China
Africa
Explore chapters and articles related to this topic
Complications of open aortofemoral bypass
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
There are extensive data in the general surgery literature on the avoidance and prevention of hernia. A recent meta-analysis specific to patients undergoing aortic surgery showed decreased hernia formation in those patients who were closed with a suture:wound length ratio of more than 4:1 and in those who underwent closure with mesh. There was no difference between midline and retroperitoneal incision.35 In high-risk patients, particularly those who have previously undergone abdominal wall repair, pre-emptive involvement with a general surgeon skilled in complex repair of abdominal wall defects may be helpful.
The Scale of the Problem
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
Samuel G. Parker, Xavier Chalhoub, Alastair C.J. Windsor
The patient presents many factors that may mean a hernia repair is either not feasible or the risk-benefit balance lies strongly in favour of not operating. A history of hernia recurrence after repair is a de facto risk for further recurrence. A population-based hospital discharge database study illustrates this point perfectly. The recurrence rate after a primary incisional hernia repair was 12% within 5 years, but the rate of recurrence (as judged by reoperation rate) after the first re-do repair was 24%, 35% after the second re-do and 39% after the third.10 Multiple recurrences may suggest an underlying defect in collagen synthesis (herniosis) and also reduces the integrity of the remaining tissues meaning that sutures may not hold as well, further predisposing to more recurrences. Likewise, a previous component separation markedly reduces the reconstructive options and suggests complexity as does recurrence after a previous mesh repair.
Parastomal Hernias
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Arun Prasad, Sanjiv Haribhakti
PH is a highly prevalent problem. In reality, almost every stoma will ultimately result in some degree of PH, if followed long enough. The complications of hernia range from asymptomatic to potentially life-threatening. The traditional paradigm of direct repair and stoma re-siting has largely been abandoned due to unacceptable recurrence rates at the initial site, as well as at the new site. The sublay or intra-abdominal approach offers the lowest recurrence rate, and is our recommendation. The decision whether to approach the surgery laparoscopically or open is based on the surgeon's level of experience and comfort. Finally, due to the known likely development of PH in the majority of cases, we recommend prophylactic parastomal reinforcement at the time of permanent stoma creation. Given the increased use of laparoscopy at the time of many colectomies, as well as the ease of placement, we favor a sublay or intraperitoneal technique in these cases.
Paraconduit hernia after minimally invasive esophagectomy – incidence and risk factors
Published in Scandinavian Journal of Gastroenterology, 2023
Henriikka Hietaniemi, Tommi Järvinen, Ilkka Ilonen, Jari Räsänen
The majority (71.4%, N = 10) of the paraconduit hernias in this study were diagnosed more than one year after the esophagectomy, and only one case within 3 months. To prevent early paraconduit hernia in our institution, the graft is sutured to the crura. If the hiatal opening is loose, we perform hiatoplasty at the posterior or anterior hiatus, depending on the anatomy. We also leave most of the omentum to the gastric conduit, which fills up the crura. Some authors greatly advocate for hiatoplasty during esophagectomy, especially anterior hiatoplasty. We believe that these methods could prevent paraconduit hernia formation in the immediate postoperative period. However, no comparative data on the effect of these maneuvers exist. In previous studies, the hernias that appeared early after esophagectomy were associated with high morbidity [29]. To the authors’ knowledge, no data on prevention of late paraconduit hernia have been published, but we believe that prevention of malnutrition, weight loss and cancer recurrence are the most significant factors.
Massive non-incisional abdominal wall hernia caused by abdominal wall weakness resulting from childhood radiation therapy: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Tatsuya Ichida, Yuki Otsuki, Koichi Ueda
There are many options for treating abdominal hernias, including suture repair, mesh repair, autologous fascia grafting, and the components separation technique. The optimal procedure is selected on the basis of the size and location of the hernial orifice, condition of the soft tissue, and other factors. Primary suturing may be appropriate when the hernia is small. However, the rate of recurrence after this procedure is reportedly 43% [6]; thus, another surgical procedure may be necessary to minimize recurrence. When the hernial orifice is large, insertion of some material is needed to close it, the surgical mesh being the most widely used. Mesh repair may be a treatment option for this case, but it may not be the best option. A partial list of mesh-related complications includes infection requiring mesh removal, mesh mechanical failure, mesh bulging, chronic pain, chronic inflammatory reaction, and mesh erosion into abdominal viscera [7]. The guidelines for laparoscopic treatment of ventral and incisional state that in many giant incisional hernias with a horizontal defect of more than 10 cm, standard open techniques and the laparoscopic intraperitoneal onlay mesh repair are insufficient [7].
Congenital diaphragmatic hernia in adults: a decade of experience from a single tertiary center
Published in Scandinavian Journal of Gastroenterology, 2022
Henriikka Hietaniemi, Tommi Järvinen, Ilkka Ilonen, Jari Räsänen
Most patients with hernia-related symptoms presented with gastrointestinal symptoms, including abdominal pain (n = 15), acute bowel occlusion (n = 4), vomiting (n = 4) or constipation (n = 1) as shown in Table 2. The hernia was found incidentally in a CT scan in seven patients (18.9%). Preoperative diagnosis was confirmed through a CT scan in 94.6% (n = 35) of cases. The remaining 5.4% (n = 2) were identified incidentally during laparoscopy for another indication and subsequently repaired. Emergency operations accounted for 36.1% (n = 13) of all CDH cases. All emergency patients experienced CDH symptoms and two patients (5.4%) underwent a small bowel resection. Most patients undergoing emergency operations (76.9%, n = 10) were unaware of the CDH. Among the three patients (23.1%) who were aware, two were awaiting operative treatment and one opted for conservative treatment (Table 2).