Laparoscopic Keyhole Versus Sugarbaker Repair in Parastomal Hernia: A Long-Term Case-Controlled Prospective Study of Consecutive Patients.

Objective: To compare laparoscopic Keyhole repair with the modified Sugarbaker repair in a nonrandomized case-controlled prospective study of consecutive patients with parastomal hernia. Background: Two reviews of uncontrolled studies concluded that the Sugarbaker repair is superior to the Keyhole repair. The present study challenges the claim. Materials and Methods: In two time periods, 135 patients with a parastomal hernia were repaired with the Keyhole technique (74 patients, using a two-layer mesh of polypropylene and polytetrafluoroethylene [ePTFE] with a self-cut slit, 1997-2009) or the Sugarbaker technique (61 patients, using a coated polypropylene mesh, 2009-2015). The patients in the two groups matched with regard to clinical profile, colostomy or ileostomy hernia, previous repairs, size of fascial defect, and simultaneous repair of a concurrent incisional hernia. Observation time was defined as time to recurrence, stoma resiting, mesh removal, death, or last nonevent visit. Results: In-hospital morbidity did not differ with two fatalities in each group. Seventy and fifty-eight patients after Keyhole and Sugarbaker repair, respectively, were available for follow-up. Two patients after Sugarbaker repair were lost to follow-up. After a median follow-up of 57 months, five recurrences were diagnosed in the Keyhole group (7%). In the Sugarbaker group, six recurrences (10%) were observed after a median follow-up of 11 months. Late mesh-related morbidity occurred in 6 and 6 patients after Keyhole (8%) and Sugarbaker repair (10%), respectively. Conclusion: The present study indicates that the Keyhole repair, using a polypropylene mesh with an antiadhesive layer, compares favorably with the Sugarbaker repair with regard to postoperative complications, recurrence rate, and late mesh-related morbidity. ClinicalTrials.gov Identifier: NCT00000418 7235.

[Case report of a spontaneous internal hernia]. / Tarmgangræn hos tidligere ikkeopereret patient med internt hernie.

Internal hernia is a rare, but life-threatening condition occurring spontaneously or as a complication to abdominal surgery. We present a case of a spontaneous herniation of the small bowel through a slit in the transverse mesocolon in an adult female with no history of previous surgery. The definition of internal hernia and the prevailing sites of occurrence are reviewed, and symptoms and in particular the challenges related to the diagnosis of internal hernias are discussed.

[Frontal fibrosing alopecia is a variant of lichen planopilaris]. / Frontal fibroserende alopeci er en variant af lichen planopilaris.

Frontal fibrosing alopecia is a scarring alopecia which typically affects the frontotemporal region of the scalp. Loss of hair in the other areas of the skin is present in the majority of cases. The condition is overrepresented among postmenopausal women, but men and premenopausal women can be affected as well. Our case is the first one described in the Danish literature. A 73-year-old woman had a typical presentation of the disease and responded well to treatment with hydroxychloroquine. We discuss clinical presentation, differential diagnosis and treatment modalities to this relatively newly described condition.