ABSTRACT
BACKGROUND: Incisional hernia (IH) repair with conventional techniques is associated with high recurrence rate. Surgical repair using prosthetic biomaterials is becoming increasingly popular. On the basis of the good results an increasing number of surgeons have begun to use this technique. However prosthesis use in contaminated fields is still debated. In complicated IH contaminating surgical procedure are often performed and the use of meshes can be hazardous. The aim of this study was to report our experience about the treatment of complicated IH with prosthetic materials in an emergency surgery setting. METHODS: From November 1995 to November 2001 55 patients were submitted to emergency surgical treatment for complicated IH. Eleven patients were treated using a prosthetic device. Patients mean age was 71.3 (range 38-91). About 70% of patients had concomitant major cardiac or pulmonary diseases. RESULTS: Thirty-two IH were strangulated, 23 were incarcerated. In all patients a viscerolysis was carried out. In 6 patients a small bowel resection was done and in 4 subjects a large bowel resection was performed. Eight patients were submitted to omental resection. There were not differences in morbidity and mortality between the studied group. Recurrence rate was significantly lower in prosthetic treated group. CONCLUSIONS: We concluded that prosthetic repair of complicated IH is feasible in selected cases allowing abdominal wall anatomy re-establishment.
Subject(s)
Emergency Treatment , Hernia, Ventral/complications , Hernia, Ventral/surgery , Adult , Aged , Aged, 80 and over , Female , Humans , Intestinal Perforation/etiology , Male , Middle Aged , Retrospective Studies , Surgical Mesh , Treatment OutcomeSubject(s)
Carcinoma, Renal Cell/secondary , Kidney Neoplasms/pathology , Pancreatic Neoplasms/secondary , Tomography, X-Ray Computed , Aged , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/pathology , Humans , Male , Pancreatic Neoplasms/diagnostic imaging , Tomography, X-Ray Computed/methodsABSTRACT
Glucagonoma, a rare neuroendocrine pancreatic tumour, is frequently malignant and often accompanied by hepatic metastases. Our aim was to consider the different treatments of metastatic glucagonoma to the liver and their results. A case of glucagonoma with metachronous, small, multiple and bilobar liver metastases is reported. Combined treatment with octreotide and hepatic arterial chemoembolization was applied with good results in terms of symptom relief, plasma glucagon levels and regression of hepatic metastases. Survival rates were also improved. Based on our experience, glucagonoma with metachronous, multiple, diffuse and bilobar hepatic metastases should be treated with octreotide plus hepatic arterial chemoembolization with improved outcome and prognosis.
