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Chen J, Wu Y, Wang Y, Zhang B, Tang J, Wang Z, Huang W, Cheng B. Transconjunctival Fat Repositioning Blepharoplasty: Is Excess Fat Herniation a Prerequisite? Plast Reconstr Surg 2024; 153:1039-1046. [PMID: 37220233 DOI: 10.1097/prs.0000000000010726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND The fat repositioning technique has been widely used for the treatment of tear trough deformity, and there is a strong belief that excess fat herniation is a prerequisite for the procedure. The purpose of this study was to evaluate its effect in patients with minimal or no excess fat herniation. METHODS A total of 232 patients underwent the procedure and met the inclusion criteria. Of them, 198 were primary cases, and 34 had a hisory of fat removal for blepharoplasty. The amount of infraorbital fat was evaluated preoperatively by palpation. Release of the tear trough ligament and fat redistribution were sequentially performed as described previously. Surgical outcome was assessed based on the Hirmand grading system and the FACE-Q scales. RESULTS Tear trough deformities were eliminated in more than 85% of cases. Aesthetic results were comparable between the primary and secondary surgery groups. The percentage of patients who complained of extremely or moderately severe tear trough deformities decreased from 86.3% preoperatively to 34.0% postoperatively. The scores of the lower eyelid FACE-Q decreased significantly ( P < 0.05). Patients were satisfied with their decision to undergo blepharoplasty (78.2 ± 18.7). Undercorrection of the tear trough occurred in 30 patients. Other complications included 12 cases of transient conjunctiva bleeding, two cases of eyelid numbness, and six cases of dry eye. These resolved spontaneously. CONCLUSION Fat repositioning is a feasible and effective technique for the treatment of tear trough deformities in patients with minimal or no excess orbital fat herniation, provided that a fat pad is palpable. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Jianwu Chen
- From the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA
| | - Yanhong Wu
- From the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA
| | - Yuzhi Wang
- From the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA
| | - Bin Zhang
- From the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA
| | - Jianbing Tang
- From the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA
| | - Zhongshan Wang
- From the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA
| | - Wenhua Huang
- The Third Affiliated Hospital, Southern Medical University
| | - Biao Cheng
- From the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA
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Jhala H, Thomas M. Cardiac herniation post left upper lobectomy and thymectomy: a case report. J Cardiothorac Surg 2024; 19:231. [PMID: 38627781 PMCID: PMC11020268 DOI: 10.1186/s13019-024-02713-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Cardiac herniation occurs when there is a residual pericardial defect post thoracic surgery and is recognised as a rare but fatal complication. It confers a high mortality and requires immediate surgical correction upon recognition. We present a case of cardiac herniation occurring post thymectomy and left upper lobectomy. CASE PRESENTATION Initial presentation: A 48-year-old male, hypertensive smoker presented with progressive breathlessness and was found to have a left upper zone mass confirmed on CT biopsy as carcinoid of unclear origin. PET-CT revealed avidity in a left anterior mediastinal area, left upper lobe (LUL) lung mass, mediastinal lymph nodes, and a right thymic satellite nodule. Intraoperatively: Access via left thoracotomy and sternotomy. The LUL tumour involved the left thymic lobe (LTL), left superior pulmonary vein (LSPV), left phrenic nerve and intervening mediastinal fat and pericardium, which were resected en-masse. The satellite nodule in the right thymic lobe (RTL) was adjacent to the junction between the left innominate vein and superior vena cava (SVC). The pericardium was resected from the SVC to the left atrial appendage. Clinical deterioration: Initially the patient was doing well clinically on day 1, however there was sudden bradycardia, hypotension, clamminess, and oligoanuria, with raised central venous pressures and troponins. ECG: no capture in leads V1-2, but positive deflections seen on posterior leads. Echo: no acoustic windows, but good windows seen posteriorly. CXR: left mediastinal shift. Redo operation: After initial resuscitation and stabilisation on the intensive care unit, on day 2 a redo-sternotomy revealed cardiac herniation into the left thoracic cavity with the left ventricular apex pointing towards the spine, and inferior caval kinking. After reduction and repair of the pericardial defect with a fenestrated GoreTex patch, the patient recovered well with complete resolution of the ECG and CXR. CONCLUSION Cardiac herniation can even occur following sub-pneumonectomy lung resections and should be considered as a differential when faced with a sudden clinical deterioration, warranting early surgical correction.
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Affiliation(s)
- Hiral Jhala
- Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, G81 4DY, Scotland.
| | - Mathew Thomas
- Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, G81 4DY, Scotland
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Palamuthusingam D, Hawley CM, Pascoe EM, Johnson DW, Palamuthusingam P, Boudville N, Jose MD, Cross NB, Fahim M. Postoperative Outcomes After Gastrointestinal Surgery in Patients Receiving Chronic Kidney Replacement Therapy: A Population-based Cohort Study. Ann Surg 2024; 279:462-470. [PMID: 38084600 DOI: 10.1097/sla.0000000000006179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
OBJECTIVE This study evaluated the postoperative mortality and morbidity outcomes following the different subtypes of gastrointestinal (GI) surgery over a 15-year period. BACKGROUND Patients receiving chronic kidney replacement therapy (KRT) experience higher rates of general surgery compared with other surgery types. Contemporary data on the types of surgeries and their outcomes are lacking. KRT was defined as patients requiring chronic dialysis (hemodialysis or peritoneal dilaysis) or having a functioning kidney transplant long-term. METHODS All incident and prevalent patients aged greater than 18 years identified in the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry as receiving chronic KRT were linked with jurisdictional hospital admission datasets between January 1, 2000 until December 31, 2015. Patients were categorized by their KRT modality [hemodialysis (HD), peritoneal dialysis (PD), home hemodialysis (HHD), and kidney transplant (KT)]. GI surgeries were categorized as upper gastrointestinal (UGI), bowel (small and large bowel), anorectal, hernia surgery, cholecystectomy, and appendicectomy. The primary outcome was the rates of the different surgeries, estimated using Poisson models. Secondary outcomes were risks of 30-day/in-hospital postoperative mortality risk and nonfatal outcomes and were estimated using logistic regression. Independent predictors of 30-day mortality were examined using comorbidity-adjusted Cox models. RESULTS Overall, 46,779 patients on chronic KRT were linked to jurisdictional hospital datasets, and 9,116 patients were identified as having undergone 14,540 GI surgeries with a combined follow-up of 76,593 years. Patients on PD had the highest rates of GI surgery (8 per 100 patient years), with hernia surgery being the most frequent. Patients on PD also had the highest risk of 30-day postoperative mortality following the different types of GI surgery, with the risk being more than 2-fold higher after emergency surgery compared with elective procedures. Infective postoperative complications were more common than cardiac complications. This study also observed a U-shaped association between body mass index (BMI) and mortality, with a nadir in the 30 to 35 kg/m 2 group. CONCLUSIONS Patients on chronic KRT have high rates of GI surgery and morbidity, particularly in those who receive PD, are older, or are either underweight or moderately obese.
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Affiliation(s)
- Dharmenaan Palamuthusingam
- Metro North Kidney Service, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, Australia
- Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
- School of Medicine, Griffith University, Southport, Queensland, Australia
| | - Carmel M Hawley
- Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
- Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Australasian Kidney Trials Network (AKTN), University of Queensland, St Lucia, Queensland, Australia
| | - Elaine M Pascoe
- Centre for Health Services Research, University of Queensland, St Lucia, Queensland, Australia
| | - David Wayne Johnson
- Australasian Kidney Trials Network (AKTN), University of Queensland, St Lucia, Queensland, Australia
- Translational Research Institute, Brisbane, Australia
| | | | - Neil Boudville
- Medical School, University of Western Australia, Stirling Highway, Perth, Western Australia
- Sir Charles Gairdner Hospital, Hospital Ave, Nedlands Western Australia
| | - Matthew D Jose
- Department of Nephrology, Royal Hobart Hospital, Hobart, Tasmania, Australia
- School of Medicine, University of Tasmania, Tasmania, Australia
| | - Nicholas B Cross
- Department of Nephrology, Te Whatu Ora Waitaha Canterbury, Christchurch Hospital, Christchurch, New Zealand
- Senior Clinical Lecturer, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
- Chief Medical Officer, New Zealand Clinical Research, New Zealand
| | - Magid Fahim
- School of Medicine, Griffith University, Southport, Queensland, Australia
- Metro South Kidney and Transplant Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Metro North Health Service, Butterfield Street, Herston, Queensland, Australia
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Parastomal Hernia Following Ileal Conduit: Incidence, Risk Factors, and Health-Related Quality of Life. J Wound Ostomy Continence Nurs 2024; 51:E2. [PMID: 38527322 DOI: 10.1097/WON.0000000000001075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
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Kim D, Choi KH, Kim H, Lee JH, Kim Y, Byun JH. Right lower lung midline herniation as a rare complication in an infant with heart-lung transplantation: A case report. Pediatr Transplant 2024; 28:e14656. [PMID: 37984827 DOI: 10.1111/petr.14656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Lung herniation is a rare complication of heart-lung transplantation that can be fatal owing to vascular compromise and airway obstruction. To date, only five cases of lung herniation related to heart-lung transplantation have been reported in the literature; however, to the best of our knowledge, this is the first worldwide report of heart-lung transplantation-related lung herniation in an infant. METHODS We describe the case of lung herniation as a rare heart-lung transplantation-related complication in an infant. A 12-month-old female baby developed severe bronchopulmonary dysplasia with severe pulmonary hypertension, and she underwent extracorporeal membrane oxygenation for cardiac collapse and lung support. Then, we performed heart-lung transplantation to manage the irreversible deterioration of her lung function. After the heart-lung transplantation, we found the radiological abnormalities persisted on follow-up chest radiographs until the 13th postoperative day diagnosed as lung herniation of the right lower lobe on chest computed tomography. RESULTS After the relocation of the herniated lung, the clinical condition of the patient improved, and the patient is currently growing without any respiratory symptoms. CONCLUSIONS In this case report, we emphasize that clinical awareness and high suspicion of this rare complication are needed for early diagnosis and proper treatment to prevent post-transplantation morbidity and mortality related to potential ischemic injury.
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Affiliation(s)
- Dohyung Kim
- Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Korea
| | - Kwang Ho Choi
- Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Korea
| | - Hyungtae Kim
- Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Korea
| | - Jae Hong Lee
- Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Korea
| | - Younga Kim
- Department of Pediatrics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Korea
| | - Joung-Hee Byun
- Department of Pediatrics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Korea
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Zhou Z, Xiong L, Yao K, Ma H, Wei W, Zhang Z, Guo S, Dong P, Li X, Jiang L, Chen D, Qin Z, Han H, Ye Y, Li Y, Wang Y, Wu Z, Tian L, Yu C, Zhou F, Li Z, Liu Z. Extraperitonealization of the ileal conduit decreases the risk of parastomal hernia: A single-center, randomized clinical trial. Cell Rep Med 2024; 5:101343. [PMID: 38154462 PMCID: PMC10829722 DOI: 10.1016/j.xcrm.2023.101343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/28/2023] [Accepted: 11/23/2023] [Indexed: 12/30/2023]
Abstract
Parastomal hernia (PSH) is a common complication in patients receiving ileal conduit urinary diversion after radical cystectomy. In this randomized controlled clinical trial, we validate our previous finding that extraperitonealization of ileal conduit decreases incidence of PSH. In total, 104 consecutive patients undergoing radical cystectomy at Sun Yat-sen University Cancer Center are randomized 1:1 to receive either modified (extraperitonealized) ileal conduit (n = 52) or conventional ileal conduit (n = 52). Primary endpoint is incidence of radiological PSH during follow-up. Incidence of radiological PSH is lower in the modified group than in the conventional group (11.5% vs. 28.8%; p = 0.028) after a median follow-up of 32 months, corresponding to a hazard ratio of 0.374 (95% confidence interval: 0.145-0.965, p = 0.034) in the modified conduit group. The results support our previous finding that extraperitonealization of the ileal conduit is effective for reducing risk of PSH in patients receiving ileal conduit diversion.
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Affiliation(s)
- Zhaohui Zhou
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Longbin Xiong
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Kai Yao
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Huali Ma
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Wensu Wei
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Zhiling Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Shengjie Guo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Pei Dong
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Xiangdong Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Lijuan Jiang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Dong Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Zike Qin
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Hui Han
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yunlin Ye
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yonghong Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yanjun Wang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Zhiming Wu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Li Tian
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Chunping Yu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Fangjian Zhou
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
| | - Zhiyong Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
| | - Zhuowei Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine Guangzhou, Guangzhou, P.R. China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
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Byers JL, Rao JN, Socci L, Hopkinson DN, Tenconi S, Edwards JG. Costal margin injuries and trans-diaphragmatic intercostal hernia: Presentation, management and outcomes according to the Sheffield classification. J Trauma Acute Care Surg 2023; 95:839-845. [PMID: 37533145 DOI: 10.1097/ta.0000000000004068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
BACKGROUND Costal margin rupture (CMR) injuries are under-diagnosed and inconsistently managed, while carrying significant symptomatic burden. We hypothesized that the Sheffield Classification system of CMR injuries would relate to injury patterns and management options. METHODS Data were collected prospectively between 2006 and 2023 at a major trauma center in the United Kingdom. Computed tomography scans were interrogated and injuries were categorized according to the Sheffield Classification. Clinical, radiologic, management and outcome variables were assessed. RESULTS Fifty-four patients were included in the study. Intercostal hernia (IH) was present in 30 patients and associated with delayed presentation ( p = 0.004), expulsive mechanism of injury (i.e. such as occurs with coughing, sneezing, or retching), higher body mass index ( p < 0.001), and surgical management ( p = 0.02). There was a bimodal distribution of the level of the costal margin rupture, with IH Present and expulsive mechanism injuries occurring predominantly at the ninth costal cartilage, and IH Absent cases and other mechanisms at the seventh costal cartilage ( p < 0.001). There were correlations between the costal cartilage being thin at the site of the CMR and the presence of IH and expulsive etiology ( p < 0.001). Management was conservative in 23 and surgical in 31 cases. Extrathoracic mesh IH repairs were performed in 3, Double Layer Mesh Repairs in 8, Suture IH repairs in 5, CMR plating in 8, CMR sutures in 2, and associated Surgical Stabilization of Rib Fractures in 11 patients. There was one postoperative death. There were seven repeat surgical procedures in five patients. CONCLUSION The Sheffield Classification is associated statistically with presentation, related chest wall injury patterns, and type of definitive management. Further collaborative data collection is required to determine the optimal management strategies. LEVEL OF EVIDENCE Therapeutic/Care Management; Level III.
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Affiliation(s)
- Jonathan L Byers
- From the Department of Thoracic Surgery, Sheffield Teaching Hospitals NHS Trust, Sheffield, England
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Parmeshwar N, Lem M, Dugan CL, Piper M. Evaluating mesh use for abdominal donor site closure after deep inferior epigastric perforator flap breast reconstruction: A systematic review and meta-analysis. Microsurgery 2023; 43:855-864. [PMID: 37697962 DOI: 10.1002/micr.31107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/03/2023] [Accepted: 08/24/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Despite improvement in abdominal morbidity with deep inferior epigastric perforator (DIEP) flap breast reconstruction compared to prior abdominally-based free flap breast reconstruction, abdominal bulge, and hernia rates have been cited anywhere from 2% to 33%. As a result, some surgeons utilize mesh or other reinforcement upon donor-site closure, but its benefit in preventing abdominal wall morbidity has not been well-defined for DIEP flaps. The purpose of this systematic review is to evaluate DIEP donor-site closure techniques and the impact of mesh type and plane on abdominal-wall morbidity including hernia and bulge, relative to primary fascial closure. METHODS MEDLINE, PubMED, Cochrane Library, and SCOPUS were systematically reviewed for studies evaluating DIEP flap breast reconstruction abdominal-donor site closure, where any mesh reinforcement or primary fascial closure was specified, and postoperative outcomes of hernia and/or abdominal bulge were reported. Analysis was performed in Review Manager (RevMan) evaluating mesh use, type, and plane relative to primary fascial closure, using the Mantel-Haenszel method to calculate odds ratios (ORs) of significance level p < .05, and a random effects model to account for inter-study heterogeneity. RESULTS Of the 2791 DIEP patients across 11 studies, 1901 patients underwent primary closure and 890 were repaired with mesh. When hernia and/or bulge were combined into a single complication, the use of any mesh did not significantly reduce its odds compared to primary closure (OR = 0.69, p = .20). Similarly, the use of any mesh did not significantly reduce the odds of bulge alone compared to primary closure (OR = 0.62, p = .43). However, the odds of hernia alone were significantly reduced by 72% with any mesh use (OR = 0.28, p = .03). CONCLUSION Mesh use was significantly associated with decreased odds of hernia alone with DIEP flap surgery, but there was no difference in bulge or combined hernia/bulge rates. As bulge is the more common abdominal morbidity after DIEP flap harvest in a patient with no prior abdominal surgery or risk factor for hernia, mesh use is not indicated in abdominal closure of all DIEP patients. Future prospective studies are warranted to characterize the specific indications for mesh use in the setting of DIEP flap surgery.
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Affiliation(s)
- Nisha Parmeshwar
- Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California, USA
| | - Melinda Lem
- Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California, USA
| | - Catherine L Dugan
- Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California, USA
| | - Merisa Piper
- Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California, USA
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Abstract
Intercostal herniation is an abnormal protrusion of lung tissue through the boundaries of the thoracic cavity. It is commonly seen after chest trauma or thoracic surgery but rarely occurs spontaneously. We report a male patient who presented with an intercostal herniation after vigorous coughing for over 2 weeks. Treatment of post-coughing intercostal hernias is either conservative management or surgical intervention, which is dictated by the signs, symptoms, site, and presence of strangulation.
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Affiliation(s)
- Mohamed H El-Farra
- University of California Riverside School of Medicine, Riverside, CA, USA
| | - Mir Wasif Ali
- Department of Cardiothoracic Surgery, St. Bernardine Medical Center, San Bernardino, CA, USA
| | - Nahidh Hasaniya
- University of California Riverside School of Medicine, Riverside, CA, USA
- Department of Cardiothoracic Surgery, St. Bernardine Medical Center, San Bernardino, CA, USA
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Li J, Wu L, Shao X, Cheng T. Postoperative perineal hernia repair: what is the evidence? Surg Today 2023; 53:1105-1115. [PMID: 36720743 DOI: 10.1007/s00595-023-02654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/27/2022] [Indexed: 02/02/2023]
Abstract
The present study determined the characteristics of perineal hernia treatment in the literature, and the incidence of postoperative recurrence was stratified according to repair techniques. A systematic search of the available literature on the treatment of postoperative perineal hernias was performed using a major database. The types of repair techniques and outcome were entered into an electronic database and a pooled analysis was performed. A total of 213 cases of postoperative perineal hernia repair were collected from 20 relevant articles in the literature after excluding case reports (n < 3). Synthetic mesh was the material used most frequently for perineal hernia repair (55.9%). The most frequently used approach in perineal hernia repair was the perineal approach (56.5%). The recurrence rate was highest with the use of biological mesh (40.4%) and the perineal approach (35.6%). The recurrence rate was lowest in the combined abdominal & perineal approach (0%), followed by the abdominal approach (8.8%) and the laparoscopic approach (11.8%). A number of different repair techniques have been described in the literature. The use of synthetic mesh via a combined abdominal-perineal approach or intraabdominal/laparoscopic approach was shown to be associated with a reduced postoperative recurrence rate.
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Affiliation(s)
- Junsheng Li
- Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China.
| | - Lisheng Wu
- Department of Hernia and Bariatric SurgeryDivision of Life Science and MedicineAnhui Province, the First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, People's Republic of China
| | - Xiangyu Shao
- Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - Tao Cheng
- Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China
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11
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Hirose Y, Nagoshi N, Tsuji O, Kono H, Iida T, Suzuki S, Takahashi Y, Nori S, Yagi M, Matsumoto M, Nakamura M, Watanabe K. Natural history and surgical outcomes of idiopathic spinal cord herniation. Spinal Cord 2023; 61:441-446. [PMID: 37380759 DOI: 10.1038/s41393-023-00904-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
STUDY DESIGN Retrospective multicenter study. OBJECTIVES Although surgery is frequently selected for the treatment of idiopathic spinal cord herniation (ISCH), its impact on functional outcomes has yet to be fully understood given the limited number of patients in previous studies. This study aims to evaluate the symptomatic history and surgical outcomes of ISCH. SETTING Three institutions in Japan. METHODS A total of 34 subjects with ISCH were retrospectively enrolled and followed up for at least 2 years. Demographic information, imaging findings, and clinical outcomes were collected. Functional status was assessed using the JOA score. RESULTS The types of neurologic deficit were monoparesis, Brown-Sequard, and paraparesis in 5, 17, and 12 cases, with their mean disease duration being 1.2, 4.2, and 5.8 years, respectively. Significant differences in disease duration were observed between the monoparesis and Brown-Sequard groups (p < 0.01) and between the monoparesis and paraparesis groups (p = 0.04). Surgery promoted significantly better recovery rates from baseline. Correlations were observed between age at surgery and recovery rate (p < 0.01) and between disease duration and recovery rate (p = 0.04). The mean recovery rates were 82.6%, 51.6%, and 29.1% in the monoparesis, Brown-Sequard, and paraparesis groups, respectively. The monoparesis group had a significantly higher recovery rate than did the Brown-Sequard (p = 0.045) and paraparesis groups (p < 0.01). CONCLUSIONS Longer disease duration was correlated with the progression of neurologic deficit. Older age, and worse preoperative neurologic status hindered postoperative functional recovery. These results highlight the need to consider surgical timing before neurologic symptoms deteriorate.
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Affiliation(s)
- Yuichiro Hirose
- Department of Orthopaedic Surgery, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo, 191-0062, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Osahiko Tsuji
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hitoshi Kono
- Department of Orthopaedic Surgery, Keiyu Orthopedic Hospital, 2267-1 Akodacho, Tatebayashi-shi, Gunma, 374-0013, Japan
| | - Tsuyoshi Iida
- Department of Orthopaedic Surgery, Kitasato Institute Hospital, Department of Orthopaedic Surgery, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8642, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yohei Takahashi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Satoshi Nori
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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12
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Belyayev LA, Parker WJ, Madha ES, Jessie EM, Bradley MJ. Primary Lung Hernia After Blunt Chest Trauma: Chest Wall Repair Strategies. Am Surg 2023; 89:2073-2075. [PMID: 34096350 DOI: 10.1177/00031348211023439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lung herniation is a rare pathology seen after trauma. A case of acquired lung hernia is presented after blunt thoracic trauma that was repaired primarily. Surgical management and decision-making for this process are discussed.
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Affiliation(s)
- Leonid A Belyayev
- Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - William J Parker
- Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Emad S Madha
- Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Elliot M Jessie
- Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
- R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD, USA
| | - Matthew J Bradley
- Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
- R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD, USA
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13
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De Vries SEN, Arts MP, Van Huijstee PJ. Intercostal lung herniation; a rare complication after mini-transthoracic approach (TTA) for thoracic disc herniation. Two case reports and review of literature. Eur Spine J 2022; 31:3708-3712. [PMID: 35318533 DOI: 10.1007/s00586-021-07023-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 08/17/2021] [Accepted: 10/05/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Lung herniation is a rare condition, most often due to thoracic injury, but has also been described as a complication following cardiothoracic surgery. Here, we report two cases of post-surgical lung herniation following a neurosurgical mini-transthoracic (mini-TTA) for treatment of thoracic herniated discs. With this report we aim to make surgeons aware of this rare complication, review existing literature on surgical repairs and describe our novel correction technique using video assisted thoracic surgery (VATS) and a combination of mesh covering the muscle defect internally and nitinol rib plates for rib approximation on the outside of the thoracic cavity. CASE DESCRIPTION Patient A was an 85-year-old man who presented with a subcutaneous swelling at the site of surgery following a left sided mini-TTA. Computed tomography (CT) revealed pulmonary tissue herniation. He underwent VATS guided reconstruction. Using two Ventralex meshes covering the defect on the inside and a NiTi-rib H-plate for rib approximation. Patient B was a 73-year-old woman who developed pulmonary complaints with a soft mass at the surgery site after a left sided mini-TTA. She also underwent VATS guided reconstruction. A large Sempramesh composite mesh and two NiTi-Rib H-plates were used. Recovery was uncomplicated and follow-up revealed no recurrence in both cases. CONCLUSION These cases should make surgeons aware of the possibility of post-surgical development of lung herniation and describe successful correction using a combination of mesh material and NiTi-Rib H-plates through a VATS technique.
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Affiliation(s)
| | - Mark P Arts
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands
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14
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Curtis Martínez C, Alcaide Quirós MJ, Aranaz Ostáriz V. Treatment of a Large Enterocele by Laparoscopic Ventral Rectopexy. Dis Colon Rectum 2021; 64:e725-e726. [PMID: 34413276 DOI: 10.1097/dcr.0000000000002224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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15
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Moneim J. Abdominal intercostal hernia and costal arch repair. BMJ Case Rep 2021; 14:e247189. [PMID: 34848432 PMCID: PMC8634248 DOI: 10.1136/bcr-2021-247189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/04/2022] Open
Abstract
A 70-year-old asthmatic man presented with a history of chronic intermittent left-sided chest pains and a bulge-like deformity of his chest which became more prominent with expiration. He sustained a traumatic fall 2 years prior whereby he fractured his right humerus at the surgical neck, requiring total arthroplasty. Examination and CT imaging of the thorax revealed a left costal arch fracture with hemidiaphragm rupture and associated transperitoneal fat herniation. He underwent left thoracolaparotomy with costal arch and diaphragmatic hernia repair. He was discharged 48 hours postoperatively and is satisfied with good outcomes under initial follow-up. This case report highlights the surgical management of a condition that usually presents late after significant trauma and may progress to visceral strangulation if untreated.
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Affiliation(s)
- Jacob Moneim
- Department of Thoracic Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK
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16
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Turzová A, Doležel R, Malík J, Hach J, Pohnán R. Posttraumatic intercostal pulmonary herniation - case report. Rozhl Chir 2021; 100:243-245. [PMID: 34465105 DOI: 10.33699/pis.2021.100.5.246-248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Pulmonary hernias are rare conditions, most are the results of an injury or previous thoracic surgery. CASE REPORT We present a case of a 48-year-old woman injured in a car accident. The examination in the trauma centre revealed a chest injury with herniation of the lung parenchyma into the chest wall and fractures of long bones of lower limbs. Initially, an osteosynthesis of the left femur and the right tibia fracture were performed. The patient underwent a subsequent surgery to repair the pulmonary hernia. CONCLUSION A pulmonary hernia is diagnosed either directly during a clinical examination or by imaging. A sovereign diagnostic method is a computed tomography. The method of treatment is a surgical repair with primary suture of the chest wall defect or implantation of a mesh to repair the pulmonary hernia.
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17
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Wu P, Huang C, Li W, Yuan A, Jin A. Application of Magnetic Resonance Diffusion Tensor Imaging in the Clinical Diagnosis of Disc Herniation after Lumbar Spine Injury. J Healthc Eng 2021; 2021:6610988. [PMID: 33777343 PMCID: PMC7969098 DOI: 10.1155/2021/6610988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/07/2021] [Accepted: 02/27/2021] [Indexed: 11/17/2022]
Abstract
Magnetic resonance diffusion-weighted imaging (DTI) provides a unique perspective on the pathophysiological and microstructural changes during spinal cord injury, with high spatial specificity; meanwhile, NM reflects the conduction and integrity of neuroelectrical signals in spinal cord fiber tracts, with time-specific and dynamic evaluation effects. The fractional anisotropy (FA) value, SEP amplitude, and neurological function score or improvement rate are correlated. The combination of DTI and NM can more reliably quantify the spinal cord function, evaluate the effectiveness of treatment, and determine the patient's prognosis, which can provide reference for clinical decision making and future research for SCI patients. That is, the lower the preoperative FA value and the lower the SEP amplitude, the worse the preoperative and postoperative neurological function, the lower the improvement rate, and the worse the prognosis of patients. Therefore, we believe that spinal cord function can be graded according to JOA scores to find the corresponding FA and SEP amplitude ranges and that, by measuring FA and SEP amplitude in the future, we can reverse the assessment of spinal cord function, expected postoperative improvement, and long-term prognosis. At the same time, FA values can also help determine the nature of the lesion to some extent.
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Affiliation(s)
- Penghuan Wu
- Department of Spinal Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, China
- Department of Orthopaedics, Affiliated Shaoguan First People's Hospital, Southern Medical University, Shaoguan, Guangdong 512000, China
| | - Chengyan Huang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, China
| | - Wenhu Li
- Department of Orthopaedics, Affiliated Shaoguan First People's Hospital, Southern Medical University, Shaoguan, Guangdong 512000, China
| | - Aidong Yuan
- Department of Orthopaedics, Affiliated Shaoguan First People's Hospital, Southern Medical University, Shaoguan, Guangdong 512000, China
| | - Anmin Jin
- Department of Spinal Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510282, China
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18
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Onodera A, Hara K, Aoyama T, Tanabe M, Shibuya S, Nakayama Y, Kawahara S, Takahashi D, Atsumi Y, Kazama K, Numata M, Tamagawa H, Yukawa N, Masuda M, Rino Y. [A Case of Port-Site Herniation from an Eight mm Port after Robot-Assisted Distal Gastrectomy]. Gan To Kagaku Ryoho 2020; 47:2367-2369. [PMID: 33468963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 63-year-old-woman was diagnosed with gastric cancer cStage ⅠA after ESD, and then, underwent robot-assisted distal gastrectomy. She vomited on the postoperative day 2 and then was inserted nasogastric tube. The amount of drainage from the tube was increased on the postoperative day 5, therefore, abdominal computed tomography scan was performed, which showed herniation of small bowel at the 8 mm port site in the left upper abdomen. The emergent surgery was performed because of difficulty in manual reduction. Intraoperative findings showed that small intestine was incarcerated at the left 8 mm port-site. The intestine was released by incising the fascia of hernia orifice, then, the fascia was repaired. There was no recurrence of gastric cancer and port-site hernia for 34 months after surgery. In general, the fascia of over 10 mm port site is sutured and closed to avoid port-site hernia, however, it is unclear whether the fascia of 8 mm port-site should be closed after robotic surgery. Since we experienced this case, we have also performed fascia suture on the 8 mm port-site in all cases. And then, we could prevent occurrence of port-site hernia in the 8 mm port-site.
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19
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Ito K, Hasegawa J, Iwahata H, Iwahata Y, Furuya N, Homma C, Kondo H, Suzuki N. Amniocele after laparoscopic myomectomy: is expectant management acceptable? Ultrasound Obstet Gynecol 2020; 56:944-946. [PMID: 31994245 DOI: 10.1002/uog.21984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Affiliation(s)
- K Ito
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - J Hasegawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - H Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Y Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - N Furuya
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - C Homma
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - H Kondo
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - N Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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20
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Xie TH, Fu Y, Ren XX, Zhang J. Incarcerated hernia of the hypogastric linea alba accompanied by intestinal obstruction. Asian J Surg 2020; 43:870-871. [PMID: 32622531 DOI: 10.1016/j.asjsur.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/19/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Tian-Hao Xie
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China.
| | - Yan Fu
- Baoding First Central Hospital, Baoding, Hebei, 071000, China
| | - Xiang-Xiang Ren
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China
| | - Jing Zhang
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, 071000, China
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21
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Jafari M, Schneider-Bordat L, Hersant B. Biological mesh used to repair perineal hernias following abdominoperineal resection for anorectal cancer. ANN CHIR PLAST ESTH 2020; 65:e15-e21. [PMID: 32517871 DOI: 10.1016/j.anplas.2019.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE This study aimed to determine the outcome for patients who had undergone perineal hernia repair, via a perineal approach, using a biological mesh post-abdominoperineal excision (APE) for anorectal cancer. METHOD All consecutive patients having undergone perineal hernia repair involving an extracellular matrix of porcine small intestinal submucosa at our hospital between 2015 and 2018 were included. Follow-up clinical examinations and computed tomography scans were performed. RESULTS Six patients were treated surgically for symptomatic perineal hernia after a median of 31 months from APE. The median follow-up after hernia repair was 11 months (interquartile range [IQR], 6-35 months). Three patients (50%) developed a recurrent perineal hernia after a median interval of 6 months. CONCLUSION Perineal hernia repair using a biological mesh resulted in a high recurrence rate in patients who had undergone APE for anorectal cancer.
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Affiliation(s)
- M Jafari
- Service de chirurgie oncologique, centre Oscar-Lambret, 3, rue Combemale, 59020 Lille cedex, France.
| | - L Schneider-Bordat
- Service de chirurgie oncologique, centre Oscar-Lambret, 3, rue Combemale, 59020 Lille cedex, France
| | - B Hersant
- Service de chirurgie plastique, reconstructrice, esthétique, et maxillo-faciale, hôpitaux universitaires Henri-Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
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22
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Carpenter K, Lockwood J, Iwanaga J, Dumont AS, Bui CJ, Tubbs RS. Herniation of orbital fat through the inferior orbital fissure and into the infratemporal fossa: a cadaveric case report and review. Surg Radiol Anat 2020; 42:1119-1121. [PMID: 32472182 DOI: 10.1007/s00276-020-02504-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/22/2020] [Indexed: 11/24/2022]
Abstract
Orbital fat herniation is primarily in a subconjunctival location. However, herniation through the inferior orbital fissure (IOF) has been scantly reported. Here, we report a cadaveric case of herniation of orbital fat through the inferior orbital fissure and into the infratemporal fossa. The cadaver's orbital anatomy and orbital fat herniation were found during routine dissection. The details of this case are reported. We also discuss anatomical variations of the inferior orbital fissure as well as the related vascular and nervous system structures related to orbital fat herniation. This is a rare case of a cadaver with this anatomical abnormality.
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Affiliation(s)
- Kennedy Carpenter
- University of Queensland-Ochsner Clinical School, New Orleans, LA, USA
| | - Joseph Lockwood
- Ochsner Clinic Neurosurgery Program, Tulane University School of Medicine, Tulane University, New Orleans, LA, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - C J Bui
- Department of Neurosurgery, Ochsner Health System, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
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23
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Rudnicki Y, Strassmann V, Gilshtein H, Wexner SD. Gastrohepatic Ligament Hernia after Laparoscopic Restorative Proctocolectomy with Ileal J-Pouch Creation. Am Surg 2020; 86:e202-e204. [PMID: 32391780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Yagmur Y, Gumus S. Retained gallbladder stones in trocar site hernia. Ann Ital Chir 2020; 9:S2239253X20032545. [PMID: 32242545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM Retained stones after laparoscopic cholecystectomy occur after perforated gallbladder during surgery. A trocar site hernia with 8 retained gallstones is presented. PATIENT-METHOD A 54-year-old female presented to our clinics with a paraumbilical hernia in trocar site. The patient had laparoscopic cholecystectomy in another hospital one year ago. Retained stones were noticed in the trocar site while preparing patients for hernia surgery. The patient had laparoscopic hernia repair with the removal of retained stones. 8 stones sized up to 2 cm were taken out of the abdomen. It seems to be the first case of retained stones in trocar site hernia. CONCLUSION Gallbladder perforations are common during laparoscopic cholecystectomy due to traction with forceps or inflammation. Careful inspection for spillage stone should be done. KEY WORDS Laparoscopic cholecystectomy, Retained Stones, hernia, Trocar Site.
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25
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Davakis S, Syllaios A, Mpaili E, Sdralis E, Charalabopoulos A. Minimally invasive oesophagectomy and emerging complications: intercostal lung hernia. Ann R Coll Surg Engl 2020; 102:e73-e74. [PMID: 31845821 PMCID: PMC7027402 DOI: 10.1308/rcsann.2019.0163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2019] [Indexed: 11/22/2022] Open
Abstract
Lung herniation is a rare entity, defined as a protrusion of the lung above the normal confines of thorax; it is caused by increased intrathoracic pressure and defects or weakness of the chest wall. Intercostal lung hernia can occur spontaneously or following thoracic trauma or surgery. Postoperative hernias are more commonly associated with less extensive surgical procedures, such as thoracoscopic surgery or mini-thoracotomy incisions, rather than with major thoracic procedures. We describe the first reported case of postoperative intercostal lung hernia following two-stage totally minimally invasive oesophagectomy for cancer, together with its successful surgical repair.
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Affiliation(s)
- S Davakis
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Syllaios
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Regional Oesophagogastric Centre, Department of Surgery, Broomfield Hospital, Chelmsford, UK
| | - E Mpaili
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Sdralis
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Regional Oesophagogastric Centre, Department of Surgery, Broomfield Hospital, Chelmsford, UK
| | - A Charalabopoulos
- First Department of Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Regional Oesophagogastric Centre, Department of Surgery, Broomfield Hospital, Chelmsford, UK
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Bhangu A, Nepogodiev D, Ives N, Magill L, Glasbey J, Forde C, Bisgaard T, Handley K, Mehta S, Morton D, Pinkney T, Mehta S, Handley K, Ives N, Bhangu A, Brown J, Forde C, Futaba K, Glasbey J, Handley K, Ives N, Khan S, Magill L, Mehta S, Morton D, Nepogodiev D, Pallan A, Patel A, Ashdown-Phillips S, Roberts T, Jowett S, Munetsi L, Pinkney T, Torrance A, Brown J, Handley K, Hilken N, Hill M, Hunter M, Ives N, Khan S, Leek S, Lilly H, Magill L, Mehta S, Sawant A, Vince A, Walters M, Bemelman W, Blussé M, Borstlap W, Busch ORC, Buskens C, Klaver C, Marsman H, van Ruler O, Tanis P, Westerduin E, Wicherts D, Das P, Essapen S, Frost V, Glennon A, Gray C, Hussain A, McNichol L, Nisar P, Scott H, Trickett J, Trivedi P, White D, Amarnath T, Ardley R, Gupta R, Hall E, Hodgkins K, Narula H, Sewell TA, Simms JM, Toms J, White T, Atkinson A, Beral D, Lancaster N, Mackenzie F, Wilson T, Cruttenden-Wood D, Gibbins J, Halls M, Hill D, Hogben K, Jones S, Lamparelli MJ, Lewis M, Moreton S, Ng P, Oglesby A, Orbell J, Stubbs B, Subramanian K, Talwar A, Wilsher S, Al-Rashedy M, Fensom C, Gok M, Hardstaff L, Malik K, Sadat M, Townley B, Wilkinson L, Cosier T, Mangam S, Rabie M, Broadley G, Canny J, Fallis S, Green N, Hawash A, Karandikar S, Mirza M, Rawstorne E, Reddan J, Richardson J, Thompson C, Waite K, Youssef H, Bisgaard T, De Nes L, Rosenstock S, Strandfelt P, Westen M, Aryal K, Kshatriya KS, Lal R, Velchuru V, Wilhelmsen E, Akbar A, Antoniou A, Clark S, Datt P, Goh J, Jenkins I, Kennedy R, Maeda Y, Nastro P, Owen H, Phillips RKS, Warusavitarne J, Bradley-Potts J, Charleston P, Clouston H, Duff S, Fatayer T, Gipson A, Heywood N, Junejo M, Kennedy J, Lalor H, Manning C, McCormick R, Parmar K, Preston S, Ramesh A, Sharma A, Telford K, Adeosun A, Hammond T, Smolen S, Topliffe J, Docherty JG, Lim M, Lim M, Macleod K, Monaghan E, Patience L, Thomas I, Walker KG, Walker M, Watson AJM, Burgess A, Ghanem Y, Glister G, Kapur S, Paily A, Pal A, Ravikumar R, Rosbergen M, Sargen K, Speakman C, Agarwal AK, Banerjee A, Borowski D, Garg D, Gill T, Johnston T, Kelsey S, Munipalle PC, Tabaqchali M, Wilson D, Acheson A, Cripps H, El-Sharkawy A, Ng O, Sharma P, Ward K, Chandler D, Courtney E, Bunni J, Butcher K, Dalton S, Flindall I, Katebe J, Roy P, Tate J, Vincent T, Williamson MER, Wood J, Bignell M, Branagan G, Broardhurst J, Chave H, Dean H, D'Souza N, Foster G, Sleight S, Sutaria R, Ahmed I, Budhoo MR, Colley J, Cruickshank N, Gill K, Hayes A, Joy H, Kamabjha C, Plowright J, Radley S, Rea M, Thumbe V, Torrance A, Varghese P, Wilkin R, Zulueta E, Allsop L, Atkari B, Badrinath K, Daliya P, Dube M, Heeley C, Hind R, Nash D, Palfreman A, Peacock O, Watson N, Blodwell M, Javaid A, Mohamad A, Muhammad K, Qureshi N, Ridgway S, Siddiqui K, Solkar M, Vere J, Wordie A, Chang J, Elgaddal S, Green M, Hollyman M, Mirza N, Rankin J, Williams G, Ali W, Hardwick A, Mohamed Z, Navid A, Netherton K, Obreja M, Rao M, Stringer J, Tennakoon A, Bullen T, Butt M, Dawson R, Dawson S, Farmer M, Garimella V, Gates Z, Wilkings L, Yeomans N, Adedeji O, Alalawi R, Al Araimi A, Ashraf S, Bach S, Beggs A, Cagigas C, Dattani M, Dimitriou N, Futaba K, Ghods-Ghorbani M, Glasbey J, Gourevitch D, Haydon G, Ismail T, Keh C, Morton DG, Narewal M, Nepogodiev D, Papettas T, Pinkney T, Poh A, Ranstorne E, Royle TJ, Shah T, Singh J, Smart C, Suggett N, Tayyab M, Vijayan D, Vohra R, Wairaich N, Yeung D, Bamford R, Chambers J, Cotton D, Houlihan R, Kynaston J, Longman R, Lowe A, Messenger D, Owais A, Phillpott C, Shabbir J, Baragwanath P, El-Sayed C, Gaunt A, Khatri C, McCullough P, Patel A, Ward S, Wilkin R, Obukofe R, Stroud R, Mason D, Williams N, Wong LS, Chaudhri S, Cooke J, Cunha M, Fairey H, Norwood M, Singh B, Thomasset S, Abbott S, Addison S, Archer J, Bhangu A, Church R, Holford E, Lenehan F, Odogwu S, Richardson L, Sidebotham J, Swan E, Tilley A, Wagstaff L, Amey I, Baird Y, Cripps N, Greenslade S, Harris G, Levy B, Mckenzie P, Misselbrook A, Moore S, Skull A, Nicol D, Reddy B, Thrush J, Iglesias Vecchio M, Dunn Y, Williams C, Furtado S, Gill M, Gilmore L, Goldsmith P, Kocialkowski C, Loganathan S, Nath R, Paraoan M, Taylor T, Allison A, Allison J, Curtis N, Dalton R, D'Costa C, Dennison G, Foster J, Francis N, Gibbons J, Hamdan M, Lewis A, Ockrim J, Sharma R, Spurdle K, Varadharajan S, Aghahoseini A, Alexander DJ, Bandyopadhyay D, Bradford I, Chitsabesan P, Coleman Z, Gibson A, Lasithiotakis K, Panagiotou D, Polyzois K, Stojkovic S, Woodcock N, Wright M, Hargest R, Jackson R, Rajesh A, Ogunbiyi O, Slater A, Yu LM. Prophylactic biological mesh reinforcement versus standard closure of stoma site (ROCSS): a multicentre, randomised controlled trial. Lancet 2020; 395:417-426. [PMID: 32035551 PMCID: PMC7016509 DOI: 10.1016/s0140-6736(19)32637-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/11/2019] [Accepted: 10/18/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Closure of an abdominal stoma, a common elective operation, is associated with frequent complications; one of the commonest and impactful is incisional hernia formation. We aimed to investigate whether biological mesh (collagen tissue matrix) can safely reduce the incidence of incisional hernias at the stoma closure site. METHODS In this randomised controlled trial (ROCSS) done in 37 hospitals across three European countries (35 UK, one Denmark, one Netherlands), patients aged 18 years or older undergoing elective ileostomy or colostomy closure were randomly assigned using a computer-based algorithm in a 1:1 ratio to either biological mesh reinforcement or closure with sutures alone (control). Training in the novel technique was standardised across hospitals. Patients and outcome assessors were masked to treatment allocation. The primary outcome measure was occurrence of clinically detectable hernia 2 years after randomisation (intention to treat). A sample size of 790 patients was required to identify a 40% reduction (25% to 15%), with 90% power (15% drop-out rate). This study is registered with ClinicalTrials.gov, NCT02238964. FINDINGS Between Nov 28, 2012, and Nov 11, 2015, of 1286 screened patients, 790 were randomly assigned. 394 (50%) patients were randomly assigned to mesh closure and 396 (50%) to standard closure. In the mesh group, 373 (95%) of 394 patients successfully received mesh and in the control group, three patients received mesh. The clinically detectable hernia rate, the primary outcome, at 2 years was 12% (39 of 323) in the mesh group and 20% (64 of 327) in the control group (adjusted relative risk [RR] 0·62, 95% CI 0·43-0·90; p=0·012). In 455 patients for whom 1 year postoperative CT scans were available, there was a lower radiologically defined hernia rate in mesh versus control groups (20 [9%] of 229 vs 47 [21%] of 226, adjusted RR 0·42, 95% CI 0·26-0·69; p<0·001). There was also a reduction in symptomatic hernia (16%, 52 of 329 vs 19%, 64 of 331; adjusted relative risk 0·83, 0·60-1·16; p=0·29) and surgical reintervention (12%, 42 of 344 vs 16%, 54 of 346: adjusted relative risk 0·78, 0·54-1·13; p=0·19) at 2 years, but this result did not reach statistical significance. No significant differences were seen in wound infection rate, seroma rate, quality of life, pain scores, or serious adverse events. INTERPRETATION Reinforcement of the abdominal wall with a biological mesh at the time of stoma closure reduced clinically detectable incisional hernia within 24 months of surgery and with an acceptable safety profile. The results of this study support the use of biological mesh in stoma closure site reinforcement to reduce the early formation of incisional hernias. FUNDING National Institute for Health Research Research for Patient Benefit and Allergan.
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Rawlinson D, Henry JA, Lama T, Genuit T, Lottenberg L. Traumatic Intercostal Splenic Herniation. Am Surg 2020; 86:e31-e32. [PMID: 32077431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Affiliation(s)
- Ala-Eddin S Sagar
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Saadia A Faiz
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vickie R Shannon
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Affiliation(s)
| | | | | | - David R Curran
- Respiratory Medicine, Mercy University Hospital, Cork, Ireland
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Tsai LH, Li WJ, Chen GH, Hsieh PF, Chang CH. Internal hernia from the interureteric space after robot-assisted radical cystectomy and urinary diversion: Two case reports. Medicine (Baltimore) 2019; 98:e17222. [PMID: 31593079 PMCID: PMC6799691 DOI: 10.1097/md.0000000000017222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Radical cystectomy and urinary diversion remains the definite management for muscle invasive bladder urothelial cancer. Internal herniation caused by ureteral adhesion is an extremely rare complication after the procedure. To the best of our knowledge, this is the first case report of small bowel obstruction and internal herniation occurring between bilateral ureters and urinary diversion after robot-assisted radical cystectomy (RARC). PATIENT CONCERNS A 64-year-old woman presented with symptom of small bowel obstruction such as nausea, vomiting, and abdominal fullness after RARC and Indiana pouch. Another 61-year-old man presented with left obstructive hydronephrosis and recurrent pyelonephritis after RARC and ileal conduit. DIAGNOSIS Both patients received computed tomography scans and the results were suggestive of small bowel herniation between bilateral ureters and urinary diversion. INTERVENTIONS The 2 patients underwent open ureterolysis and internal hernia reduction. During the operation, bowel loop herniation between the interureteral spaces were found. OUTCOMES Both patients recovered smoothly after second operation. LESSONS The incidence of internal herniation may increase by the growing use of RARC. Suitable stoma position, appropriate length of ureter dissection, and retroperitonealization can help prevent this complication.
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Sá Vieira V. Lung hernia: A rare consequence of a chest trauma. Rev Port Cir Cardiotorac Vasc 2019; 26:185-186. [PMID: 31734968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Vitor Sá Vieira
- Former Thoracic Surgery Unit Coordinator, Hospital Cuf Descobertas, Lisboa, Portugal
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Lopes S, Costa R, Maciel J, Casanova J, Bastos PC, Pinho P. Lung Hernia Related with a Rope Bullfight: Case Report. Rev Port Cir Cardiotorac Vasc 2019; 26:219-222. [PMID: 31734975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Indexed: 06/10/2023]
Abstract
Lung herniation is an uncommon entity which was fully classified in 1845 after the study of several case reports. Acquired lung hernia, especially traumatic, is the most common etiology. In the absence of clear guidelines, management of lung hernia is made in a case-by-case basis. We present an asymptomatic middle lobe hernia perceptible on physical examination, but diagnosed initially by imaging studies. Patient medical history included a blunt bull trauma fourteen years before.
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Affiliation(s)
- Sara Lopes
- Department of Cardiothoracic Surgery, São João Hospital, Porto, Portugal
| | - Rita Costa
- Department of Cardiothoracic Surgery, São João Hospital, Porto, Portugal
| | - João Maciel
- Department of Cardiothoracic Surgery, São João Hospital, Porto, Portugal
| | - Jorge Casanova
- Department of Cardiothoracic Surgery, São João Hospital, Porto, Portugal
| | | | - Paulo Pinho
- Department of Cardiothoracic Surgery, São João Hospital, Porto, Portugal
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Gorospe L, Almeida-Aróstegui NA, Miguelena-Hycka J. Delayed Incidental Diagnosis of Posttraumatic Cardiac Herniation. Rev Esp Cardiol (Engl Ed) 2019; 72:343. [PMID: 29773333 DOI: 10.1016/j.rec.2018.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 04/11/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Luis Gorospe
- Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain.
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Bertrand K, Lefevre JH, Creavin B, Luong M, Debove C, Voron T, Chafai N, Tiret E, Parc Y. The management of perineal hernia following abdomino-perineal excision for cancer. Hernia 2019; 24:279-286. [PMID: 30887380 DOI: 10.1007/s10029-019-01927-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 03/11/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Perineal hernia (PH) is a tardive complication following abdomino-perineal resection (APR). Many repair methods are described and evidences are lacking. The aim of this study was to report PH management, analyze surgery outcomes and review the available literature. METHODS We retrospectively included all consecutive PH repair after APR performed between 2001 and 2017. We recorded data on APR surgery, PH symptoms and repair, and follow-up (recurrence and morbidity). Literature review included published articles on PubMed between 1960 and 2017. RESULTS 24 PH repairs were included. The approach was perineal N = 16, abdominal N = 5 and combined N = 3. A biological mesh was used for 17, a synthetic for 5 and a flap for 2 patients. The median follow-up was 25 months. Overall morbidity was 37.5% (N = 9): 37.5% for the perineal, 20% for the abdominal, and 66.7% for the combined approach. Complications occurred in 35.3% of biological and 20% of synthetic mesh repairs. Recurrence rate was 41.7%, similar for biological (n = 8, 47.1%) and synthetic meshs (n = 2; 40%). No recurrence occurred in the flap group. Depending of the approach, we found 50% for perineal (n = 8) and 40% of the abdominal cohort (N = 2). Among twelve studies, recurrence rates ranged from 0 to 66.7%. Abdominal or laparoscopic approach with synthetic mesh was associated with less recurrences (0 and 12.5% respectively) and complications (37.5% and 9.5%). CONCLUSIONS Recurrences following PH repair are high irrespective of the repair technique. More studies are necessary to identify PH risk factors and decide the appropriate perineal reconstruction.
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Affiliation(s)
- K Bertrand
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
| | - J H Lefevre
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France.
| | - B Creavin
- Department of Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - M Luong
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
| | - C Debove
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
| | - T Voron
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
| | - N Chafai
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
| | - E Tiret
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
| | - Y Parc
- Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
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Ebrahimi R, Kermansaravi M, Eghbali F, Pazouki A. Gastric remnant perforation due to trocar site herniation after laparoscopic Roux-en-Y gastric bypass. Ann R Coll Surg Engl 2019; 101:e88-e90. [PMID: 30602308 PMCID: PMC6400925 DOI: 10.1308/rcsann.2018.0216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2018] [Indexed: 11/22/2022] Open
Abstract
A 39-year-old woman was admitted with colicky left upper-quadrant pain, dyspnoea, low-grade fever, tachycardia and a subtle left upper-quadrant tenderness without leucocytosis. Computed tomography revealed a distended gastric remnant due to small-bowel loop herniation at the trocar site. The patient underwent a diagnostic laparoscopy as her general condition worsened. Perforation across the staple line was seen and repaired. The postoperative period was uneventful. As a rare complication of laparoscopic Roux-en-Y gastric bypass, small-bowel obstruction is of great importance because it can lead to gastric remnant perforation if not managed correctly. There have been rare reports of trocar site herniation as a cause of small-bowel obstruction following laparoscopic Roux-en-Y gastric bypass. Prompt diagnostic laparoscopy should be considered. This is the first case reported in which the excluded stomach was perforated due to trocar site herniation of the small-bowel loop. It should be noted that the tissue around the perforation is fragile and proper tension should be employed when it is repaired. Generally, an omental patch is not encouraged.
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Affiliation(s)
- R Ebrahimi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M Kermansaravi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of International Federation for Surgery of Obesity, Hazrat e Rasool Hospital, Tehran, Iran
| | - F Eghbali
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - A Pazouki
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of International Federation for Surgery of Obesity, Hazrat e Rasool Hospital, Tehran, Iran
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Frostberg E. [Internal herniation underneath the left external iliac artery after radical prostatectomy with extensive lymph node dissection]. Ugeskr Laeger 2019; 181:V02170151. [PMID: 30799807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 65-year-old male underwent acute surgery because of a partly ischaemic small intestine due to internal herniation underneath the left external iliac artery. The iatrogenic defect in the peritoneum was created 15 months earlier, when the patient had a robot-assisted radical prostat-ectomy with pelvic lymph node dissection performed. The ischaemic small bowel was resected under a laparotomy, and creation of a temporary stoma was necessary. The peritoneal defect was left open. The patient recovered, and the stoma was surgically closed two months later.
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Falcone V, Stopp T, Feichtinger M, Kiss H, Eppel W, Husslein PW, Prager G, Göbl CS. Pregnancy after bariatric surgery: a narrative literature review and discussion of impact on pregnancy management and outcome. BMC Pregnancy Childbirth 2018; 18:507. [PMID: 30587161 PMCID: PMC6307154 DOI: 10.1186/s12884-018-2124-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 11/27/2018] [Indexed: 02/07/2023] Open
Abstract
Bariatric surgery (BS) is regarded to be the most effective treatment of obesity with long lasting beneficial effects including weight loss and improvement of metabolic disorders. A considerable number of women undergoing BS are at childbearing age.Although the surgery mediated weight loss has a positive effect on pregnancy outcome, the procedures might be associated with adverse outcomes as well, for example micronutrient deficiencies, iron or B12 deficiency anemia, dumping syndrome, surgical complications such as internal hernias, and small for gestational age (SGA) offspring, possibly due to maternal undernutrition. Also, there is no international consensus concerning the ideal time to conception after BS. Hence, the present narrative review intents to summarize the available literature concerning the most common challenges which arise before and during pregnancy after BS, such as fertility related considerations, vitamin and nutritional deficiencies and their adequate compensation through supplementation, altered glucose metabolism and its implications for gestational diabetes screening, the symptoms and treatment of dumping syndrome, surgical complications and the impact of BS on pregnancy outcome. The impact of different bariatric procedures on pregnancy and fetal outcome will also be discussed, as well as general considerations concerning the monitoring and management of pregnancies after BS.Whereas BS leads to the mitigation of many obesity-related pregnancy complications, such as gestational diabetes mellitus (GDM), pregnancy induced hypertension and fetal macrosomia; those procedures pose new risks which might lead to adverse outcomes for mothers and offspring, for example nutritional deficiencies, anemia, altered maternal glucose metabolism and small for gestational age children.
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Affiliation(s)
- Veronica Falcone
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Tina Stopp
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Michael Feichtinger
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Wunschbaby Institut Feichtinger, Lainzerstrasse 6, Vienna, Austria
| | - Herbert Kiss
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Wolfgang Eppel
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Peter Wolf Husslein
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Gerhard Prager
- Department of General Surgery, Division of Bariatric Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christian S Göbl
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Kronenfeld J, Mentzer CJ, Lieberman H. Traumatic Extrathoracic Lung Herniation. Am Surg 2018; 84:e527-e528. [PMID: 30606365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Goldenshluger M, Goitein D, Segal G, Apter S, Mor E, Klang E. Petersen Hernia in Pregnancy: A Report of Two Cases and Their Radiologic Findings. Isr Med Assoc J 2018; 20:588-589. [PMID: 30221877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Michael Goldenshluger
- Department of General and Oncological Surgery C, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Goitein
- Department of General and Oncological Surgery C, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Segal
- Department of General Surgery A, Emek Medical Center, Afula, Israel
| | - Sara Apter
- Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel
| | - Eyal Mor
- Department of General and Oncological Surgery C, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Klang
- Department of Radiology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract
Gastric Bypass: Weight Loss with Complications Abstract. Roux-en-Y gastric bypass (RYGBP) is the most often performed bariatric operation worldwide with internal hernia as one of the main long-term complications. To our knowledge, we report the first case of post-ischemic small-bowel strictures observed after a successful operation of an internal hernia after RYGBP. During emergency surgery a Petersen and a Brolin hernia were diagnosed and repaired. The initially ischemic small intestine was recovered. However, a week later the patient presented herself again due to ischemia-induced small-bowel strictures. These were treated successfully by endoscopic balloon dilatation.
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Affiliation(s)
- Maria Nucera
- 1 Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Kantonsspital Baden, Baden-Dättwil
| | - Mark Mahanty
- 1 Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Kantonsspital Baden, Baden-Dättwil
| | | | - Antonio Nocito
- 1 Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Kantonsspital Baden, Baden-Dättwil
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Leclercq WKG, van Sambeek A, Uittenbogaart M, Niemarkt HJ, Bongers MY, van Laar JOEH. [Abdominal pain in a pregnant patient who had gastric reduction surgery: risks associated with a history of bariatric surgery]. Ned Tijdschr Geneeskd 2018; 162:D2616. [PMID: 30182623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Pregnant women who previously had bariatric surgery may develop acute abdominal pain during pregnancy that may be related to previous operations. Two patients, a 38-year-old twin-primigravida who had a gestation period of 24+6 weeks and a 26-year-old woman who had a gestation period of 24 weeks, both of whom had laparoscopic gastric bypass (RYGB) surgery 2 and 3 years previously, developed abdominal pain. The patients were not ill, but had diffuse abdominal pain in combination with normal blood tests and imaging. Patient B had undergone laparoscopy at another centre after 5 weeks of gestation for internal herniation. After referral to our multidisciplinary Bariatric-Obstetric-Neonatal (MD-BON) team, diagnostic laparoscopy was advised as internal herniation was deemed possible. In both patients, internal herniation was indeed found in Petersen's space and jejunal mesenteric defect, which was closed using laparoscopic surgery. Both women delivered healthy offspring afterwards. The presence of a MD-BON team allows for an increased awareness of potential long-term complications associated with earlier bariatric surgery in pregnancy.
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Affiliation(s)
- Wouter K G Leclercq
- Máxima Medisch Centrum, afd. Chirurgie, Eindhoven-Veldhoven
- Contact: W.K.G. Leclercq
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Sodhi A, Crandall M, Sasser WF, Jasra B. Iatrogenic Intercostal Pulmonary Hernia Repaired Using a Combination of Video-Assisted Thoracoscopic Technique and Mini-Thoracotomy. Am Surg 2018; 84:e257-e258. [PMID: 30454340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Venkatasamy A, Huynh TT, Caron B, Veillon F. The hourglass sign. Abdom Radiol (NY) 2018; 43:1508-1509. [PMID: 28936631 DOI: 10.1007/s00261-017-1321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Hourglass sign is a useful imaging clue for diagnosing diaphragmatic ruptures with viscera herniation on multidetector CT, with a sensitivity ranging from 16% to 63% and a specificity around 98%-100%. This sign is also commonly found in the literature under the name "Collar sign," first described in 1995 by Worthy et al. It refers to the waistlike constriction of the herniated structure at the site of the diaphragmatic rupture.
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Affiliation(s)
- Aina Venkatasamy
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, Strasbourg, France.
| | - Tri Thai Huynh
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, Strasbourg, France
| | - Bénédicte Caron
- Service de Gastro-entérologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Francis Veillon
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, Strasbourg, France
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Förster CE, Füglistaler I, Steinemann DC. Intraoperative check for enterocele in perineal stapled prolapse resection. Tech Coloproctol 2018; 22:389-391. [PMID: 29766343 DOI: 10.1007/s10151-018-1796-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
- C E Förster
- Pelvic Floor Unit, St.Clara Hospital Basel, Kleinriehenstrasse 30, 4016, Basel, Switzerland
| | - I Füglistaler
- Pelvic Floor Unit, St.Clara Hospital Basel, Kleinriehenstrasse 30, 4016, Basel, Switzerland
| | - D C Steinemann
- Pelvic Floor Unit, St.Clara Hospital Basel, Kleinriehenstrasse 30, 4016, Basel, Switzerland.
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Abstract
Surgeons who close major laparotomy incisions in a single layer (excluding skin) usually put interrupted sutures of non-absorbable monofilament material. In 305 consecutive patients we have, instead, used continuous deep-bite mass sutures with satisfactory results. The suture material, chosen at random, was either monofilament nylon, monofilament stainless steel wire or polyglycolic acid (PGA). The length of material used was measured, and this figure divided by the number of bites to give the mean distance from the cut edges at which the needle had been inserted. The ratio of length of suture material to number of bites ranged from 3-10 em (mean 5.90, s.d.I.46). There were no burst abdomens, but 26 incisonal hernias were detected within six months of operation; these were significantly associated with male sex, old age, long incisions, long operations, postoperative coughing and distension, blood transfusion and wound sepsis. Steel sutures were removed from 5 patients because of pain or sinuses, and nylon sutures from one. We conclude that laparotomy closure by a single continuous layer of sutures is satisfactory, and that there is little to choose among nylon, PGA and steel. The incidence of incisional hernias would be reduced by the elimination of wound sepsis.
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Chen H, Yuan F, Chen SW, Guo Y, Wang G, Deng ZF, Tian HL. Predicting posttraumatic hydrocephalus: derivation and validation of a risk scoring system based on clinical characteristics. Metab Brain Dis 2017; 32:1427-1435. [PMID: 28391551 DOI: 10.1007/s11011-017-0008-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/30/2017] [Indexed: 11/29/2022]
Abstract
Posttraumatic hydrocephalus (PTH) is a disorder of disturbed cerebrospinal fluid (CSF) dynamics after traumatic brain injury (TBI). It can lead to brain metabolic impairment and dysfunction and has a high risk of clinical deterioration and worse outcomes. The incidence and risk factors for the development of PTH after decompressive craniectomy (DC) has been assessed in previous studies, but rare studies identify patients with higher risk for PTH among all TBI patients. This study aimed to develop and validate a risk scoring system to predict PTH after TBI. Demographics, injury severity, duration of coma, radiologic findings, and DC were evaluated to determine the independent predictors of PTH during hospitalization until 6 months following TBI through logistic regression analysis. A risk stratification system was created by assigning a number of points for each predictor and validated in an independent cohort. The model accuracy was assessed by the area under the receiver operating characteristic curve (AUC). Of 526 patients in the derivation cohort, 57 (10.84%) developed PTH during 6 months follow up. Age > 50 yrs (Odd ratio [OR] = 1.91, 95% confidence interval [CI] 1.09-3.75, 4 points), duration of coma ≥1 w (OR = 5.68, 95% CI 2.57-13.47, 9 points), Fisher grade III (OR = 2.19, 95% CI 1.24-4.36, 5 points) or IV (OR = 3.87, 95% CI 1.93-8.43, 7 points), bilateral DC (OR = 6.13, 95% CI 2.82-18.14, 9 points), and extra herniation after DC (OR = 2.36, 95% CI 1.46-4.92, 5 points) were independently associated with PTH. Rates of PTH for the low- (0-12 points), intermediate- (13-22 points) and high-risk (23-34 points) groups were 1.16%, 35.19% and 78.57% (p < 0.0001). The corresponding rates in the validation cohort, where 17/175 (9.71%) developed PTH, were 1.35%, 37.50% and 81.82% (p < 0.0001). The risk score model exhibited good-excellent discrimination in both cohorts, with AUC of 0.839 versus 0.894 (derivation versus validation) and good calibration (Hosmer-Lemshow p = 0.56 versus 0.68). This model will be useful to identify patients at high risk for PTH who may be candidates for preventive interventions, and to improve their outcomes.
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Affiliation(s)
- Hao Chen
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Fang Yuan
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Shi-Wen Chen
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Yan Guo
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Gan Wang
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Zhi-Feng Deng
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Heng-Li Tian
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Xuhui District, Shanghai, 200233, China.
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Ben Hamida Nouaili E, Ayadi I, Boukhris R, Marrakchi Z. Lumbar hernia in a newborn revealing Lumbo-costovertebral syndrome. Tunis Med 2017; 95:505-506. [PMID: 29694657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Levic K, Rosen KV, Bulut O, Bisgaard T. Low incidence of perineal hernia repair after abdominoperineal resection for rectal cancer. Dan Med J 2017; 64:A5383. [PMID: 28673377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Perineal hernia may be a long-term complication to conventional abdominoperineal resection or proctocolectomy. We analysed the incidence of post-operative perineal hernia repair and described patient-reported outcome measures (PROMS) after perineal hernia repair. METHODS This was a nationwide retrospective analysis of consecutive Danish patients undergoing conventional abdominoperineal resection or proctocolectomy for rectal cancer from 1 January 2004 to 31 December 2014 combined with patients undergoing a subsequent repair for a perineal hernia during the follow-up period from 1 January 2004 to 31 December 2016. Patients were sent a quality of life questionnaire (HerQles A) and related PROMS. RESULTS The incidence of perineal hernia repair was 0.83%. A total of 2,170 patients underwent proctocolectomy and conventional abdominoperineal resection, and 18 patients had a subsequent perineal hernia repair. Four patients developed a clinical hernia recurrence, another four patients reported moderate/severe perineal pain or heaviness during physical activity and complained of poor perception of health, and one patient reported that the perineal hernia repair had a negative impact on sexual function. CONCLUSIONS The incidence of perineal hernia repair was below 1% after conventional abdominoperineal resection and proctocolectomy. PROMS and risk of recurrence may benefit from centralising perineal hernia repair. FUNDING none. TRIAL REGISTRATION not relevant.
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Taylor S, Keshavamurthy J. Lung herniation following thoracostomy. Europace 2017; 19:1001. [PMID: 28204455 DOI: 10.1093/europace/euw312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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