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1.
Article in English | MEDLINE | ID: mdl-38817686

ABSTRACT

An upside-down stomach is a rare type of hiatal hernia. An 83-year-old woman presented to the emergency room with abdominal pain and vomiting. Computed tomography revealed an upside-down stomach and the incarceration of a part of the gastric body into the abdominal cavity. Upper gastrointestinal endoscopy revealed a circular ulcer caused by gastric ischemia. Although she was discharged after 1 week of conservative therapy, she was readmitted to the hospital 1 day after discharge because of a recurrence of hiatal hernia incarceration. She underwent laparoscopic surgery 4 days after readmission and recovered successfully.

2.
J Abdom Wall Surg ; 3: 12780, 2024.
Article in English | MEDLINE | ID: mdl-38952417

ABSTRACT

Background: By separating the abdominal wall, transversus abdominis release (TAR) permits reconstruction of the abdominal wall and the placement of large mesh for many types of hernias. However, in borderline cases, the mobility of the layers is inadequate, and additional bridging techniques may be required for tension-free closure. We now present our own data in this regard. Patients and Methods: In 2023, we performed transversus abdominis release on 50 patients as part of hernia repair. The procedures were carried out using open (n = 25), robotic (n = 24), and laparoscopic (n = 1) techniques. The hernia sac was always integrated into the anterior suture and, in the case of medial hernias, was used for linea alba reconstruction. Results: For medial hernias, open TAR was performed in 22 cases. Additional posterior bridging was performed in 7 of these cases. The ratio of mesh size in the TAR plane to the defect area (median in cm) was 1200cm2/177 cm2 = 6.8 in patients without bridging, and 1750cm2/452 cm2 = 3.8 in those with bridging. The duration of surgery (median in min) was 139 and 222 min and the hospital stay was 6 and 10 days, respectively. Robotic TAR was performed predominantly for lateral and parastomal hernias. These procedures took a median of 143 and 242 min, and the hospital stay was 2 and 3 days, respectively. For robotic repair, posterior bridging was performed in 3 cases. Discussion: Using the TAR technique, even complex hernias can be safely repaired. Additional posterior bridging provides a reliable separation of the posterior plane from the intestines. Therefore, the hernia sac is always available for anterior reconstruction of the linea alba. The technique can be implemented as an open or minimally invasive procedure.

3.
Cureus ; 16(5): e61387, 2024 May.
Article in English | MEDLINE | ID: mdl-38953091

ABSTRACT

Herniation of bowel contents between the peritoneal cavity proper and the omental bursa, through the foramen of Winslow, can present diagnostic challenges that can potentially delay necessary surgical intervention. This case describes a 49-year-old female with a past medical history of hiatal hernia and biliary dyskinesia who presented to the emergency department with severe epigastric and right lower quadrant abdominal pain one day after a reported gastrointestinal illness of unknown etiology. Initial emergency department workup demonstrated an elevated white blood cell count without lactic acidosis. Computed tomography imaging was interpreted as gastric distension with volvulus around the mesentery and second portion of the duodenum. Intraoperatively, the entirety of the right colon was noted to have passed through the foramen of Winslow into the lesser sac. This led to twisting of the mesocolon causing compression of the duodenum and a gastric outlet obstruction. After surgical reduction of the herniation, the patient noted great improvement in pain and other symptoms.

4.
Eur J Pediatr ; 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38954007

ABSTRACT

To develop a nomogram model for predicting contralateral patent processus vaginalis in children with unilateral inguinal hernia or hydrocele. A retrospective analysis was conducted on 259 children with unilateral inguinal hernia or hydrocele who underwent laparoscopic surgery at the Southern Hospital of Southern Medical University from January 2021 to December 2023. The patients were randomly divided into a training set (n = 207) and a validation set (n = 52) in an 8:2 ratio to analyze the characteristics of CPPV. Multivariate logistic regression analysis was used to screen for independent risk factors for CPPV, and a nomogram prediction model was constructed. The predictive ability, calibration, and clinical net benefit of the model were evaluated by plotting receiver operating characteristic (ROC) curves, calibration curves (HL), and clinical decision curves (DCA). Among children under 1 year old, the laparoscopic exploration revealed a CPPV incidence rate of 55.17%. The incidence rates for children aged 2-10 years ranged from 29.03 to 39.13%, and the incidence rate for children aged 11-14 years was 21.21%. Multivariate logistic regression analysis showed that age (OR = 0.9, 95%CI 0.82-0.99, P = 0.035) and female gender (OR = 2.42, 95%CI 1.21-4.83, P = 0.013) were independent risk factors for CPPV, and the incidence of CPPV decreased with age. The area under the ROC curve (AUC) for the training set of the constructed model was 0.632, and the AUC for the validation set was 0.708. The Hosmer-Lemeshow goodness-of-fit test indicated good model fit (training set P = 0.085, validation set P = 0.221), and the DCA curve suggested good clinical benefit.The nomogram model developed in this study demonstrates good clinical value. Children with unilateral inguinal hernia or hydrocele who are younger in age and female gender should undergo careful intraoperative exploration for the presence of CPPV. What is Known: • The probability of developing inguinal hernia in children with CPPV is 11%-25%, and redo surgery can increase surgical risks and financial burden. • The risk factors of unilateral inguinal hernia combined with CPPV are controversial. What is New: • Age and female gender are independent risk factors for CPPV. • A nomogram prediction model was constructed to provide a theoretical basis as well as an assessment tool for preoperative evaluation of whether children with unilateral indirect inguinal hernia are susceptible to CPPV.

5.
Pediatr Surg Int ; 40(1): 166, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38954216

ABSTRACT

PURPOSE: To report our experience with laparoscopic repair of anterior congenital diaphragmatic hernia (CDH) using extracorporeal subcutaneous knot tying and to define recurrence risk factors. METHODS: This retrospective unicentric study included children who underwent laparoscopic repair of anterior CDH without patch, using extracorporeal knot tying of sutures passed through the full thickness of the abdominal wall (2013-2020). A systematic review of the literature with meta-analysis was performed using the MEDLINE database since 2000. RESULTS: Eight children were included (12 months [1-183]; 10.6 kg [3.6-65]). Among the two patients with Down syndrome, one with previous cardiac surgery had a recurrence at 17 months postoperatively. In our systematic review (26 articles), among the 156 patients included, 10 had a recurrence (none with patch). Recurrence was statistically more frequent in patients with Down syndrome (19.4%) than without (2.5%) (p < 0.0001), and when absorbable sutures were used (50%) instead of non-absorbable sutures (5.3%) (p < 0.0001). CONCLUSION: Laparoscopic repair of anterior CDH without patch was a safe and efficient surgical approach in our patients. The use of a non-absorbable prosthetic patch should be specifically discussed in anterior CDH associated with Down syndrome and/or in case of previous cardiac surgery to perform a diaphragmatic tension-free closure.


Subject(s)
Hernias, Diaphragmatic, Congenital , Herniorrhaphy , Laparoscopy , Recurrence , Humans , Hernias, Diaphragmatic, Congenital/surgery , Hernias, Diaphragmatic, Congenital/complications , Laparoscopy/methods , Retrospective Studies , Infant , Herniorrhaphy/methods , Male , Female , Child, Preschool , Child , Suture Techniques , Infant, Newborn , Adolescent , Down Syndrome/complications , Risk Factors
6.
Int J Surg Case Rep ; 121: 109976, 2024 Jun 29.
Article in English | MEDLINE | ID: mdl-38954968

ABSTRACT

INTRODUCTION AND IMPORTANCE: Repairing incisional abdominal wall hernia with nonabsorbable meshes is one of the most common procedures in general surgery. Mesh migration into the intestine is rare but a serious complication. It can occur months or even years after surgery and often presents with vague abdominal pain, making diagnosis tricky. CASE PRESENTATION: We report a rare case of a 52-year-old female presenting a small bowel obstruction secondary to mesh migration from the abdominal wall into the intestine, 10 years after repeated surgical repair of a ventral incisional hernia. At surgery, a mesh was migrated into a small bowl. The patient had a small bowel resection. The postoperative course was simple and the patient was discharged after 5 days. CASE DISCUSSION: Incisional hernia repair with mesh is one of the most commonly performed surgical procedures worldwide. Many complications have been linked to the use of mesh; among the most frequently reported are seromas, hematomas, and infections. Mesh migration remains an uncommon event after incisional hernia repair, and even rarer when considering complete migration within the intestinal lumen. The exact cause of this complication remains unknown. Multiple hypotheses have been proposed for mesh migration. Abdominal pain, intermittent or persistent intestinal obstruction, mass formation, and viscus perforation represent the most common clinical manifestation. Total removal of the mesh via laparoscopy or laparotomy is recommended, along with either partial or entire resection of the organ. CONCLUSION: Mesh migration is a an uncommon possible complication in case of incisional hernia mesh repair and it requires often surgical intervention.

7.
Asian J Endosc Surg ; 17(3): e13352, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38956777

ABSTRACT

We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair (TEP). A 79-year-old man presented with a right inguinal swelling that had been treated three times on the same side with anterior approaches. Computed tomography confirmed a recurrent inguinal bladder hernia. TEP was performed after identifying the bladder hernia preoperatively, with previous surgeries that used a plug-and-patch technique through an anterior approach. The extraperitoneal approach allowed the bladder to be reduced without injury and the hernia to be safely repaired using a 3D Max® Light Mesh. The postoperative recovery was uneventful, with no recurrence after 1 year. TEP facilitates the diagnosis and repair of bladder hernias, emphasizing the importance of preoperative diagnosis and the efficacy of endoscopic procedures in bladder hernia repair, even in recurrent cases.


Subject(s)
Hernia, Inguinal , Herniorrhaphy , Laparoscopy , Recurrence , Humans , Male , Hernia, Inguinal/surgery , Aged , Herniorrhaphy/methods , Laparoscopy/methods , Surgical Mesh , Urinary Bladder Diseases/surgery
8.
Cureus ; 16(6): e61589, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38962612

ABSTRACT

Inguinal hernias are the most common type of hernias in the groin, affecting 27% of the population, with a nine to 12 times higher incidence in men. The primary treatment for this condition typically involves a surgical procedure, with most surgeons opting for mesh placement through a laparoscopic approach. While this procedure is generally associated with low complication rates (primarily hematomas, seromas, and scrotal edema), there are some highly infrequent complications reported such as postoperative small bowel obstruction (SBO), estimated to occur in approximately 0.1%-0.5% of cases, most commonly during transabdominal preperitoneal (TAPP) repair. It is crucial to emphasize the importance of using skilled surgical techniques and adhering to established guidelines in postoperative patient care to minimize the risk of these complications. We describe a case of a 47-year-old male patient who underwent bilateral TAPP repair for inguinal hernias and subsequently experienced postoperative complications, including the development of a hematoma and SBO, requiring a re-intervention that evidenced a peritoneal pocket hernia.

9.
Tech Coloproctol ; 28(1): 79, 2024 Jul 04.
Article in English | MEDLINE | ID: mdl-38965146

ABSTRACT

BACKGROUND: Perineal hernia (PH) is a late complication of abdominoperineal resection (APR) that may compromise a patient's quality of life. The frequency and risk factors for PH after robotic APR adopting recent rectal cancer treatment strategies remain unclear. METHODS: Patients who underwent robotic APR for rectal cancer between December 2011 and June 2022 were retrospectively examined. From July 2020, pelvic reinforcement procedures, such as robotic closure of the pelvic peritoneum and levator ani muscles, were performed as prophylactic procedures for PH whenever feasible. PH was diagnosed in patients with or without symptoms using computed tomography 1 year after surgery. We examined the frequency of PH, compared characteristics between patients with PH (PH+) and without PH (PH-), and identified risk factors for PH. RESULTS: We evaluated 142 patients, including 53 PH+ (37.3%) and 89 PH- (62.6%). PH+ had a significantly higher rate of preoperative chemoradiotherapy (26.4% versus 10.1%, p = 0.017) and a significantly lower rate of undergoing pelvic reinforcement procedures (1.9% versus 14.0%, p = 0.017). PH+ had a lower rate of lateral lymph node dissection (47.2% versus 61.8%, p = 0.115) and a shorter operative time (340 min versus 394 min, p = 0.110). According to multivariate analysis, the independent risk factors for PH were preoperative chemoradiotherapy, not undergoing lateral lymph node dissection, and not undergoing a pelvic reinforcement procedure. CONCLUSIONS: PH after robotic APR for rectal cancer is not a rare complication under the recent treatment strategies for rectal cancer, and performing prophylactic procedures for PH should be considered.


Subject(s)
Perineum , Postoperative Complications , Proctectomy , Rectal Neoplasms , Robotic Surgical Procedures , Humans , Retrospective Studies , Robotic Surgical Procedures/adverse effects , Robotic Surgical Procedures/methods , Male , Female , Risk Factors , Middle Aged , Perineum/surgery , Aged , Proctectomy/adverse effects , Proctectomy/methods , Rectal Neoplasms/surgery , Incidence , Postoperative Complications/etiology , Postoperative Complications/epidemiology , Hernia/etiology , Hernia/prevention & control , Hernia/epidemiology , Incisional Hernia/etiology , Incisional Hernia/prevention & control , Incisional Hernia/epidemiology
10.
Int J Surg Case Rep ; 121: 110006, 2024 Jul 04.
Article in English | MEDLINE | ID: mdl-38972105

ABSTRACT

INTRODUCTION AND IMPORATNCE: Introduction: Bochdalek's hernia (BH) is a congenital diaphragmatic hernia predominantly diagnosed in the pediatric population but infrequently found in adults. This paper presents a unique case of an adult patient with a left-sided BH accompanied by gastric volvulus and an intrathoracic kidney. CASE OF PRESENTATION: A 21-year-old male presented with abdominal pain and vomiting. An MDCT scan revealed a twisted stomach, spleen, and kidney herniated into the chest due to left diaphragmatic eventration. Surgery involved untwisting the stomach, relocating the organs, and removing the hernia sac. DISCUSSION: Bochdalek hernias (BHs) are rare conditions in which abdominal organs move into the chest due to defects in the diaphragm. BH usually occurs on the left side and can be triggered by factors such as pregnancy, obesity, or trauma. Symptoms can vary from abdominal pain to chest discomfort, and diagnosis can be challenging. Imaging tests such as CT scans are essential for accurate diagnosis. In adults, the BH can contain various organs, such as the spleen and kidney. Rarely, BH can be associated with an ectopic kidney located inside the chest cavity. In some cases of BH, there is a risk of complications such as gastric volvulus, where the stomach twists on itself, leading to potentially serious symptoms such as severe abdominal pain and vomiting. CONCLUSION: This case underscores the severe risks of BH in adults, such as gastric twisting and blockage, necessitating urgent surgery. Timely diagnosis and surgical intervention are crucial for preventing life-threatening outcomes. More research is needed to improve the management of this rare condition.

11.
Semin Pediatr Surg ; 33(4): 151443, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38972214

ABSTRACT

With improvements in initial care for patients with congenital diaphragmatic hernia (CDH), the number of CDH patients with severe disease who are surviving to discharge has increased. This growing population of patients faces a unique set of long-term challenges, multisystem adverse outcomes, and post-intervention complications requiring specialized multidisciplinary follow-up. Early identification and intervention are essential to mitigate the potential morbidity associated with these challenges. This manuscript outlines a general framework for long-term follow-up for the CDH patient, including cardiopulmonary, gastrointestinal, neurodevelopmental, surgical, and quality of life outcomes.

12.
Hernia ; 2024 Jul 06.
Article in English | MEDLINE | ID: mdl-38970697

ABSTRACT

PURPOSE: The aim of this work is to describe the rational, feasibility and clinical and Quality-of-life improvement results of a fully endoscopic preperitoneal repair for midline and lateral abdominal wall hernias, starting from the space of Retzius in a "bottom-to-up" approach. METHODS: An observational prospective data-collected and quality of life study is performed in selected patients with less than 10 cm. in diameter midline and lateral abdominal wall hernias. A suprapubic upward e-TEP technique from a previously dissected Retzius space, is performed in all cases. The surgical goal is to perform a total free-tension abdominal wall reconstruction followed by a prosthetic hernioplasty. Clinical Data is classified in preoperative, intraoperative, and postoperative variables, including a quality-of-life clinical evaluation based on an improvement of HerQLes score. RESULTS: A total of 30 patients underwent this approach from September 2017 to October 2022 in a single-surgeon practice. A total restoration of the previous abdominal wall anatomy and a prosthetic repair were achieved in all cases. The mean operative time was 142.53 min, with a significant shorter time in lateral hernias approach. Minor complications (Clavien-Dindo I) were collected in 10% of the patients. Major complications (Clavien-Dindo IIIb) occurred in 6.66% of the patients. The mean pain at discharge was 1.83 VAS, with a significant lower pain in M-eTEP approach for lateral hernias. The mean hospital stay was 42.4 h. No seroma, hematoma, chronic pain, or recurrence was observed in the mean follow-up (20.33 months). A clinical and quality of life improvement was found in 92.9% of the patients, measured by a minimal clinical important difference (MCID) between preoperative and postoperative HerQLes score. CONCLUSION: Despite being a technically demanding approach, the results obtained by this approach are compatible in safety and feasibility with other minimally invasive preperitoneal hernia repair techniques, in addition to obtaining a significant improvement in the quality of life of patients.

13.
Cureus ; 16(7): e63771, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38966780

ABSTRACT

Lumbar hernias are rare abdominal wall hernias that occur in the posterolateral abdominal wall. Intra-peritoneal or extra-peritoneal contents typically protrude through defects in one of two anatomical triangles. The superior lumbar triangle (Grynfeltt-Lesshaft triangle) is an inverted triangle bordered by the 12th rib superiorly, the internal oblique muscle laterally, and the erector spinae muscle medially. The inferior lumbar triangle (Petit's triangle) is an upright triangle bordered by the iliac crest inferiorly, the external oblique muscle laterally, and the latissimus dorsi muscle medially. Surgical repair has been described via open or laparoscopic approach. A 69-year-old male patient presented with right flank pain and swelling. He was involved in a motorcycle accident 10 months prior, which likely resulted in the development of a traumatic lumbar hernia which was demonstrated on the CT scan. The hernia was clinically incarcerated, and the defect contained the cecum and ileocecal valve. The defect was noted just superior to the iliac crest, by definition, making this an inferior lumbar hernia or a Petit's hernia. The hernia was repaired via robotic-assisted laparoscopic transabdominal approach. A peritoneal flap was created exposing the fascial defect. The fascia was primarily repaired with suture. The defect was reinforced with an 11.4 cm round Ventralight ST mesh in the preperitoneal space. The patient tolerated the procedure well with no acute complications. He was discharged the same day as an outpatient with appropriate pain control. Short-term follow-up demonstrated no recurrent hernia present and symptoms resolved. Lumbar hernias are a rare occurrence with no gold standard technique for repair. The benefits of the laparoscopic approach have been described over the open approach. This case report describes utilizing a minimally invasive approach to primarily repair a lumbar hernia defect while also reinforcing the hernia with mesh in the preperitoneal space.

14.
J Abdom Wall Surg ; 3: 12907, 2024.
Article in English | MEDLINE | ID: mdl-38966856

ABSTRACT

Background: Our study addresses the gap in ventral hernia repair literature, regarding the long-term effectiveness of robotic transabdominal retrorectus umbilical prosthetic repair (r-TARUP) for primary and incisional ventral hernias. This study aimed to report the 3-year recurrence rates and overall patient outcomes including quality of life. Method: A retrospective review of prospective collected data analyzed 101 elective r-TARUP patients from August 2018 to January 2022. Data collected included demographics, hernia sizes, mesh types, postoperative outcomes and the European Hernia Society Quality of Life questionnaire (EuraHS-QoL) before and after surgery. Results: The average age of the group of patients was 53, having a mean body mass index (BMI) of 32 kg/m, with 54% incisional and 46% primary hernias, with mean length and width of 4.4 cm and 6.1 cm, utilizing synthetic 58% and bioabsorbable 42% mesh types. The majority were classified as Centers of Disease Control and Prevention (CDC) class I wounds. Postoperative complications included seroma (2%), hematoma (3%), which required surgical intervention, with no significant correlation to mesh type. A strong positive correlation was found between Transversus Abdominis Release (TAR) and increased length of hospital stay (correlation coefficient: 0.731, p < 0.001). Preoperative quality of life assessments demonstrated statistically significant improvements when compared to postoperative assessments at 3 years, with a mean (±SD) of 61.61 ± 5.29 vs. 13.84 ± 2.6 (p < 0.001). Mean follow up of 34.4 months with no hernia recurrence at 1 year and 3 recurrence at the 2-3 years follow up (3.2%). Conclusion: The r-TARUP technique has proven to be safe and effective for repairing primary and incisional ventral hernias, with a low recurrence rate during this follow up period with a noticeable improvement in quality of life (QoL).

16.
Sci Rep ; 14(1): 15389, 2024 07 04.
Article in English | MEDLINE | ID: mdl-38965256

ABSTRACT

The objective was to explore the efficacy of single-port laparoscopic percutaneous extraperitoneal closure using double-modified hernia needles with hydrodissection (SLPEC group) and two-port laparoscopic percutaneous extraperitoneal closure (TLPEC group) for the treatment of giant indirect inguinal hernias in children. We performed a retrospective review of all children with giant indirect inguinal hernias (inner ring orifice diameter ≥ 1.5 cm) who underwent laparoscopic high ligation of the hernia sac at FuJian Children's Hospital from January 2019 to December 2021. We collected data from the medical records of all the children and analysed their clinical characteristics and operation-related and follow-up information. Overall, this study included a cohort of 219 patients with isolated giant inguinal hernias who had complete clinical data and who had undergone laparoscopic high ligation of the hernia sac at our centre. All procedures were successfully performed for the 106 patients who underwent SLPEC and for the 113 patients who underwent TLPEC at our centre. There were no statistically significant differences in patient age, sex, body weight, follow-up time or the side of inguinal hernia between the SLPEC group and the TLPEC group (P = 0.123, 0.613, 0.121, 0.076 and 0.081, respectively). However, there were significant differences in the bleeding volume, visual analogue scale (VAS) score, and postoperative activity time between the two groups (P ≤ 0.001). The operation times in the TLPEC group were significantly longer than those in the SLPEC group (P = 0.048), but there were no significant differences in hospital length of stay or hospitalization costs between the two groups (P = 0.244 and 0.073, respectively). Incision scars were found in 2 patients in the SLPEC group and 9 patients in the TLPEC group, and there was a significant difference between the two groups (P = 0.04). However, the incidence of ipsilateral hernia recurrence, surgical site infection, suture-knot reactions and chronic inguinodynia did not significantly differ between the two groups (P = 0.332, 0.301, 0.332 and 0.599, respectively). Postoperative hydrocele occurred in only 1 male child in the SLPEC group and in no male children in the TLPEC group, and there was no difference between the two groups (P = 0.310). In this study, there were no cases of testicular atrophy or iatrogenic ascent of the testis. Compared with the TLPEC group, the SLPEC group had the advantages of a concealed incision, light scarring, minimal invasiveness, a reduced operation time, minimal bleeding, mild pain and rapid recovery. In conclusion, SLPEC using double-modified hernia needles with hydrodissection and high ligation of the hernia sac is a safe, effective and minimally invasive surgery. The cosmetic results are impressive, and the follow-up results are promising.


Subject(s)
Hernia, Inguinal , Herniorrhaphy , Laparoscopy , Humans , Hernia, Inguinal/surgery , Male , Laparoscopy/methods , Female , Retrospective Studies , Child, Preschool , Child , Herniorrhaphy/methods , Herniorrhaphy/instrumentation , Needles , Infant , Treatment Outcome , Postoperative Complications/epidemiology , Postoperative Complications/etiology
17.
ANZ J Surg ; 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38946690

ABSTRACT

BACKGROUND: Ventral hernia repair is a common elective surgical procedure lacking strong evidence for specific operative approaches. This study aimed to evaluate the outcomes of primary suture repair or polypropylene sandwich mesh repair for ventral hernias. The main outcome measures were the rate of hernia recurrence, and evaluation of long-term complications and patient-reported outcomes. METHODS: This retrospective cohort study evaluated patient perceived recurrence and pain in patients who had undergone a primary ventral hernia (epigastric, supraumbilical, or umbilical) repair or small (≤20 mm) midline incisional hernia repair 10 years after the procedure. Short-term follow-up occurred up to 6 weeks after the initial operation, while long-term follow-up included patients who were reviewed clinically or interviewed via telephone at or beyond 3 years after the procedure. RESULTS: Most (75/100, 75.0%) patients had an extra-peritoneal sandwich mesh repair. Short-term follow-up showed minimal pain and normal activities for all patients (97/97, 100%). Long-term follow-up (median 12 years [IQR 11-13]) was achieved in 95.9% (93/97) of patients with only a small number reporting a slight bulge (5/93, 5.4%) and intermittent mild discomfort (8/93, 8.6%). Nine patients (9/97, 9.3%) experienced hernia recurrence, diagnosed at a median of 26 months [interquartile range, IQR, 7-58] post-operatively. CONCLUSIONS: These findings suggest that an open sandwich mesh technique is a safe and effective method for repairing primary ventral hernias and small midline incisional hernias and is associated with favourable long-term patient-reported outcomes.

18.
Mol Imaging Radionucl Ther ; 33(2): 115-117, 2024 Jun 28.
Article in English | MEDLINE | ID: mdl-38949490

ABSTRACT

In a 55-year-old woman with sigmoid colon cancer, a subcutaneous mass in the left lower abdomen was incidentally found and gradually enlarged. For further diagnosis and staging, an 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography scan was performed, which revealed a subcutaneous mass in the left lower abdomen with mild uptake of 18F-FDG, suggesting the possibility of metastasis. However, post-surgery and pathological confirmation, this mass was diagnosed as a drain-site hernia containing fallopian tube fimbria, which is extremely rare but should be considered in the differential diagnosis of subcutaneous mass in the lower abdomen.

19.
Cureus ; 16(1): e52638, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38957333

ABSTRACT

This is a case report of a man in his 60s who was diagnosed with a small bowel obstruction due to an internal hernia caused by a ureterocutaneous fistula. Internal hernia caused by the ureter following urinary diversion is rare, posing challenges in preoperative diagnosis and carrying the risk of intraoperative injury due to the resemblance of a ureterocutaneous fistula to an adhesive band. The presentation and surgical management are discussed in this case report.

20.
Front Nutr ; 11: 1265920, 2024.
Article in English | MEDLINE | ID: mdl-38957866

ABSTRACT

Background: The relationship between dietary factors and hernias is currently unclear. Methods: The UK Biobank was used to extract dietary factors that were used as exposures, including intake of alcohol, non-oily fish, beef, fresh fruit, oily fish, salad/raw vegetables, dried fruit, coffee, cereal, salt, tea, water, cooked vegetables, cheese, Lamb/mutton, pork, poultry, processed meat, and bread. The FinnGen biobank was used to obtain GWAS data on hernias as outcomes. The main analysis of this study was performed using the weighted median, MR-Egger, and IVW methods. Cochran's Q test was utilized to assess heterogeneity. To find potential outliers, the MR-PRESSO method was used. Leave-one-out analysis was employed to assess the IVW method's robustness. Results: Alcoholic consumption per week (OR: 0.614; p = 0.00614) reduced the risk of inguinal hernia. Alcohol intake frequency (OR: 1.309; p = 0.0477) increased the risk of ventral hernia (mainly including incisional hernia and parastomal hernia). The intake of non-oily fish (OR: 2.945; p = 0.0214) increased the risk of inguinal hernia. Salt added to food (OR: 1.841; p = 0.00267) increased the risk of umbilical hernia. Cheese intake (OR: 0.434; p = 0.000536) and dried fruit intake (OR: 0.322; p = 0.00716) decreased the risk of ventral hernia, while cooked vegetable intake (OR: 4.475; p = 0.0380) increased the risk of ventral hernia. No causal relationships were found with hernias from other dietary factors. Conclusion: Inguinal, umbilical, and ventral hernias are all related to dietary factors.

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