hiatal hernia, increased number of transient lower esophageal sphincter relaxations, increased acid, and pepsin secretion, duodeno-gastro-esophageal reflux of bile acids and trypsin. Other factors contributing to the pathophysiology of GERD include poor esophageal clearance, delayed gastric emptying and impaired mucosal defensive factors...
March 1, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28228200/complex-ventral-hernia-repair-with-acellular-dermal-matrices-clinical-and-quality-of-life-outcomes
#12
John Scott Roth, Amanda Zachem, Margaret A Plymale, Daniel L Davenport
Acellular dermal matrices (ADMs) are used in conjunction with complex hernia repair, but their efficacy is often debated. This study assesses clinical and quality of life (QOL) outcomes in multiply comorbid patients undergoing complex ventral hernia repair using ADMs. After obtaining institutional review board approval, a prospective study was conducted evaluating patients undergoing complex ventral incisional hernia repair with abdominal wall reconstruction (AWR) using either human (Flex HD) or porcine ADM (Strattice)...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28219909/atypical-presentation-of-a-spontaneous-coeliac-artery-dissection-resulting-in-jejunal-ischaemia
#13
Jayan George, Harsh Nathani, Andrew Hu, Ahmed Al-Mukhtar
We describe a case of a 59-year-old man with no significant medical history apart from a hiatus hernia and depression who presented with periumbilical pain which woke him at night. Before this he had 6 weeks of generalised abdominal pain. Blood tests were relatively normal and CT revealed some ill-defined stranding around the coeliac artery. He was diagnosed with a spontaneous coeliac artery dissection. Given the complexity of the case, a multidisciplinary team approach was adopted. He was managed conservatively and improved significantly over the next few days...
February 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28217988/complex-abdominal-wall-defect-repair-using-biologic-porcine-matrix
#14
Eleftherios Gialamas, Alexandre Balaphas, Michela Assalino, Philippe Morel, Christian Toso, Wojciech Staszewicz
BACKGROUND: The management of patients with complex abdominal wall defect (CAWD) is challenging, and requires appropriate surgical planning, and intensive patient preparation in order to minimize postoperative complications. The aim of this work was to review the management of CAWD using one-stage repair with biologic mesh. METHODS: We retrospectively reviewed patients with CAWD having undergone repair with biologic mesh between January 2013 and October 2014. Demographics, preoperative assessment, intraoperative management and postoperative outcomes were assessed...
February 17, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28202162/trends-in-open-abdominal-surgery-in-the-united-states-observations-from-9-950-759-discharges-using-the-2009-2013-national-inpatient-sample-nis-datasets
#15
Martin J Carney, Jason M Weissler, Justin P Fox, Michael G Tecce, Jesse Y Hsu, John P Fischer
INTRODUCTION: Incisional hernia (IH) represents a complex and costly surgical complication. We aim to address trends in open surgery to better understand potential drivers of hernia risk. MATERIAL AND METHODS: Using the 2009-2013 NIS, a cross-sectional review of hospital discharges associated with an open abdominal surgery was performed. RESULTS: Between 2009 and 2013, there were nearly 10 million discharges associated with an open abdominal surgery...
January 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28195304/association-between-psychological-health-and-wound-complications-after-surgery
#16
P Britteon, N Cullum, M Sutton
BACKGROUND: Surgical wound complications remain a major cause of morbidity, leading to higher costs and reduced quality of life. Although psychological health is widely considered to affect wound healing, the evidence on wound outcomes after surgery is mixed. Studies generally focus on small samples of patients undergoing a specific procedure and have limited statistical power. METHODS: This study investigated the relationship between three different measures of anxiety and/or depression and seven adverse surgical outcomes using observational data collected before and after surgery between 2009 and 2011...
February 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28190559/use-of-renal-near-infrared-spectroscopy-measurements-in-congenital-diaphragmatic-hernia-patients-on-ecmo
#17
Patricio E Lau, Stephanie Cruz, Joseph Garcia-Prats, Milenka Cuevas, Christopher Rhee, Darrell L Cass, Sarah E Horne, Timothy C Lee, Stephen E Welty, Oluyinka O Olutoye
INTRODUCTION: This study tests the hypothesis that renal tissue oxygen saturation as measured by Near Infrared Spectroscopy (NIRS) would correlate with urine output in neonates with congenital diaphragmatic hernia (CDH) on extracorporeal membrane oxygenation (ECMO). METHODS: Between 2012 and 2015, neonates with CDH were enrolled as part of a comprehensive study that provided renal/cerebral/abdominal NIRS monitoring for the duration of ECMO support. Continuous NIRS measurements, mean arterial pressure, and urine output were recorded...
January 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28187028/comparison-of-surgeon-specialty-in-open-ventral-hernia-repair
#18
Chris M Reid, Michael G Brandel, Amanda A Gosman
BACKGROUND: Ventral hernia repair is a common procedure and is undertaken by surgeons with varying training backgrounds. Outcomes after hernia repair depend on numerous factors, some being patient or surgeon specific. It remains unclear what the ideal roles are for general and plastic surgeons in open ventral hernia repair. We hypothesized that open ventral hernia repair by plastic surgeons is safe and comparable with general surgeons. METHODS: We performed a retrospective observational study using data from the National Surgical Quality Improvement Program database from 2007 to 2013...
February 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28164052/treatment-of-stiff-elbow-in-young-patients-with-interpositional-arthroplasty-for-mobility-case-series
#19
R Sivakumar, V SomaSheker, Prahalad Kumar Shingi, T Vinoth, M Chidambaram
INTRODUCTION: The elbow is a complex joint involving many articulations and complex biomechanics come into play. Elbow motion is crucial to upper limb movement that loss of 50% of elbow function equals to loss of 80% of upper extremity global function. Restoring movement and stability is challenging to the surgeon while treating a stiff elbow. Unlike other arthroplasties of hip and knee, total elbow arthroplasty (TEA) may not be a primary treatment. Interpositional arthroplasty (IPA) can be considered a viable option in posttraumatic arthritis of elbow in young patients...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28140767/ruptured-abdominal-aneurysm-disguised-as-an-incarcerated-inguinal-hernia
#20
J Colpaert, B Willaert, Y Van Molhem
An incarcerated inguinal hernia is a textbook example of a basic and straightforward diagnosis. In rare cases, an incarcerated hernia may be a symptom of more complex underlying pathology. In this case report a patient with a ruptured abdominal aortic aneurysm presented with an incarcerated left inguinal hernia. Only two other cases have been reported with a stable patient at initial presentation. The diagnosis was suspected when blood seeping next to the internal inguinal ring was detected, and an urgent ultrasound in the operating room confirmed the diagnosis...
January 31, 2017: Acta Chirurgica Belgica
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