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Primary hernia

Frederik Berrevoet
Management of a patient with an open abdomen is difficult, and the primary closure of the fascial edges is essential to obtain the best patient outcome, regardless of the initial etiology of the open abdomen. The use of temporary abdominal closure devices is nowadays the gold standard to have the highest closure rates with mesh-mediated fascial traction as the proposed standard of care. However, the incidence of incisional hernias, although much more controlled than when leaving an abdomen open, is high and reaches up to 65%...
2018: Frontiers in Surgery
A J Perez, I N Haskins, A S Prabhu, D M Krpata, C Tu, S Rosenblatt, K Hashimoto, T Diago, B Eghtesad, M L J Rosen
Background: Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define. Objective: To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution. Methods: Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016...
2018: International Journal of Organ Transplantation Medicine
Sibylle C Mellinghoff, Jörg Janne Vehreschild, Blasius J Liss, Oliver A Cornely
BACKGROUND: Surgical site infections (SSIs) are among the most common hospital acquired infections. While the incidence of SSI in certain indicator procedures is the subject of ongoing surveillance efforts in hospitals and health care systems around the world, SSI rates vary markedly within surgical categories and are poorly represented by routinely monitored indicator procedures (eg, mastectomy or hernia surgery). Therefore, relying on indicator procedures to estimate the burden of SSI is imprecise and introduces bias as hospitals may take special precautions to achieve lower SSI rates...
March 12, 2018: JMIR Research Protocols
Amit Surve, Daniel Cottam, Andres Sanchez-Pernaute, Antonio Torres, Joshua Roller, Yong Kwon, Joshua Mourot, Bleu Schniederjan, Bo Neichoy, Paul Enochs, Michael Tyner, Jon Bruce, Scott Bovard, Mitchell Roslin, Muhammad Jawad, Andre Teixeira, Myur Srikanth, Jason Free, Hinali Zaveri, David Pilati, Jamie Bull, LeGrand Belnap, Christina Richards, Walter Medlin, Rena Moon, Austin Cottam, Sarah Sabrudin, Samuel Cottam, Aneesh Dhorepatil
BACKGROUND: The single-anastomosis duodenal switch procedure is a type of duodenal switch that involves a loop anastomosis rather than traditional Roux-en-Y reconstruction. To date, there have been no multicenter studies looking at the complications associated with post-pyloric loop reconstruction. OBJECTIVES: The aim of the study was to report the incidence of complications associated with loop duodeno-ileostomy (DI) following single-anastomosis duodenal switch (SADS) procedures...
February 2, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
H Hande Aydinli, Colin Peirce, Erman Aytac, Feza H Remzi
INTRODUCTION: Abdominal wound closure is a challenge in patients undergoing colorectal surgery with a complex history of multiple abdominopelvic operations. Loss of domain of the abdominal fascia because of prior laparotomies precludes the use of simple, everyday abdominal wound closure techniques. Furthermore, ongoing intra-abdominal sepsis, with or without a concurrent entero- or colocutaneous fistula, increases the risk of postoperative morbidity and mortality in this patient population...
April 2018: Diseases of the Colon and Rectum
Arpad Ivanecz, Bojan Krebs, Andraz Stozer, Tomaz Jagric, Irena Plahuta, Stojan Potrc
Background: The aim of the study was to compare the outcome of pure laparoscopic and open simultaneous resection of both the primary colorectal cancer and synchronous colorectal liver metastases (SCLM). Patients and methods: From 2000 to 2016 all patients treated by simultaneous resection were assessed for entry in this single center, clinically nonrandomized trial. A propensity score matching was used to compare the laparoscopic group (LAP) to open surgery group (OPEN)...
March 2018: Radiology and Oncology
Kristoffer Andresen
Inguinal hernias are a protrusion of the peritoneum through a weakening in the groin in which abdominal content (intestines or fat) can herniate and cause a bulge. Inguinal hernias can be painful and require surgery. Worldwide, approximately 20 million patients are operated each year, with 10,000 in Denmark. The repair of inguinal hernias causes pain and 16% of patients experience chronic pain six months after the standard, open, mesh-based Lichtenstein technique. Therefore, surgeons are trying to improve the techniques by finding new ways of operating...
March 2018: Danish Medical Journal
Stina Öberg, Kristoffer Andresen, Tobias W Klausen, Jacob Rosenberg
BACKGROUND: Chronic pain affects 10%-12% of patients after inguinal hernia repairs. Some have suggested that less foreign material may theoretically prevent pain. If the prevalence of chronic pain is less after nonmesh repairs, selected hernias might be repaired without mesh. Our aim was to clarify if nonmesh repairs are superior to mesh repairs regarding chronic pain. METHODS: For this systematic review, searches were conducted in five databases. The main outcome was chronic pain reported a minimum of six months after mesh and nonmesh repair in adult patients with a primary inguinal hernia...
March 2, 2018: Surgery
Sabrina Trippoli, Erminia Caccese, Giorgio Tulli, Pierluigi Ipponi, Claudio Marinai, Andrea Messori
BACKGROUND: In the clinical literature on abdominal hernia repair, no sound criteria have been established to support the use of biological meshes as opposed to synthetic ones. Furthermore, the information on biological meshes is quite scarce, and so their place in therapy has not yet been defined. METHODS: The treatment of primary and incisional ventral hernia was the target intervention evaluated in our analysis. Our study consisted of the following phases: a) Identification of the biologic meshes available on the market; b) Literature search focused on efficacy and safety of these meshes; c) Analysis of the findings derived from the literature search...
March 1, 2018: International Journal of Surgery
Jun Liu, Xin Zheng, Shouxia Chai, Meirong Lei, Zehui Feng, Xuelin Zhang, Violeta Lopez
OBJECTIVE: This study examined the effects of WeChat-assisted perioperative instructions for parents whose children were to undergo herniorrhaphy. METHOD: A randomized controlled trial was conducted in a day surgery center in China. Participants were randomly assigned to the intervention (WeChat) group (n = 209) and the control (Leaflet) group (n = 209). The primary outcomes of this study were parents' knowledge regarding hernia and rate of cancellation of children's surgery...
February 19, 2018: Patient Education and Counseling
Michael J Fitzgerald, Sarah Ullrich, Kumar Singh, Oren Misholy, Peter Kingham, Mary S Brady
Parastomal hernia repair remains a significant surgical challenge. Recurrence after standard "keyhole" or primary suture repair is common. We adopted and modified a new technique using a construct shaped like an inverted top hat. We review our experience over the last six years in the first 30 patients (31 consecutive procedures). Of these 31 procedures, six (19%) resulted in a parastomal hernia recurrence with a median follow-up of 31 months (range 0.5-80). Four of the recurrences occurred in our initial experience, when we constructed the top hat of xenograft alone...
February 22, 2018: American Journal of Surgery
Steve Halligan, Sam G Parker, Andrew A Plumb, Chris Pj Wood, Richard W Bolton, Susan Mallett, Alastair Cj Windsor
OBJECTIVE: Complex ventral hernia repair is performed increasingly, exacerbated by the obesity epidemic. Imaging can characterise hernia morphology and diagnose recurrence. By systematic review we investigated the extent to which studies employ imaging. METHODS: The PubMed database was searched for studies of ventral hernia repair January 1995 to March 2016. Hernias of all size were eligible. Independent reviewers screened articles and extracted data from selected studies related to study design, use of pre- and post-operative hernia imaging, and the proportion of subjects imaged...
February 27, 2018: British Journal of Radiology
Numan Karaarslan, Ibrahim Yilmaz, Hanefi Ozbek, Duygu Sirin Yasar, Necati Kaplan, Yener Akyuva, Aylin Gonultas, Ozkan Ates
AIM: In this scientific research project, the researchers aimed to determine the gene expression patterns of nucleus pulposus (NP) in cell cultures obtained from degenerated or intact tissues. MATERIAL AND METHODS: Whereas 12 of the cases were diagnosed with lumbar disc hernia and had undergone lumbar microdiscectomy, 12 cases had undergone traumatic intervertebral discectomy and corpectomy, along with discectomy after spinal trauma. NP-specific markers and gene expressions of the reagents of the extracellular matrix in the experimental setup were tested at the 0th, 24th, and 48th hours by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR)...
January 22, 2018: Turkish Neurosurgery
J Li, X Zhang, Q Sun, W Li, A Yu, H Fu, K Chen
PURPOSE: Degradation of collagen has been suggested involved in the pathogenesis of inguinal hernia. In this study, we aim to evaluate circulating biomarkers of procollagen type I N-terminal propeptide (PINP), procollagen type III N-terminal propeptide (PIIINP), matrix metalloproteinases (MMP)-2, MMP-9, copper and zinc in primary and recurrent inguinal hernia patients. METHODS: This study included 110 inguinal hernia patients: 45 patients had primary indirect inguinal hernia, 40 patients had primary direct inguinal hernia, 15 patients had recurrent indirect inguinal hernia and 10 patients had recurrent direct inguinal hernia...
February 26, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
In Geol Ho, Kyong Ihn, Eun-Jung Koo, Eun Young Chang, Jung-Tak Oh
PURPOSE: This study aimed to evaluate the usefulness of laparoscopic repair of inguinal hernia (LR) in infants in comparison with open hernia repair (OR). METHODS: We retrospectively analyzed the clinical data of 465 infants treated for inguinal hernia from January 2006 to December 2015. Among them, 124 underwent LR and 341 underwent OR. RESULTS: In the OR group, 16.1% (55/341) primarily underwent bilateral inguinal hernia repair and 13.6% (42/308) subsequently developed metachronous contralateral inguinal hernia during follow-up...
February 7, 2018: Journal of Pediatric Surgery
Tuure Saarinen, Ulla Kettunen, Kirsi H Pietiläinen, Anne Juuti
BACKGROUND: Consensus on the necessity of esophagogastroduodenoscopy (EGD) before bariatric surgery is lacking. Recommendations and practices vary by country and unit. Several reports have expressed concerns on gastroesophageal reflux disease (GERD) and its consequences after sleeve gastrectomy (SG) and the risk of leaving a premalignant lesion in the excluded stomach after Roux-en-Y gastric bypass (RYGB). OBJECTIVES: We explored the number and types of clinically significant findings in preoperative EGDs and how they associate with preexisting GERD-symptoms (SG) and premalignant lesions (RYGB)...
February 14, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Fabio Rondelli, Laura Franco, Ruben Carlo Balzarotti Canger, Graziano Ceccarelli, Cecilia Becattini, Walter Bugiantella
PURPOSE: Surgical site infection (SSI) is one of the most frequent complications after stoma closure and the optimal skin closure technique is still not clear. The goal of this review was to compare outcomes with purse-string closure technique (PSC) versus conventional closure technique (CCT) for skin closure after stoma reversal. METHODS: We performed a systematic review and meta-analysis of available randomized controlled trials (RCTs) to compare SSI rate within 30 days, operative time, hospital stay, incisional hernia and intestinal obstruction rates between PSC and CCT...
February 20, 2018: International Journal of Surgery
Fernando Ruiz-Jasbon, Kristina Ticehurst, Jukka Ahonen, Jonny Norrby, Marie-Lois Ivarsson
Background and Objectives: The role of long-term degradable implants in reducing the risk of chronic postoperative pain after inguinal hernia repair is still unclear. A pilot study using a synthetic long-term resorbable mesh in Lichtenstein repair showed good results regarding pain and discomfort in patients with indirect inguinal hernia (IH) without recurrences, but higher recurrence rate in patients with direct inguinal hernia (DH). The purpose of this study was to assess the incidence of pain and early recurrence in patients with LIH surgically treated with the TEP technique using a long-term degradable mesh...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
C-C Chiang, H-Y Yang, Y-C Hsu
BACKGROUND: While performing unilateral TEP herniorrhaphy, controversy still exists about whether to do contralateral exploration or not. Routine contralateral exploration has been proposed to prevent metachronous contralateral hernias by the repair of incidental contralateral occult hernias. Some surgeons have even proposed to do prophylactic bilateral TEP herniorrhaphy for unilateral hernia patients. To evaluate the appropriateness of not doing contralateral exploration in unilateral TEP herniorrhaphy, we reviewed our experiences under our practice of no contralateral exploration and we also reviewed other published literature...
February 19, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Ruth Kaufmann, Jens A Halm, Hasan H Eker, Pieter J Klitsie, Jeroen Nieuwenhuizen, Dick van Geldere, Maarten P Simons, Erwin van der Harst, Martijne van 't Riet, Bronno van der Holt, Gert Jan Kleinrensink, Johannes Jeekel, Johan F Lange
BACKGROUND: Both mesh and suture repair are used for the treatment of umbilical hernias, but for smaller umbilical hernias (diameter 1-4 cm) there is little evidence whether mesh repair would be beneficial. In this study we aimed to investigate whether use of a mesh was better in reducing recurrence compared with suture repair for smaller umbilical hernias. METHODS: We did a randomised, double-blind, controlled multicentre trial in 12 hospitals (nine in the Netherlands, two in Germany, and one in Italy)...
March 3, 2018: Lancet
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