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Reconstruction of abdominal wall

Dragoş Predescu, Silviu Constantinoiu
Background: A few decades ago, esophageal substitution was mainly dedicated particularly in postcaustic esophageal stenosis; currently, the reconstruction has expanded its palette of indications to other areas of benign esophageal pathology (severe motor disorders, esophageal achalasia with multiple relapses, peptic stenosis, etc.) but has also become a quasi-obligatory final time in the esophagectomy for cancer whenever it is possible. The techniques of esophageal reconstruction using the stomach, regardless of the indication and the chosen technical option, remain a valuable and effective method...
January 2018: Chirurgia
Alvaro Robin-Lersundi, Luis Blazquez Hernando, Javier López-Monclús, Arturo Cruz Cidoncha, Carlos San Miguel Méndez, Elena Jimenez Cubedo, Miguel Angel García-Ureña
BACKGROUND: Posterior component separation with transversus abdominis release technique is increasingly being used for abdominal wall reconstruction in complex abdominal wall repair. The main purpose of this study is to present a modification of the surgical technique originally described that facilitates the surgical procedure and offers additional advantages. METHODS: Based on the knowledge of the anatomy of the retromuscular space and the preperitoneal aerolar tissue distribution, we start the incision on the posterior rectus sheath from the arcuate line in a down to up direction...
March 3, 2018: Langenbeck's Archives of Surgery
Miguel Costa-Silva, Barbara Ferreira, Ana Brinca, Ricardo Vieira
An 81-year-old woman was admitted with a nodular cutaneous melanoma of the abdominal wall involving the umbilicus. After performing wide excision with 2 cm margin of the melanoma, umbilical reconstruction and defect closure were planned. After careful consideration, we decided to use an island pedicle flap which allowed closure of the defect and reconstruction of the umbilicus.
October 2017: Journal of Cutaneous and Aesthetic Surgery
Assaf A Zeltzer, Randy A De Baerdemaeker, Benoit Hendrickx, Katrin Seidenstücker, Carola Brussaard, Moustapha Hamdi
Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition...
March 1, 2018: Acta Chirurgica Belgica
Angie Zhang, Deniz Dayicioglu
BACKGROUND: The deep inferior epigastric perforator (DIEP) flap has gradually become the superior choice for autologous breast reconstruction because it reduces donor site morbidity, abdominal wall complications, and postoperative recovery time when compared with other flap types. METHODS: The purposes of this study are to report on the experience and clinical outcomes of consecutive DIEP flap breast reconstructions performed by a single surgeon at a cancer center between April 2011 and May 2016 and to characterize the trends among these flaps...
February 23, 2018: Annals of Plastic Surgery
Sergio Henrique Bastos Damous, George Felipe Bezerra Darce, Renato Silveira Leal, Adilson Rodrigues Costa, Pedro Henrique Alves Ferreira, Celso de Oliveira Bernini, Edivaldo Massazo Utiyama
INTRODUCTION: Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. PRESENTATION OF CASE: Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head...
February 15, 2018: International Journal of Surgery Case Reports
Ju Shuai, Li Ying, Ji Chang-Xue, Zhang Biao
OBJECTIVE: To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointestinal bleeding in patients with hepatic schistosomiasis. METHODS: Thirty-three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis (a bleeding group) and 29 schistosomiasis cirrhosis patients without bleeding (a non-bleeding group) were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT...
March 27, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
Salvatore A Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: We evaluated the incidence of and the risk factors for readmission in patients who underwent abdominal wall reconstruction (AWR) using acellular dermal matrix (ADM) and assess whether readmission affects AWR long-term outcomes. METHODS: A retrospective, single-center study of patients underwent AWR with ADM was conducted. The primary outcome was the incidence of unplanned readmission within 30 days after the initial discharge post-AWR. Secondary outcomes were surgical site occurrence (SSO) and hernia recurrence at follow-up...
February 5, 2018: American Journal of Surgery
Jinjian Huang, Youming Deng, Jianan Ren, Guopu Chen, Gefei Wang, Feng Wang, Xiuwen Wu
Injectable hydrogels have been an attractive topic in biomaterials. However, during gelation in vivo, they are easy to disperse due to tissue exudates, thus leading to failure of controlled drug release. To solve this problem, we present a novel polysaccharide-based injectable hydrogel via self-crosslinking of aldehyde-modified xanthan (Xan-CHO) and carboxymethyl-modified chitosan (NOCC). The physical properties were optimized by adjusting the mass ratio of Xan-CHO and NOCC. Experiments revealed that this material exhibited the characteristics of self-healing, anti-enzymatic hydrolysis, biocompatibility and biodegradability...
April 15, 2018: Carbohydrate Polymers
Annika Senghaas, Thomas Kremer, Volker J Schmidt, Leila Harhaus, Christoph Hirche, Ulrich Kneser, Amir K Bigdeli
Despite considerable advances in reconstructive surgery, massive abdominal wall defects continue to pose a significant surgical challenge. We report the case of a 72-year-old morbidly obese female patient with Clostridium septicum-related gas gangrene of the abdominal wall. After multidisciplinary treatment and multiple extensive debridements, a massive full-thickness defect (40 cm × 35 cm) of the right abdominal wall was present. The abdominal contents were covered with a resorbable mesh to prevent evisceration...
February 16, 2018: Microsurgery
Z Song, D Yang, J Yang, X Nie, J Wu, H Song, Y Gu
PURPOSE: Abdominal wall defects caused by neoplasms with large extended resection defects remain a challenging problem. Autologous flaps, meshes, and component separation techniques are effective in reconstructing these defects. We retrospectively reviewed and assessed the success of reconstruction using tensor fascia lata flap with or without meshes. METHODS: 18 patients with abdominal wall neoplasms were identified during the period from 2007 to 2016. A retrospective review of office charts and hospital records was performed...
February 7, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Tatsuhiko Ogawa
BACKGROUND: Desmoid-type fibromatosis is characterized by desmoid tumors, which are benign soft tissue tumors that can be locally aggressive but typically do not metastasize. Desmoid tumors can manifest anywhere in the body, and those in the abdominal cavity account for approximately 30 to 50% of all such tumors. Complete resection with free margins has been the standard treatment, but non-surgical therapies have been implemented recently. However, if tumors are strongly invasive and/or persistently recur, radical surgical resection with free margins remains the primary treatment...
February 7, 2018: Journal of Medical Case Reports
Hugo Palma Rios, André Goulart, Pedro Leão
INTRODUCTION: Performing surgery on patients with Crohn's disease is a true challenge due to the elevated risk of complications related to the chronic proinflammatory response. Stenosis is the leading cause of intestinal resection in these patients. CASE REPORT: The authors present the case of a 50-year-old woman with inflammatory stenosis of the terminal ileum due to Crohn's disease. The patient underwent a laparoscopic ileocecal resection, which was complicated by a small anastomotic dehiscence with localized peritonitis...
January 2018: Wounds: a Compendium of Clinical Research and Practice
Hiroaki Inoue, Takashi Kanazawa, Satoshi Kubota, Souichiro Miyake, Michihiro Ishida, Yasuhiro Chouda
The case involved a 67-year-old man. Type 2 gastric cancer in the body of stomach was discovered, and the patient was referred to this department, where distal gastrectomy with Roux-en-Y reconstruction was carried out. The pathological classification was pT2N2H0P0CY0M0, pStage II B, and S-1 administration was started as postoperative adjuvant therapy. After 10 months of administration, a chest computed tomography(CT)scan revealed fine nodular shadows and irregular thickening of the alveolar septa in both lungs, a finding that was judged to be carcinomatous lymphangiosis...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Isao Arai, Shigeharu Inoue, Ichiro Ohhashi, Chieko Tamura, Kazuya Hiraoka
We herein report an interesting case in which a complete response was achieved with oral anticancer monotherapy for unresectable lymph node metastasis after surgery for cecal cancer. A 78-year-old woman was referred to our hospital to undergo a detailed examination for anemia. The examination led to a diagnosis of cecal cancer. She underwent open right hemicolectomy combined with adjacent abdominal wall resection and reconstruction of abdominal wall defects the next month. During follow-up without adjuvant therapy at her request, right iliac lymph node metastasis was detected 5 months later...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Akemi Watanabe, Hiroyuki Fukunari, Yousuke Kawai, Makoto Aoki, Satoshi Saito, Yuya Umebayashi, Kenji Shitara, Tetsuji Hayashi, Gen Watanabe, Hiroshi Ajioka
A 63-year-old man presented with the chief complaint of an unpleasant feeling in the chest after a meal.Esophagogastroduodenoscopy revealed interminglement of ulcer infiltration type lesions and protruding lesions in the lower esophagus.A large type 1 protruding lesion was located mainly in the esophagogastric junction(EGJ)and it progressed towards the stomach.A hypertrophic and protruding lesion on the lower esophageal wall and a 6 cm tumor in the major axis of the fornix were observed on thoracic and abdominal CT, and an endocrine cell carcinoma or basaloid carcinoma were suggested after biopsy...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
F Köckerling, N N Alam, S A Antoniou, I R Daniels, F Famiglietti, R H Fortelny, M M Heiss, F Kallinowski, I Kyle-Leinhase, F Mayer, M Miserez, A Montgomery, S Morales-Conde, F Muysoms, S K Narang, A Petter-Puchner, W Reinpold, H Scheuerlein, M Smietanski, B Stechemesser, C Strey, G Woeste, N J Smart
INTRODUCTION: Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations...
January 31, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Zhu-Le Wang, Shi-Zhou Wu, Zhi-Feng Li, Jin-Hai Guo, Yi Zhang, Jin-Kui Pi, Jun-Gen Hu, Xi-Jing Yang, Fu-Guo Huang, Hui-Qi Xie
Abdominal wall defects are a common medical problem, and inadequate repair methods can lead to serious complications. Abdominal wall reconstruction using autologous tissue, or non-biological, biological, or composite patches is often performed to repair defective areas. In particular, composite patches containing both polymeric and biological materials have gained increasing attention due to their good mechanical properties and biocompatibility. However, it is still unclear whether the quality of repairs using composite patches is superior to that of a biological patch...
January 29, 2018: Journal of Biomaterials Science. Polymer Edition
Vinay S Gundlapalli, Adeyemi A Ogunleye, Kiandra Scott, Eric Wenzinger, Jason P Ulm, Lance Tavana, Rana C Pullatt, Kevin O Delaney
The deep inferior epigastric perforator (DIEP) flap is a mainstay of autologous breast reconstruction. The da Vinci robot has recently been adapted for an increasing number of reconstructive surgeries. The literature has yet to describe its use for the intra-abdominal harvest of the deep inferior epigastric vessels (DIEV) during DIEP flap breast reconstruction. We show the use of the da Vinci robotic surgical system for the intra-abdominal dissection of DIEV during delayed breast reconstruction with a DIEP flap in a 51-year-old female who had undergone a right modified radical mastectomy...
January 25, 2018: Microsurgery
Takeshi Hijikawa, Hidesuke Yanagida, Masanori Yamada, Kazuhiko Yoshioka, Mayumi Inaba, Hiroaki Kitade
The patient was a 76-year-old man who underwent laparoscopic cholecystectomy with a diagnosis of cholecystolithiasis. Since the definite diagnosis of gallbladder carcinoma was made after the operation, he underwent additional resection. Four years later, he revisited the hospital complaining of painful swelling of the port site of his epigastrium. Magnetic resonance imaging of the abdomen revealed a mass 3.4 cm in diameter at the epigastrium. Thus, port site recurrence of gallbladder carcinoma was the suspected diagnosis...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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