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Arquivos Brasileiros de Cirurgia... 2021In the definition of the mesh to be used to correct hernias, porosity, amount of absorbable material and polypropylene should be considered in the different stages of...
BACKGROUND
In the definition of the mesh to be used to correct hernias, porosity, amount of absorbable material and polypropylene should be considered in the different stages of healing process.
AIM
To evaluate the inflammatory reaction in the use of macro and microporous meshes of high and low weight in the repair of defects in the abdominal wall of rats.
METHODS
Ninety Wistar rats (Rattus norvegicus albinus) were used. The animals were submitted to similar surgical procedures, with lesion of the ventral abdominal wall, maintaining the integrity of the parietal peritoneum and correction using the studied meshes (Prolene®, Ultrapro® and Bard Soft®). Euthanasia was performed at 30, 60 and 120 days after surgery. The abdominal wall segments were submitted to histological analysis using H&E, Masson's trichrome, immunohistochemistry, picrosirius red and tensiometric evaluation.
RESULTS
On the 120th day, the tensiometric analysis was superior with Ultrapro® macroporous mesh. The inflammatory process score showed a significant prevalence of subacute process at the beginning and at the end of the study. Microporous meshes showed block encapsulation and in macroporous predominance of filamentous encapsulation.
CONCLUSION
The Ultrapro® mesh showed better performance than the others in healing process of the abdominal wall.
Topics: Abdominal Wall; Animals; Peritoneum; Polypropylenes; Rats; Rats, Wistar; Surgical Mesh
PubMed: 34133524
DOI: 10.1590/0102-672020210001e1577 -
Journal of Korean Medical Science Dec 2023Infants with congenital anomalies of the digestive system and abdominal wall defects requiring surgery are at risk of growth and developmental delays. The aim of this...
BACKGROUND
Infants with congenital anomalies of the digestive system and abdominal wall defects requiring surgery are at risk of growth and developmental delays. The aim of this study was to analyze long-term growth and developmental outcomes for infants with congenital anomalies of the digestive system and abdominal wall defects who underwent surgery in Korea.
METHODS
We extracted data from the Korean National Health Insurance Service database for the years 2013-2019. Major congenital anomalies were defined according to the International Classification of Diseases-10 and surgery insurance claim codes. The χ² test and the Cochran-Armitage trend test were performed for data analysis.
RESULTS
A total of 4,574 infants with major congenital anomalies in the digestive system and abodminal wall defects, who had undergone surgey, were reviewed. Anorectal obstruction/stenosis was the most prevalent anomaly (4.9 per 10,000 live births). The prevalence of congenital anomalies of the digestive system was 15.5 per 10,000 live births, and that of abdominal wall defects was 1.5 per 10,000 live births. Seven percent of infants with congenital anomalies in the digestive system died, of which those with diaphragmatic hernia had the highest mortality rate (18.8%). Among 12,336 examinations at 6, 12, 24, 36, 48, 60, and 72 months of age, 16.7% showed a weight below the 10th percentile, 15.8% had a height below the 10th percentile, and 13.2% had a head circumference below the 10th percentile. Abnormal developmental screening results were observed in 23.0% of infants. Infants with esophageal atresia with/without tracheoesophageal fistula most often had poor growth and development. Delayed development and cerebral palsy were observed in 490 (10.7%) and 130 (2.8%) infants respectively. Comparing the results of infants born in 2013 between their 24- and 72-month health examinations, the proportions of infants with poor height and head circumference growth increased by 6.5% and 5.3%, respectively, whereas those with poor weight growth and abnormal developmental results did not markedly change between the two examinations.
CONCLUSION
Infants with congenital anomalies of the digestive system and abdominal wall defects exhibit poor growth and developmental outcomes until 72 months of age. Close monitoring and careful consideration of their growth and development after discharge are required.
Topics: Infant; Pregnancy; Female; Humans; Child; Adolescent; Abdominal Wall; Parturition; Digestive System; Republic of Korea; Congenital Abnormalities
PubMed: 38111278
DOI: 10.3346/jkms.2023.38.e372 -
The British Journal of Radiology Jan 2017The diagnosis of abdominal wall pathology is often obvious on clinical physical examination; however, multimodality imaging often yields incidental, and occasionally... (Review)
Review
The diagnosis of abdominal wall pathology is often obvious on clinical physical examination; however, multimodality imaging often yields incidental, and occasionally important, findings aiding in assessing the overall clinical picture. While various hernias are common, there are numerous other causes of abdominal wall pathology. Knowledge of these entities is crucial to avoid misinterpretation and assure proper radiological judgment.
Topics: Abdominal Wall; Contrast Media; Female; Hernia, Abdominal; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Multimodal Imaging; Radiographic Image Enhancement; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasonography, Doppler
PubMed: 27792404
DOI: 10.1259/bjr.20160719 -
Journal of Robotic Surgery Oct 2021When approaching complex abdominal wall hernias at either index operation or a subsequent reoperation for recurrent incarcerated abdominal wall hernias, a majority of...
When approaching complex abdominal wall hernias at either index operation or a subsequent reoperation for recurrent incarcerated abdominal wall hernias, a majority of surgeons consider mesh placement a key step in the prevention of a future recurrence. While the laparoscopic and open approaches show no significant difference in hernia recurrence, the laparoscopic approach to complex abdominal wall hernias does reduce surgical-site infection, postoperative ileus, improves short-term quality-of-life scores, and reduces hospital length of stay (Davies et al. in Am Surg 78(8):888-892, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500604/ , 2012, McGreevy et al. in Surg Endosc 17(11):1778-1780, https://www.ncbi.nlm.nih.gov/pubmed/12958679 , 2003, Bittner et al. in Surg Endosc 33:3069-3139, https://doi.org/10.1007/s00464-019-06907-7 , 2019). In this paper, we describe a robotic approach with a pulley technique to the fixation of polypropylene mesh in complex abdominal wall reconstruction. Our primary aim is to offer a new perspective to the re-creation of challenging abdominal walls and to encourage other surgeons to gain proficiency in the robotic approach. Additionally, the material cost to the technique is lower than that of self-expanding or deployable mesh reinforcements used in other laparoscopic approaches. Over time, as an institution breaks even on the cost of a robot with their return on investment, this technique offers potential cost-saving.
Topics: Abdominal Wall; Hernia, Ventral; Humans; Laparoscopy; Robotic Surgical Procedures; Surgical Mesh
PubMed: 33113093
DOI: 10.1007/s11701-020-01161-9 -
European Radiology Aug 2018Complex ventral hernia (CVH) describes large, anterior, ventral hernias. The incidence of CVH is rising rapidly due to increasing laparotomy rates in ever older, obese... (Review)
Review
UNLABELLED
Complex ventral hernia (CVH) describes large, anterior, ventral hernias. The incidence of CVH is rising rapidly due to increasing laparotomy rates in ever older, obese and co-morbid patients. Surgeons with a specific interest in CVH repair are now frequently referring these patients for imaging, normally computed tomography scanning. This review describes what information is required from preoperative imaging and the surgical options and techniques used for CVH repair, so that radiologists understand the postoperative appearances specific to CVH and are aware of the common complications following surgery.
KEY POINTS
• Complex ventral hernia (CVH) describes large abdominal wall hernias (e.g. width ≥10cm). • CVH patients are being referred increasingly for preoperative and postoperative imaging. • Imaging is pivotal to characterise preoperative morphology and quantify loss of domain. • Postoperative imaging appearances are contingent on the surgical methods used for CVH repair. • Postoperative complications are depicted easily by imaging.
Topics: Abdominal Wall; Female; Hernia, Ventral; Herniorrhaphy; Humans; Male; Middle Aged; Postoperative Care; Postoperative Complications; Preoperative Care; Recurrence; Surgical Mesh; Tomography, X-Ray Computed
PubMed: 29532239
DOI: 10.1007/s00330-018-5328-z -
Journal of Radiology Case Reports Feb 2015Synovial sarcoma is the fourth most common type of soft-tissue sarcoma (following undifferentiated pleomorphic sarcoma, liposarcoma, and rhabdomyosarcoma), and should be... (Review)
Review
Synovial sarcoma is the fourth most common type of soft-tissue sarcoma (following undifferentiated pleomorphic sarcoma, liposarcoma, and rhabdomyosarcoma), and should be considered a high-grade neoplasm with a high number of local recurrences and late metastases. Synovial sarcoma predominantly occurs in adolescents and young adults, and typically arises near the joints of the lower extremity. However, this tumor can also occur at uncommon sites such as the abdominal wall, which is illustrated in this article. Furthermore, we reviewed the available literatures on the clinical, pathological and radiological appearances, as well as the current knowledge concerning treatment options and prognosis.
Topics: Abdominal Wall; Adult; Biopsy, Large-Core Needle; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Sarcoma, Synovial; Tomography, X-Ray Computed
PubMed: 25926925
DOI: 10.3941/jrcr.v9i2.1992 -
Medicina (Kaunas, Lithuania) Jul 2019Doppler ultrasound of umbilical and fetal vessels is useful for monitoring fetal well-being, fetal anemia, intrauterine growth retardation, and other perinatal...
Doppler ultrasound of umbilical and fetal vessels is useful for monitoring fetal well-being, fetal anemia, intrauterine growth retardation, and other perinatal outcomes. The adverse perinatal outcome and circulatory changes can be reflected in fetal Doppler studies. The aim of this study was to evaluate the effect of increased pressure exerted on the maternal abdominal wall during routine ultrasound on the middle cerebral artery (MCA), resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV). A prospective study was conducted, in which we included 40 pregnant women between 24 + 0 and 41 + 3 gestational weeks (GW), with singleton pregnancies, without any associated pathologies, undergoing routine US examination. We recorded the flow velocity waveforms in the MCA, and we measured the RI, PI, PSV, and the applied pressure on to the maternal abdominal wall-needed for a proper evaluation of MCA. We then repeated the same measurements at two different higher pressure levels, at the same time having a proper image of the targeted vessel. We found significant differences for the PI and RI levels with an increase in abdominal pressure (median PI 1.46, 1.58, and 1.92, respectively; median RI 0.74, 0.78, and 0.85, respectively; < 0.05), for both PI and RI. At the same time, we found no significant differences for PSV in the studied group in relationship with increase in abdominal pressure (median PSV 39.56, 40.10, and 39.70, respectively; > 0.05). The applied abdominal pressure by the examiner's hand, during routine US scan in pregnancy, can modify the MCA parameters of blood flow resistance (PI and RI) when measured by Doppler US, thus influencing the diagnostic accuracy in a series of pregnancy associated pathologies, such as chronic fetal distress (CFD) or intrauterine growth restriction (IUGR).
Topics: Abdominal Wall; Adult; Analysis of Variance; Blood Flow Velocity; Female; Fetal Monitoring; Gestational Age; Health Status Indicators; Humans; Middle Cerebral Artery; Pregnancy; Pressure; Prospective Studies; Romania; Ultrasonography, Prenatal
PubMed: 31357513
DOI: 10.3390/medicina55080410 -
Cancer Reports (Hoboken, N.J.) Sep 2022Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine and nervous system. NETs, often found in the gastrointestinal tract, can be found... (Review)
Review
BACKGROUND
Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine and nervous system. NETs, often found in the gastrointestinal tract, can be found anywhere in the body, and have metastatic potential. NETs occasionally present with metastatic disease without an identifiable primary tumor.
CASE
A 79-year-old female patient presented with an abdominal wall mass. Percutaneous biopsy was consistent with a NET. Preoperative endoscopy and PillCam were unremarkable. PET Dotatate demonstrated uptake in the abdominal wall as well as vague uptake in the pelvis. Intraoperatively, we identified a suspicious nodule on the sigmoid colon, which was consistent with a drop metastasis on final pathology.
CONCLUSION
In this case report we present a patient with a NET metastasis to the abdominal wall without a known primary site. This case highlights the limitations of endoscopy and imaging in the workup of metastatic NETs. Additionally, this is a novel case report of a metastatic NET to the abdominal wall without an identifiable primary site.
Topics: Abdominal Wall; Aged; Female; Humans; Neoplasms, Unknown Primary; Neuroendocrine Tumors; Peritoneal Neoplasms; Positron-Emission Tomography; Radionuclide Imaging
PubMed: 35142106
DOI: 10.1002/cnr2.1610 -
CMAJ : Canadian Medical Association... Jun 2018
Topics: Abdominal Wall; Anticoagulants; Budd-Chiari Syndrome; Electrocardiography; Endovascular Procedures; Humans; Male; Middle Aged; Treatment Outcome; Vena Cava, Inferior
PubMed: 29866895
DOI: 10.1503/cmaj.180120 -
International Journal of Hyperthermia :... 2018Surgery constitutes the standard approach for abdominal wall endometriosis (AWE), but is invasive. High-intensity focused ultrasound (HIFU) ablation is effective and...
BACKGROUND
Surgery constitutes the standard approach for abdominal wall endometriosis (AWE), but is invasive. High-intensity focused ultrasound (HIFU) ablation is effective and safe for the treatment of AWE, but no study has compared HIFU and surgery.
OBJECTIVE
To report our experience about the benefits and adverse events of surgery compared to HIFU for the treatment of AWE.
METHODS
This was a retrospective study of 54 consecutive Chinese women with AWE after cesarean section treated at the First Affiliated Hospital of Chongqing Medical University (China) between January 2012 and December 2014. The patients underwent surgery (n = 29) or HIFU (n = 25). The technical success rate, adverse events, and recurrence were assessed.
RESULTS
The technical success rate was 100% in both groups. The complete remission rate was 92.0% (23/25) in the HIFU group, and 100% (29/29) in the surgery group. Numeric rating scale (NRS) scores after HIFU were significantly improved from 6.9 to 0.3.During the median follow-up period of 32 months (range, 19-46 months), the durations of pain relief were 29.7 ± 12.6 months and 25.0 ± 13.5 months in the surgery and HIFU groups, respectively (p = .337). Three patients (10.7%) experienced pain recurrence in the surgery group, and two (8.0%) in the HIFU group. Major adverse events occurred in four (13.8%) and one (4.0%) patients in the surgery and HIFU groups, respectively (p > .05).
CONCLUSIONS
HIFU appears to be beneficial for the treatment of AWE, and may reduce adverse events. Compared with surgery, HIFU does not induce blood loss or tissue defects.
Topics: Abdominal Wall; Adult; Cohort Studies; Endometriosis; Female; High-Intensity Focused Ultrasound Ablation; Humans; Retrospective Studies
PubMed: 30208746
DOI: 10.1080/02656736.2018.1511836