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The Journal of Surgical Research Jul 2024Pulmonary lobectomy can result in intercostal nerve injury, leading to denervation of the rectus abdominis (RA) resulting in asymmetric muscle atrophy or an abdominal...
INTRODUCTION
Pulmonary lobectomy can result in intercostal nerve injury, leading to denervation of the rectus abdominis (RA) resulting in asymmetric muscle atrophy or an abdominal bulge. While there is a high rate of intercostal nerve injury during thoracic surgery, there are no studies that evaluate the magnitude and predisposing factors for RA atrophy in a large cohort.
METHODS
A retrospective chart review was conducted of 357 patients who underwent open, thoracoscopic or robotic pulmonary lobectomy at a single academic center. RA volumes were measured on computed tomography scans preoperatively and postoperatively on both the operated and nonoperated sides from the level of the xiphoid process to the thoracolumbar junction. RA volume change and association of surgical/demographic characteristics was assessed.
RESULTS
Median RA volume decreased bilaterally after operation, decreasing significantly more on the operated side (-19.5%) versus the nonoperated side (-6.6%) (P < 0.0001). 80.4% of the analyzed cohort experienced a 10% or greater decrease from preoperative RA volume on the operated side. Overweight individuals (body mass index 25.5-29.9) experienced a 1.7-fold greater volume loss on the operated side compared to normal weight individuals (body mass index 18.5-24.9) (P = 0.00016). In all right-sided lobectomies, lower lobe resection had the highest postoperative volume loss (Median (interquartile range): -28 (-35, -15)) (P = 0.082).
CONCLUSIONS
This study of postlobectomy RA asymmetry includes the largest cohort to date; previous literature only includes case reports. Lobectomy operations result in asymmetric RA atrophy and predisposing factors include demographics and surgical approach. Clinical and quality of life outcomes of RA atrophy, along with mitigation strategies, must be assessed.
Topics: Humans; Male; Female; Retrospective Studies; Middle Aged; Aged; Rectus Abdominis; Pneumonectomy; Muscular Atrophy; Postoperative Complications; Tomography, X-Ray Computed; Adult
PubMed: 38754252
DOI: 10.1016/j.jss.2024.04.011 -
Journal of Cosmetic Dermatology Dec 2022Patients with multiple pregnancies, multiple pregnancies, and a history of severe obesity, the abdominal wall muscles, and skin exhibit rectus abdominis separation and...
OBJECTIVES
Patients with multiple pregnancies, multiple pregnancies, and a history of severe obesity, the abdominal wall muscles, and skin exhibit rectus abdominis separation and skin laxity due to prolonged overstretching, which causes damage to both the patient's appearance and health. Abdominoplasty is a surgical solution to the problems of separation of the rectus abdominis muscle and laxity of the skin of the abdominal wall under direct vision, which is important for patients with the above problems. Currently, many studies have been reported on abdominoplasty, however, no reverent bibliometric analyses of abdominoplasty have been published.
METHODS
In this study, we screened 1,119 studies on abdominoplasty between 2011 and 2021 based on the Web of Science Core Collection (WOSCC) database and performed a bibliometric analysis.
RESULTS
We found that high-quality research related to abdominoplasty has increased in the last decade, and the United States was the leading country in the field of abdominoplasty. Stanford university ranked first in number of publications and citations. Aesthetic surgery journal was the most productive journal, followed by the Plastic and reconstructive surgery and Aesthetic plastic surgery. In addition, bariatric surgery, venous thromboembolism, rectus diastasis, breast reconstruction and umbilicoplasty are the keywords of recent publications that are the focus of current research.
CONCLUSION
This study provides a comprehensive analysis and visualization of global research trends on abdominoplasty from 2011 to 2021, and improvements in abdominoplasty to reduce the incidence of postoperative complications will remain a focus of future research.
Topics: Pregnancy; Female; Humans; Abdominoplasty; Abdominal Wall; Rectus Abdominis; Plastic Surgery Procedures; Postoperative Complications
PubMed: 36047672
DOI: 10.1111/jocd.15342 -
Journal of Bodywork and Movement... Apr 2022Suspension training reportedly enhances core musculature co-contraction. This study investigated whether the use of a suspension trainer increases core musculature...
Suspension training reportedly enhances core musculature co-contraction. This study investigated whether the use of a suspension trainer increases core musculature co-activation during exercises vs. its floor counterpart. Participants were 25 healthy volunteers (16 men, 9 women; age: 27.24 ± 4.02 years). Wireless electromyography electrodes were placed bilaterally at the rectus abdominis (RA), erector spinae (ES), and abdominal obliques (OB). Test order (push-up, bridge, and prone plank) was randomized (exercise and condition) with a 3-min rest period between tests. Co-contraction ratios between muscle groups were estimated by root mean square. Ratios (RA/ES, RA/OB, ES/OB) were analyzed using paired t-tests (P ≤ .05). For all floor exercises, co-contraction of core musculature was significantly higher than suspension trainer. During suspension training, perturbations due to increased agonist activation without similar increases in antagonists may be too intense for untrained or injured individuals. Individuals lacking muscle control to recruit muscles concurrently may benefit from mastering traditional floor exercises to promote joint stiffness and stability before suspension trainer exercises.
Topics: Abdominal Muscles; Adult; Electromyography; Exercise; Exercise Therapy; Female; Humans; Male; Rectus Abdominis; Young Adult
PubMed: 35500983
DOI: 10.1016/j.jbmt.2022.02.018 -
Journal of Electromyography and... Jun 2023The independent effects of sloped walking or carrying a heavy backpack on posture and torso muscle activations have been reported. While the combined effects of sloped...
The independent effects of sloped walking or carrying a heavy backpack on posture and torso muscle activations have been reported. While the combined effects of sloped walking and backpack loads are known to be physically demanding, how back and abdominal muscles adapt to walking on slopes with heavy load is unclear. This study quantified three-dimensional pelvis and torso kinematics and muscle activity from longissimus, iliocostalis, rectus abdominis, and external oblique during walking on 0° and ± 10° degree slopes with and without backpack loads using two different backpack configurations (hip-belt assisted and shoulder-borne). Iliocostalis activity was greater during downhill and uphill compared to level walking, but longissimus was only greater during uphill. Rectus abdominis activity was greater during downhill and uphill compared to level, while external oblique activity decreased as slopes progressed from down to up. Longissimus, but not iliocostalis, activity was reduced during both backpack configurations compared to walking with no pack. Hip-belt assisted load carriage required less rectus abdominis activity compared to using shoulder-borne only backpacks; however, external oblique was not influenced by backpack condition. Our results revealed different responses between iliocostalis and longissimus, and between rectus abdominis and external obliques, suggesting different motor control strategies between anatomical planes.
Topics: Humans; Biomechanical Phenomena; Weight-Bearing; Walking; Torso; Rectus Abdominis
PubMed: 37004379
DOI: 10.1016/j.jelekin.2023.102769 -
International Journal of Molecular... Oct 2022Gestational diabetes mellitus (GDM) is recognized as a "window of opportunity" for the future prediction of such complications as type 2 diabetes mellitus and pelvic...
Transcriptomic Profiling of Rectus Abdominis Muscle in Women with Gestational Diabetes-Induced Myopathy: Characterization of Pathophysiology and Potential Muscle Biomarkers of Pregnancy-Specific Urinary Incontinence.
Gestational diabetes mellitus (GDM) is recognized as a "window of opportunity" for the future prediction of such complications as type 2 diabetes mellitus and pelvic floor muscle disorders, including urinary incontinence and genitourinary dysfunction. Translational studies have reported that pelvic floor muscle disorders are due to a GDM-induced-myopathy (GDiM) of the pelvic floor muscle and rectus abdominis muscle (RAM). We now describe the transcriptome profiling of the RAM obtained by Cesarean section from GDM and non-GDM women with and without pregnancy-specific urinary incontinence (PSUI). We identified 650 genes in total, and the differentially expressed genes were defined by comparing three control groups to the GDM with PSUI group (GDiM). Enrichment analysis showed that GDM with PSUI was associated with decreased gene expression related to muscle structure and muscle protein synthesis, the reduced ability of muscle fibers to ameliorate muscle damage, and the altered the maintenance and generation of energy through glycogenesis. Potential genetic muscle biomarkers were validated by RT-PCR, and their relationship to the pathophysiology of the disease was verified. These findings help elucidate the molecular mechanisms of GDiM and will promote the development of innovative interventions to prevent and treat complications such as post-GDM urinary incontinence.
Topics: Pregnancy; Humans; Female; Diabetes, Gestational; Rectus Abdominis; Cesarean Section; Diabetes Mellitus, Type 2; Transcriptome; Urinary Incontinence; Muscular Diseases; Biomarkers; Gene Expression Profiling
PubMed: 36361671
DOI: 10.3390/ijms232112864 -
Physical and Engineering Sciences in... Dec 2023This study proposes and investigates the feasibility of the passive assistive device to assist agricultural harvesting task and reduce the Musculoskeletal Disorder (MSD)...
This study proposes and investigates the feasibility of the passive assistive device to assist agricultural harvesting task and reduce the Musculoskeletal Disorder (MSD) risk of harvesters using computational musculoskeletal modelling and simulations. Several passive assistive devices comprised of elastic exotendon, which acts in parallel with different back muscles (rectus abdominis, longissimus, and iliocostalis), were designed and modelled. These passive assistive devices were integrated individually into the musculoskeletal model to provide passive support for the harvesting task. The muscle activation, muscle force, and joint moment were computed with biomechanical simulations for unassisted and assisted motions. The simulation results demonstrated that passive assistive devices reduced muscle activation, muscle force, and joint moment, particularly when the devices were attached to the iliocostalis and rectus abdominis. It was also discovered that assisting the longissimus muscle can alleviate the workload by distributing a portion of it to the rectus abdominis. The findings in this study support the feasibility of adopting passive assistive devices to reduce the MSD risk of the harvesters during agricultural harvesting. These findings can provide valuable insights to the engineers and designers of physical assistive devices on which muscle(s) to assist during agricultural harvesting.
Topics: Mechanical Phenomena; Back Muscles; Computer Simulation; Rectus Abdominis; Self-Help Devices
PubMed: 37493930
DOI: 10.1007/s13246-023-01305-9 -
Hernia : the Journal of Hernias and... Aug 2021The postpartum abdomen presents significant challenges to the surgeon. It is anatomically complex, with often substantial symptomatic divarication of the rectus... (Review)
Review
PURPOSE
The postpartum abdomen presents significant challenges to the surgeon. It is anatomically complex, with often substantial symptomatic divarication of the rectus abdominis, affecting all anterior abdominal wall layers. This may lead to profound functional sequelae, and often, of more importance to patients, a significant physical deformity. The complex interplay of functional/physical symptoms can result in reduced quality of life (QoL) as well as negative body image/self-esteem. Postpartum women may seek abdominoplasty to address the whole scope of these concerns. Whilst techniques have evolved achieving such goals operatively, the impact of such surgery on QoL/mental health has yet to be established.
METHODS
We perform a comprehensive review of potential options of validated patient-reported outcome measures (PROMs) for consideration of use in postpartum women seeking abdominoplasty; in addition to discussing current driving factors for seeking surgery and associated ethics.
RESULTS
Pressure on postpartum women to return their abdominal wall contour to a pre-pregnant state is high. This poses important ethical considerations for surgeons. There are several well-established/validated PROMs used in body contouring in massive weight loss/bariatric population groups, including Body-Q and Body-QoL scales, but none yet specific to postpartum women.
CONCLUSION
PROMs use to enable establishment of the true value of abdominoplasty in postpartum women, not just in terms of functional/physical restoration, but also in terms of delivering a positive impact on patients' mental health and QoL, are important. Further research is needed to determine if those already developed are appropriate or whether a postpartum-specific PROM would be beneficial.
Topics: Abdominal Wall; Abdominoplasty; Female; Herniorrhaphy; Humans; Postpartum Period; Pregnancy; Quality of Life; Rectus Abdominis
PubMed: 34309770
DOI: 10.1007/s10029-021-02470-0 -
BMC Anesthesiology Jan 2020Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery.
METHODS
A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine/morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and off-bed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded.
RESULTS
Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores.
CONCLUSIONS
The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery.
TRIAL REGISTRATION
Chinese Clinical Trial Registry, ChiCTR 1,800,015,141, 10 March 2018.
Topics: Abdominal Muscles; Analgesics, Opioid; Anesthetics, Local; China; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Levobupivacaine; Male; Middle Aged; Morphine; Nerve Block; Pain, Postoperative; Prospective Studies; Rectus Abdominis; Splenectomy; Ultrasonography, Interventional
PubMed: 31973700
DOI: 10.1186/s12871-020-0941-1 -
Surgical Endoscopy Oct 2021A subcutaneous endoscopic onlay repair for ventral hernia with an anterior plication of diastasis recti (DR) has been published under different names in different... (Review)
Review
BACKGROUND
A subcutaneous endoscopic onlay repair for ventral hernia with an anterior plication of diastasis recti (DR) has been published under different names in different countries. The aim of this systematic review is to assess the safety and feasibility of different named techniques with the same surgical concept.
METHODS
The PRISMA guidelines were followed during all stages of this systematic review. The MINORS score system was used to perform qualitative assessment of all studies included in this review. Recommendations were then summarized for the following pre-defined key items: protocol, research question, search strategy, study eligibility, data extraction, study designs, risk of bias, publication bias, heterogeneity, and statistical analysis.
RESULTS
The systematic literature search found 2548 articles, 317 of which were duplicates and excluded from analysis. The titles and abstracts from the remaining 2231 articles were assessed. After careful evaluation, 2125 articles were determined to be unrelated to our study and subsequently excluded. The full text of the remaining 106 articles was thoroughly assessed. Case reports, editorials, letters to the editor, and general reviews were then excluded. A total of 13 articles were ultimately included for this review, describing a similar subcutaneous endoscopic approach for repair of concomitant ventral hernias and rectus diastasis defined under nine different named techniques on 716 patients. The number of patients in those studies varied from 10 to 201. The mean operative time varied from 68.5 to 195 min. The most common complication was seroma, followed by pain requiring intervention, hematoma, and surgical site infection.
CONCLUSIONS
There are a few technique variations described in different studies, but with no significant differences in outcomes. We, therefore, propose to unify these procedures under one term, ENDoscopic Onlay Repair (ENDOR). This technique has shown to be effective and safe, with seroma being the most common complication.
Topics: Diastasis, Muscle; Endoscopy; Hernia, Ventral; Herniorrhaphy; Humans; Rectus Abdominis; Surgical Mesh
PubMed: 34031740
DOI: 10.1007/s00464-021-08560-5 -
Plastic and Reconstructive Surgery Nov 2020Rectus diastasis is a common condition that can result in a protruding abdomen, causing cosmetic and functional disability. Although it is usually repaired during... (Review)
Review
BACKGROUND
Rectus diastasis is a common condition that can result in a protruding abdomen, causing cosmetic and functional disability. Although it is usually repaired during abdominoplasty or herniorrhaphy, there is a lack of consensus with regard to the repair indications and optimal surgical techniques. The goal of this study is to provide an updated review of the surgical techniques used for rectus diastasis repair and their comparative efficacy.
METHODS
In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, Embase, and Cochrane databases were searched for articles that discussed the surgical management of rectus diastasis and reported on either outcomes, complications, or recurrence rates. Data detailing surgical techniques were extracted, and pooled analyses of complication and recurrence rates were performed, controlling for surgical approach, common variations in technique, and an associated herniorrhaphy.
RESULTS
Thirty-seven studies describing 45 techniques were included. An open rectus diastasis repair was performed in 24 of the studies. After controlling for an associated herniorrhaphy, there was no statistically significant difference in surgical complication and recurrence rates between open and laparoscopic approaches (p = 0.165 and p = 0.133, respectively). Although a double-layer suture closure was associated with a significantly lower rate of complications (p = 0.002), no significant difference was found for suture type absorbability.
CONCLUSIONS
Surgical repair of rectus diastasis is safe and effective through both open and laparoscopic approaches. Although suture type absorbability does not affect complication or recurrence rates, a double-layer suture closure can decrease surgical complications. The pooled analysis of complication and recurrence rates can help improve informed consent and patient education.
Topics: Abdominoplasty; Diastasis, Muscle; Humans; Rectus Abdominis; Recurrence
PubMed: 33136963
DOI: 10.1097/PRS.0000000000007252