ABSTRACT
BACKGROUND: forced repair of a giant abdominal wall defect end with unsatisfactory results despite development of prosthetics materials. The enlargement of abdominal wall dimensions could be realized altogether other methods with the aid of pneumo-peritoneum. The aim of the study is to evaluate early results of the method used for patients with giant incisional hernias. MATERIAL AND METHODS: between june 1998 - june 2013, 17 patients (4 males) with giant abdominal wall defects (incisional and inguinal hernias) were prepaired for radical surgery with pneumoperitoneum. Average age was 64.35 years. We reevaluated the standard constants of the pulmonary function,blood gases, and intra-vesical pressure in 3 moments: before the first gas insuflation, 24 hours before surgery and in the 7th daypost operatively. RESULTS: the method was free of accidents or incidents, no mortality was recorded. The respiratory function was significantly increased and also the intra-abdominal pressure. CONCLUSION: our results suggest that the method of progressive pneumoperitoneum is safe, costless of choice for creating a clear compatibility between the wall and abdominal content inpatients with giant abdominal wall defects. Also ensures a longterm and stable improvement of the respiratory function in all its components.
Subject(s)
Hernia, Inguinal/surgery , Hernia, Ventral/surgery , Pneumoperitoneum, Artificial , Preoperative Care , Aged , Female , Humans , Male , Middle Aged , Preoperative Care/methods , Recurrence , Respiratory Function Tests/methods , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: The prosthetic repair of incisional hernias drastically reduced the incidence of recurrence, but increased the associated morbidity. We report a consecutive series of patients with incisional hernias operated by Rives- Stoppa procedure. The aim is to identify the early and late complications associated with the procedure. MATERIAL AND METHODS: 275 patients admitted and operated on between 2002-2006 were prospectively evaluated by direct examination and questionnaire. RESULTS: 171 responded in 2007 and 148 in 2009; direct examination was obtained 143 and 118 patients respectively.Recurrence rate 6.7%. Good and very good comfort rates in 58%. CONCLUSIONS: Similar results with the expert centre.
Subject(s)
Hernia, Ventral/surgery , Quality of Life , Surgical Mesh , Adult , Aged , Female , Follow-Up Studies , Hernia, Ventral/etiology , Humans , Male , Middle Aged , Prospective Studies , Recurrence , Surgical Mesh/adverse effects , Surveys and Questionnaires , Time Factors , Treatment Outcome , Wound HealingABSTRACT
The aim of the conservative treatment of postoperative external digestive fistulae is to obtain a reduction of the output, thus favoring spontaneous closure and shortening outcome. A retrospective comparative study has been performed on two groups of patients with postoperative anastomotic gastrointestinal and pancreatic fistulae. Group A included 18 cases (14 anastomotic, 4 pancreatic fistulae) receiving conventional treatment only. Group B included 25 cases (18 anastomotic and 7 pancreatic fistulae) in which Sandostatin was associated to conventional therapy, using daily doses ranging from 0.1 mg to 0.3 mg, administered after variable intervals after fistulas' occurrence. Duration of treatment ranged from 1 to 25 days. In group A, 27.77% of the cases were cured in comparison with group B in which the healing rate increased to 56%. Global hospital mortality rate was 25.58% (11 cases). In group A this was 44.44% (8 cases) in comparison with group B with 12% (3 cases) only. As a conclusion of our study, the use of Sandostatin is remarkable effective in the treatment of external digestive postoperative fistulae. Thus a doubling of healing rate and a reduction by 73% of mortality rate was achieved.
