ABSTRACT
INTRODUCTION: The proportion of recurrent repairs in the total collective of inguinal hernia repairs among men is 11.3-14.3% and among women 7.0-7.4%. The rate of re-recurrences is reported to be 2.9-9.2%. To date, no case series has been published on second and ≥ third recurrences and their treatment outcomes. Only case reports are available. MATERIALS AND METHODS: In an analysis of data from the Herniamed Registry the perioperative and 1-year follow-up outcomes of 16,206 distinct patients who had undergone first recurrent (n = 14,172; 87.4%), second recurrent (n = 1,583; 9.8%) or ≥ third recurrent (n = 451; 2.8%) inguinal hernia repair between September 1, 2009 and July 1, 2017 were compared. RESULTS: The intraoperative complication rate for all recurrent repairs was between 1-2%. In the postoperative complications a continuous increase was observed (first recurrence: 3.97% vs second recurrence: 5.75% vs ≥ third recurrence 8.65%; p < 0.001). That applied equally to the complication-related reoperation rates (first recurrence: 1.50% vs second recurrence: 2.21% vs ≥ third recurrence 2.66; p = 0.020). Likewise, the re-recurrence rate rose significantly (first recurrence: 1.95% vs second recurrence: 2.72% vs ≥ third recurrence 3.77; p = 0.005). Similarly, the rate of pain requiring treatment rose highly significantly with an increasing number of recurrences (first recurrence: 5.21% vs second recurrence: 6.70% vs ≥ third recurrence 10.86; p = < 0.001). CONCLUSION: The repair of re-recurrences in inguinal hernia is associated with increasingly more unfavorable outcomes. For the first recurrence the guidelines should definitely be noted. For a second and ≥ third recurrence diagnostic laparoscopy may help to select the best possible surgical technique.
Subject(s)
Hernia, Inguinal/surgery , Herniorrhaphy/methods , Reoperation/methods , Female , Humans , Laparoscopy/methods , Male , Middle Aged , Recurrence , Registries , Treatment OutcomeABSTRACT
Experience in the diagnosis and treatment of nodular forms of thyroid carcinoma is generalized. Among 4,601 patients who underwent operation for nodular goiter 338 (7.3%) were found to have carcinoma. Aspiration biopsy was widely used in establishing the diagnosis and chromothyrolymphography during the operation. The method of operative treatment consists in extrafascial resection of the thyroid gland and subsequent substitution therapy with thyroidine or thyrotoxine.
Subject(s)
Goiter, Nodular/surgery , Thyroid Neoplasms/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Needle , Child , Child, Preschool , Combined Modality Therapy , Female , Goiter, Nodular/complications , Goiter, Nodular/diagnosis , Goiter, Nodular/drug therapy , Hormones/therapeutic use , Humans , Lymphography , Male , Middle Aged , Surgical Procedures, Operative/methods , Thyroid Hormones/therapeutic use , Thyroid Neoplasms/complications , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/drug therapy , Thyroxine/therapeutic useABSTRACT
On the basis of the analysis of observation of 24 patients, the causes and mechanisms of the Ogilvie syndrome development after the operation were studied. The incidence of occurrence of the syndrome in 1615 patients with acute ileus has been established. Its clinical forms, methods for diagnosis and treatment were studied.
Subject(s)
Colonic Pseudo-Obstruction/diagnosis , Postoperative Complications/diagnosis , Acute Disease , Cause of Death , Chi-Square Distribution , Colonic Pseudo-Obstruction/etiology , Colonic Pseudo-Obstruction/mortality , Colonic Pseudo-Obstruction/pathology , Diagnostic Errors , Humans , Intestine, Large/pathology , Postoperative Complications/etiology , Postoperative Complications/mortality , Postoperative Complications/pathology , Retrospective Studies , Ukraine/epidemiologyABSTRACT
The experience with surgical treatment of 4476 patients with a nodular form of goiter has been summarized. Of them, in 2684 the solitary nodes were revealed, in 1359--the multiple ones, in 433--the mixed ones. Operative intervention was performed with regard for spreading of the thyroid gland lesion: from sparing resection to total thyroidectomy with transplantation of a graft under superficial fascia of chest.
