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Reconstruction of abdominal wall

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https://www.readbyqxmd.com/read/29141786/intraluminal-thrombus-is-associated-with-early-rupture-of-abdominal-aortic-aneurysm
#1
Stephen J Haller, Jeffrey D Crawford, Katherine M Courchaine, Colin J Bohannan, Gregory J Landry, Gregory L Moneta, Amir F Azarbal, Sandra Rugonyi
BACKGROUND: The implications of intraluminal thrombus (ILT) in abdominal aortic aneurysm (AAA) are currently unclear. Previous studies have demonstrated that ILT provides a biomechanical advantage by decreasing wall stress, whereas other studies have associated ILT with aortic wall weakening. It is further unclear why some aneurysms rupture at much smaller diameters than others. In this study, we sought to explore the association between ILT and risk of AAA rupture, particularly in small aneurysms...
November 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29116312/malignant-transformation-of-abdominal-wall-endometriosis-to-clear-cell-carcinoma-case-report
#2
João Kleber de Almeida Gentile, Renato Migliore, Fábio Jorge Neubaner Kistenmacker, Marcio Menezes de Oliveira, Rodrigo Biscuola Garcia, Fang Chia Bin, Pedro Marcos Santinho Bueno de Souza, José César Assef
BACKGROUND: Malignant transformation of endometriosis in the abdominal wall is a rare and still poorly understood event. Less than 30 cases have been reported in the worldwide literature. Most cases of solid tumors are report in a previous abdominal scar with malignant transformation of a focus of endometriosis. Presence of lymph node metastases in nearby chains is frequent and is associated with poor prognosis. CASE REPORT: We report a case of a 42-year-old woman with a history of abdominal surgery (Pfannenstiel) to resect abdominal wall endometriosis...
November 6, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/29112945/biomechanical-changes-during-abdominal-aortic-aneurysm-growth
#3
Raoul R F Stevens, Andrii Grytsan, Jacopo Biasetti, Joy Roy, Moritz Lindquist Liljeqvist, T Christian Gasser
The biomechanics-based Abdominal Aortic Aneurysm (AAA) rupture risk assessment has gained considerable scientific and clinical momentum. However, such studies have mainly focused on information at a single time point, and little is known about how AAA properties change over time. Consequently, the present study explored how geometry, wall stress-related and blood flow-related biomechanical properties change during AAA expansion. Four patients with a total of 23 Computed Tomography-Angiography (CT-A) scans at different time points were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/29074444/porcine-abdominal-cutaneous-flap-model-a-simple-and-reliable-method
#4
R Lartizien, M Bouyer, L Vinit, G Bettega
The increase of reconstructive microsurgery procedures leads to the development of various technologies. Before being validated in human clinical studies, these technologies and devices need to be validated on animal models. We present a simple, reliable and reproducible model of a cutaneous flap in pigs. This flap is pedicled on the superficial inferior epigastric pedicle (SIEP). The surgical technique is described. This flap can be buried and, if necessary, harvested on both sides. It did not alter the abdominal wall, and so it has allowed painless long-term follow-up of the animals...
October 23, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29073726/reconstruction-of-extensive-thoracic-wall-defect-using-the-external-oblique-myocutaneous-flap-an-analysis-on-20-chinese-patients-with-locally-advanced-soft-tissue-sarcoma
#5
Chun-Meng Wang, Ruming Zhang, Peng Luo, Zhiqiang Wu, Biqiang Zheng, Yong Chen, Yingqiang Shi
BACKGROUND: Soft tissue sarcomas are rare neoplasms that can occur in the thoracic wall, abdominal wall, extremities, and inguinal region. Wide local resection, with precise histological margin control, results in large skin defects that are challenging to close. Various repair procedures, such as vertical rectus abdominis flaps (VRAM), latissimus dorsi flaps, and tensor fascia lata (TFL) flaps are used to cover broad thoracic wall defects. Although the cosmetic reconstruction results of using these flaps are often excellent, each has significant drawbacks...
October 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29068903/redefining-the-rectus-sheath-implications-for-abdominal-wall-repair
#6
Imran R A Punekar, Joseph S Khouri, Michael Catanzaro, Aizaz L Shaikh, Howard N Langstein
BACKGROUND: The abdominal wall is frequently manipulated in a variety of reconstructive procedures, and its anatomy is well described. Our clinical observations, however, contradict the standard depiction of the components of the abdominal wall at various levels - particularly regarding the course of the transversus abdominis muscle (TA). Therefore, we sought to characterize the components of the rectus sheath at various anatomic levels corresponding to surgical landmarks in order to define key points relevant to abdominal wall repair...
October 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29063447/stage-iv-gastric-cancer-successfully-treated-by-multidisciplinary-therapy-including-chemotherapy-immunotherapy-and-surgery-a-case-report
#7
Makoto Kawamoto, Hideya Onishi, Norihiro Koya, Hiroyuki Konomi, Kenji Mitsugi, Risa Tanaka, Junichi Motoshita, Takashi Morisaki, Masafumi Nakamura
BACKGROUND: The prognosis of stage IV gastric cancer (GC) still remains unfavorable. Multidisciplinary approaches should therefore be considered to improve the survival of patients with stage IV GC. We report here a case of primary GC with potentially unresectable metastasis, successfully treated by a multidisciplinary approach including chemotherapy, immunotherapy, and surgery. CASE PRESENTATION: A 74-year-old man presented with multiple left neck masses. Abdominal computed tomography showed a thickened gastric wall and multiple lymphadenopathies including left supraclavicular lymph node...
October 23, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29046098/infection-of-ptfe-mesh-15-years-following-pedicled-tram-flap-breast-reconstruction-mechanism-and-aetiology
#8
A Elfaki, A Gkorila, M Khatib, C M Malata
The pedicled transverse rectus abdominis myocutaneous (TRAM) flap procedure is still widely used for breast reconstruction. The repair of the flap harvest site in the transverse rectus abdominis muscle and sheath is often assisted by the use of prosthetic meshes. This decreases the risk of abdominal wall weakness and herniation but, being a foreign body, it also carries the risk of infection. In this report, we describe the case of a 63-year-old patient who, whilst receiving chemotherapy for metastatic breast cancer, presented with an infected polytetrafluoroethylene mesh 15 years after pedicled TRAM flap immediate breast reconstruction...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29035177/use-of-epidural-analgesia-as-an-adjunct-in-elective-abdominal-wall-reconstruction-a-review-of-4983-cases
#9
Efstathios Karamanos, Sophie Dream, Anthony Falvo, Nathan Schmoekel, Aamir Siddiqui
CONTEXT: Use of epidural analgesia in patients undergoing elective abdominal wall reconstruction is common. OBJECTIVE: To assess the impact of epidural analgesia in patients undergoing abdominal wall reconstruction. DESIGN: All patients who underwent elective ventral hernia repair from 2005 to 2014 were retrospectively identified. Patients were divided into two groups by the postoperative use of epidural analgesics as an adjunct analgesic method...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29030835/a-new-technique-for-tension-free-reconstruction-in-large-incisional-hernia
#10
Gabriele Munegato, Landino Fei, Michele Schiano di Visconte, Danilo Da Ros, Luana Moras, Gabriele Bellio
In the surgical management of large incisional hernias, the main target is the closure of the abdominal wall defect on the midline without a dangerous increase in the intraabdominal pressure. In this setting, new intraperitoneal prosthesis and components separation techniques were proposed to solve this problem. Both solutions present some critical issues. A new surgical approach with a free lateral double layer prosthesis totally in polypropylene both sides (FLaPp(®)) is proposed to overcome this problem...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29026517/dermatofibrosarcoma-protuberans-coexisting-in-a-patient-with-a-vascular-malformation-a-rare-coincidence
#11
Parthena Deskoulidi, Michael Sofopoulos, Pantelis Diamantopoulos, Thaleia Nikolaidou, Nikolaos Maltzaris, Maria Theodorakopoulou, Christos Klonaris, Niki Arnogiannaki, Maria Kotrotsiou, Spiros Stavrianos
Dermatofibrosarcoma protuberans with fibrosarcomatous differentiation (DFSP-FS) is a rare soft tissue tumor with more aggressive behavior and it is not clear what causes this type of skin cancer. We describe the case of a 48-year-old woman who was born with a vascular malformation in the sternal region and presented suddenly with a soft tissue sarcoma (DFSP-FS) in the same territory. She was initially treated by embolization as the sarcoma was misdiagnosed but the tumor within 6 months seemed to be growing rapidly and reached a giant dimension with ulceration and required surgical intervention...
October 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28958281/an-innovative-way-to-separate-gastrointestinal-and-abdominal-wall-reconstruction-after-complex-abdominal-trauma
#12
David H Livingston, David V Feliciano
Despite advances in trauma care, a subset of patients surviving damage control cannot achieve fascial closure and require split-thickness skin grafting (STSG) of their open abdomen. Controversy exists as to whether reconstruction of the gastrointestine (GI) should be staged or performed at the time of abdominal wall reconstruction (AWR). Many surgeons do not believe that operations through the STSG can be completed safely or without loss of graft. This series reviews the outcomes of operations for GI reconstruction performed through the elevated healed STSG...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958271/operative-outcomes-after-open-abdominal-wall-reconstruction-with-retromuscular-mesh-fixation-using-fibrin-glue-versus-transfascial-sutures
#13
COMPARATIVE STUDY
Adam S Weltz, Udai S Sibia, H Reza Zahiri, Alexa Schoeneborn, Adrian Park, Igor Belyansky
Ideal fixation techniques have not been fully elucidated at the time of complex open abdominal wall reconstruction (AWR). We compared operative outcomes and quality of life with retromuscular mesh fixation using fibrin glue (FG) versus transfascial sutures (TS). Retrospective review identified complex hernia patients who underwent open AWR with mesh from November 2012 through April 2016. Multivariate analysis examined postoperative outcomes between groups. Quality of life was assessed using the Carolinas Comfort Scale...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28953519/the-use-of-bilayered-fascia-lata-with-an-interpositional-omental-flap-for-autologous-repair-of-contaminated-abdominal-fascial-defects
#14
Hui Chai Fong, Bien-Keem Tan, Pierce Kh Chow, Hock Soo Ong
INTRODUCTION: Contaminated abdominal fascial defects, such as those seen in enterocutaneous fistula, or wound dehiscence with mesh exposure, are a significant source of morbidity and present unique reconstructive challenges. We present our technique of using the fascia lata, augmented with an interpositional omental flap, for complete autologous reconstruction of contaminated fascial defects, and the postoperative results of 3 cases. METHODS: Three patients with contaminated abdominal defects underwent wound debridement/fistula resection and immediate reconstruction with fascia lata and omentum flap...
November 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28917217/post-operative-c-reactive-protein-profile-following-abdominal-wall-reconstruction-with-transversus-abdominis-posterior-components-separation
#15
A Pearce, L Thornton, P A Sutton, C J Walsh
INTRODUCTION: Abdominal wall reconstruction using posterior component separation with transversus abdominis release (AWTAR) produces a unique post-operative CRP profile, when compared to routine elective colorectal operations. Therefore, we aim to establish the normal post-operative C-reactive protein (poCRP) profile following AWRTAR and reduce the unnecessary invasive interventions in patients already at greater risk of septic complications. METHODS: A retrospective analysis of daily poCRP levels was performed both for patients who underwent uncomplicated AWRTAR (n=12), and a comparator group of uncomplicated open right hemicolectomies (RH) matched for age and sex (n=24)...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28917019/the-trend-toward-minimally-invasive-complex-abdominal-wall-reconstruction-is-it-worth-it
#16
Igor Belyansky, Adam S Weltz, Udai S Sibia, Justin J Turcotte, Haley Taylor, H Reza Zahiri, T Robert Turner, Adrian Park
BACKGROUND: Open abdominal wall reconstruction (AWR) was previously one of the only methods available to treat complex ventral hernias. We set out to identify the impact of laparoscopy and robotics on our AWR program by performing an economic analysis before and after the institution of minimally invasive AWR. METHODS: We retrospectively reviewed inpatient hospital costs and economic factors for a consecutive series of 104 AWR cases that utilized separation of components technique (57 open, 38 laparoscopic, 9 robotic)...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28906567/self-calibrating-wave-encoded-variable-density-single-shot-fast-spin-echo-imaging
#17
Feiyu Chen, Valentina Taviani, Jonathan I Tamir, Joseph Y Cheng, Tao Zhang, Qiong Song, Brian A Hargreaves, John M Pauly, Shreyas S Vasanawala
BACKGROUND: It is highly desirable in clinical abdominal MR scans to accelerate single-shot fast spin echo (SSFSE) imaging and reduce blurring due to T2 decay and partial-Fourier acquisition. PURPOSE: To develop and investigate the clinical feasibility of wave-encoded variable-density SSFSE imaging for improved image quality and scan time reduction. STUDY TYPE: Prospective controlled clinical trial. SUBJECTS: With Institutional Review Board approval and informed consent, the proposed method was assessed on 20 consecutive adult patients (10 male, 10 female, range, 24-84 years)...
September 14, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28904708/-latissimus-dorsi-flap-in-reconstruction-following-treatment-of-giant-tumor-of-the-abdominal-wall-about-a-rare-case
#18
Karim Bourra, Samir El Mazouz
We report the case of a 16-year old patient presenting with giant, multinodular, mesenchymal tumor of the abdominal wall occupying the left abdominal region and measuring 25 cm on the vertical axis, 20 cm on the transverse axis, mobile when compared with the deep structures and gradually increasing in volume over childhood and neglected. After small biopsy, which showed desmoid tumor, the patient underwent complete surgical resection of the tumor with immediate reconstruction by free muscolo skin flap of the latissimus dorsi attached to the large blood vessels of the inguinal fold (left iliac artery and left external iliac vein), connected by termino lateral anastomosis...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28887252/correlation-of-intraluminal-thrombus-deposition-biomechanics-and-hemodynamics-with-surface-growth-and-rupture-in-abdominal-aortic-aneurysm-application-in-a-clinical-paradigm
#19
Eleni Metaxa, Konstantinos Tzirakis, Nikolaos Kontopodis, Christos V Ioannou, Yannis Papaharilaou
BACKGROUND: The natural history of abdominal aortic aneurysm (AAA) can be investigated through longitudinal evaluation of localized aneurysm characteristics exploiting clinical images. The major challenge is to identify corresponding regions between follow-ups. We have recently developed an algorithm (VascForm) based on nonrigid registration that can obtain surface correspondence and quantify surface growth distribution. METHODS: A ruptured AAA with an initial computed tomography scan 2 years ago was studied...
September 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28871371/management-of-skin-and-subcutaneous-tissue-in-complex-open-abdominal-wall-reconstruction
#20
REVIEW
I Khansa, J E Janis
PURPOSE: Open abdominal wall reconstruction is often a complex endeavor, usually performed on patients with multiple risk factors and co-morbidities. METHODS: In this article, we review soft tissue management techniques that can optimize the skin and subcutaneous tissue, with the goal of reducing surgical-site occurrences. RESULTS: Regardless of the hernia repair technique used, outcomes can be highly dependent on the appropriate management of the skin and subcutaneous tissue...
September 4, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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