ABSTRACT
PURPOSE: To evaluate the incidence of incisional hernia in patients undergoing direct access to the abdominal cavity in urological surgery. METHODS: We conducted a systematic review in Pubmed, Embase, and Cochrane Central from 1980 to the present according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Eighty-four studies were selected for inclusion in this analysis, and meta-analysis and meta-regression were performed. RESULTS: The total incidence in the 84 studies was 4.8% (95% CI 3.7% - 6.2%) I2 93.84%. Depending on the type of incision, it was higher in the open medial approach: 7.1% (95% CI 4.3%-11.8%) I2 92.45% and lower in laparoscopic surgery: 1.9% (95% CI 1%-3.4%) I2 71, 85% According to access, it was lower in retroperitoneal: 0.9% (95% CI 0.2%-4.8%) I2 76.96% and off-midline: 4.7% (95% CI 3.5%-6.4%) I2 91.59%. Regarding the location of the hernia, parastomal hernias were more frequent: 15.1% (95% CI 9.6% - 23%) I2 77.39%. Meta-regression shows a significant effect in reducing the proportion of hernias in open lateral, laparoscopic and hand-assisted compared to medial open access. CONCLUSION: The present review finds the access through the midline and stomas as the ones with the highest incidence of incisional hernia. The use of the lateral approach or minimally invasive techniques is preferable. More prospective studies are warranted to obtain the real incidence of incisional hernias and evaluate the role of better techniques to close the abdomen.
Subject(s)
Incisional Hernia , Urologic Surgical Procedures , Humans , Incisional Hernia/epidemiology , Incisional Hernia/etiology , Incidence , Urologic Surgical Procedures/adverse effects , Laparoscopy/adverse effectsSubject(s)
Intestinal Obstruction , Intussusception , Neoplasms , Humans , Adult , Intussusception/diagnostic imaging , Intussusception/etiology , Intussusception/surgery , Intestinal Polyps/complications , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Intestinal Obstruction/surgeryABSTRACT
A 77-year-old male underwent a colonoscopy because of a positive fecal occult blood test. A polyp was removed from the rectum, 12 cm from the anal margin, with a hyperplastic appearance, covered by a cap of whitish fibrinoid exudate. The pathological report reported a hyperplastic polyp with foci of bone metaplasia in the lamina propria.
Subject(s)
Polyps , Rectal Neoplasms , Aged , Colonoscopy , Humans , Male , Metaplasia , Rectal Neoplasms/diagnostic imaging , Rectal Neoplasms/surgery , RectumABSTRACT
BACKGROUND: Secondary malignancies of the thyroid gland are a rare finding in clinical practice. In addition, colorectal metastasis to the thyroid (CMT) is even more infrequently diagnosed. The source of the primary tumor follows demographic and ethnic patterns, which reflects the most prevalent malignancies in the different populations. Colorectal cancer is one of the most common types of cancer worldwide; nevertheless, CMT is infrequently diagnosed. Most of them are identified during the follow-up of gastrointestinal primary malignancies. Due to the improvement of image techniques, oncological treatment, and follow-up, survival and consequent diagnosis of metastatic disease are more frequent. Those facts make this entity a diagnostic and therapeutic challenge, due to the lack of information and the difficulties performing clinical trials and research. CASE SUMMARY: Here, we present a case report of a patient diagnosed with CMT of adenocarcinoma of the rectum evidenced during follow-up, 4 years after neoadjuvant chemoradiotherapy, who had subsequent curative surgical treatment of the primary tumor and inter-current lung bilateral metastases. CONCLUSION: Thyroid metastases of extra-thyroid origin are an uncommon finding, even rarer in cases of CMT. The diagnostic process, as well as survival of oncologic patients is improving, and consequently the number of metastases to the thyroid gland is increasing.
ABSTRACT
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