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American Family Physician Apr 2005
Review
Topics: Diagnosis, Differential; Granuloma, Pyogenic; Hernia, Umbilical; Humans; Infant; Infections; Male; Umbilicus; Urachus
PubMed: 15864900
DOI: No ID Found -
JSLS : Journal of the Society of... 2021The surgical approach for treating ventral hernia is still under debate, as well as the optimal devices to be used for such treatment. For small size defects, the...
INTRODUCTION
The surgical approach for treating ventral hernia is still under debate, as well as the optimal devices to be used for such treatment. For small size defects, the tendency is to use the open approach, due to the lower cost/efficiency ratio. However, for medium-size defects, even though costlier, laparoscopy provides better results. The present study analyzes the results of a simple and effective laparoscopic technique for mesh repairing of small and medium size ventral defects using Ventralex® ST patch.
METHOD
Between January 1, 2015 and January 31, 2020, 93 patients with ventral primary nonobstructive abdominal wall defects (up to 3 cm) treated laparoscopically using the intraperitoneal onlay mesh repair technique with Ventralex® patch (22 patients) and Ventralex® ST patch (71 patients). Results were prospectively analyzed based on postoperative complications, postoperative pain, recurrent hernia, and quality of life.
RESULTS
The technique was used in 60 patients with umbilical hernia (64.5%), 18 patients with juxta-umbilical hernia (19.3%), and 15 patients with epigastric hernia (16.1%). Out of these, 22 patients had nonreducible (nonobstructive) hernia. The median operating time was 55 minutes (range 40-80 min). Minor complications were recorded in 15 cases (16.1%). The mean hospitalization time was 1.24 days (range 1-2). After a median follow-up of 39 months (range 20-81), the recurrence rate was 11.1% and nil (p = 0.010), and other complaints were recorded in 11.1% and 3.3% of patients (p = 0.293), for Ventralex® patch and Ventralex® ST patch, respectively.
CONCLUSIONS
In conclusion, the use of Ventralex® ST patch for laparoscopic intraperitoneal onlay mesh repair of small and medium size ventral hernia is simpler and more cost-effective than standard laparoscopic patches, with superior results when compared to Ventralex® patch.
Topics: Abdominal Wall; Hernia, Umbilical; Hernia, Ventral; Herniorrhaphy; Humans; Laparoscopy; Quality of Life; Recurrence; Surgical Mesh
PubMed: 35087264
DOI: 10.4293/JSLS.2021.00071 -
Ultrasound in Obstetrics & Gynecology :... Dec 2000
Review
Topics: Adult; Bladder Exstrophy; Female; Fetal Diseases; Hernia, Umbilical; Humans; Pregnancy; Pregnancy, Multiple; Triplets; Ultrasonography
PubMed: 11169378
DOI: 10.1046/j.1469-0705.2000.00281.x -
BMC Surgery Oct 2021Umbilical hernia repair, despite its perceived simplicity, is associated with recurrence between 2.7 and 27%, in mesh repair and non mesh repair respectively. Many...
INTRODUCTION
Umbilical hernia repair, despite its perceived simplicity, is associated with recurrence between 2.7 and 27%, in mesh repair and non mesh repair respectively. Many factors are recognized contributors to recurrence however multiple defects in the linea alba, known to occur in up to 30% of patients, appear to have been overlooked by surgeons.
AIMS
This systematic review assessed reporting of second or multiple linea alba defects in patients undergoing umbilical hernia repair to establish if these anatomical variations could contribute to recurrence along with other potential factors.
METHODS
A systematic review of all published English language articles was undertaken using databases PubMed, Embase, Web of Science and Cochrane Library from January 2014 to 2019. The search terms 'Umbilical hernia' AND 'repair' AND 'recurrence' were used across all databases. Analysis was specified in advance to avoid selection bias, was registered with PROSPERO (154173) and adhered to PRISMA statement.
RESULTS
Six hundred and forty-six initial papers were refined to 10 following article review and grading. The presence of multiple linea alba defects as a contributor to recurrence was not reported in the literature. One paper mentioned the exclusion of six participants from their study due multiple defects. In all 11 factors were significantly associated with umbilical hernia recurrence. These included: large defect, primary closure without mesh, high BMI in 5/10 publications; smoking, diabetes mellitus, surgical site Infection (SSI) and concurrent hernia in 3/10. In addition, the type of mesh, advanced age, liver disease and non-closure of the defect were identified in individual papers.
CONCLUSION
This study identified many factors already known to contribute to umbilical hernia recurrence in adults, but the existence of multiple defects in the linea, despite it prevalence, has evaded investigators. Surgeons need to be consider documentation of this potential confounder which may contribute to recurrence.
Topics: Adult; Databases, Factual; Hernia, Umbilical; Humans; Recurrence; Surgical Mesh; Surgical Wound Infection
PubMed: 34641834
DOI: 10.1186/s12893-021-01358-1 -
Cirugia Pediatrica : Organo Oficial de... Jul 2020Amyand's hernia is defined as the presence of the cecal appendix inside the hernia sac. It is usually located on the right side, but left-sided cases due to intestinal...
INTRODUCTION
Amyand's hernia is defined as the presence of the cecal appendix inside the hernia sac. It is usually located on the right side, but left-sided cases due to intestinal malrotation have also been reported.
CASE PRESENTATION
3-month-old male infant diagnosed with omphalocele at the 12th week of gestation undergoing surgery 48 hours post-birth. Bilateral inguinal hernia was diagnosed during follow-up, so scheduled bilateral herniotomy was performed. During surgery, the cecal appendix was identified inside the left herniary sac, so prophylactic appendectomy was carried out.
CONCLUSIONS
The incidence of Amyand's hernia ranges from 0.4 to 1% - three times higher in pediatric patients. Left-sided hernias are often associated with intestinal rotation disorders. Treatment of right Amyand's hernia is described in Losanoff-Basson's classification. In left-sided hernias, prophylactic appendectomy is recommended to avoid diagnostic confusion in case of appendicitis.
Topics: Appendectomy; Appendix; Hernia, Inguinal; Hernia, Umbilical; Herniorrhaphy; Humans; Infant; Male
PubMed: 32657099
DOI: No ID Found -
Chirurgia (Bucharest, Romania : 1990) 2014A newborn with abdominal wall defect is one of the most dramatic cases in neonatology, but also a challenge for pediatric surgeons. This article describes the...
A newborn with abdominal wall defect is one of the most dramatic cases in neonatology, but also a challenge for pediatric surgeons. This article describes the fundamental concepts of two major abdominal wall defects - gastroschisis and omphalocele - including options and principles of prenatal and postnatal care. Although these birth defects of the abdominal wall are always grouped together, they are two separate and distinct entities, with many differences in terms of pathology and associated anomalies; this explains the different therapeutic approach and results. For a correct management of the newborn with this anomaly, it is essential to understand the similarities and differences between gastroschisis and omphalocele. This article emphasises the similarities between these two parietal defects, highlighting the differences as well.
Topics: Abdominal Wall; Acetylcholinesterase; Biomarkers; Diagnosis, Differential; Gastroschisis; Hernia, Umbilical; Humans; Infant, Newborn; Prognosis; Treatment Outcome; Ultrasonography, Prenatal; alpha-Fetoproteins
PubMed: 24524464
DOI: No ID Found -
Hernia : the Journal of Hernias and... Apr 2017Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in... (Review)
Review
BACKGROUND
Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well. However, convincing evidence is lacking. We have conducted a systematic review on safety, feasibility, and advantages of local anesthesia for umbilical hernia repair.
METHODS
A systematic review was conducted according to the PRISMA guidelines. Outcome parameters were duration of surgery, surgical site infection, perioperative and postoperative complications, postoperative pain, hernia recurrence, time before discharge, and patient satisfaction.
RESULTS
The systematic review resulted in nine included articles. Various anesthetic agents were used, varying from short acting to longer acting agents. There was no consensus regarding the injection technique and no conversions to general anesthesia were described. The most common postoperative complication was surgical site infection, with an overall percentage of 3.4%. There were no postoperative deaths and no allergic reactions described for local anesthesia. The hernia recurrence rate varied from 2 to 7.4%. Almost 90% of umbilical hernia patients treated with local anesthesia were discharged within 24 h, compared with 47% of patients treated with general anesthesia. The overall patient satisfaction rate varied from 89 to 97%.
CONCLUSION
Local anesthesia for umbilical hernia seems safe and feasible. However, the advantages of local anesthesia are not sufficiently demonstrated, due to the heterogeneity of included studies. We, therefore, propose a randomized controlled trial comparing general versus local anesthesia for umbilical hernia repair.
Topics: Anesthesia, Local; Feasibility Studies; Hernia, Umbilical; Herniorrhaphy; Humans; Length of Stay; Operative Time; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Recurrence; Surgical Wound Infection; Treatment Outcome
PubMed: 28108822
DOI: 10.1007/s10029-017-1577-z -
La Clinica Terapeutica Jul 2021Giant omphalocele and large gastroschisis remain challenging issues faced by pediatric surgeons and neonatal intensivists. In this report, we presented 3 neonatal cases...
Giant omphalocele and large gastroschisis remain challenging issues faced by pediatric surgeons and neonatal intensivists. In this report, we presented 3 neonatal cases with complex congenital abdo-minal wall defects that were successfully treated with vacuum-assisted closure (VAC). Case 1 had a ruptured giant omphalocele and was treated with VAC for 24 days. She was successfully discharged at 78 days old. Case 2 had large gastroschisis that was unretractable using silo reduction. She was treated with VAC for 19 days and was succes-sfully discharged at 69 days old. Case 3 had large gastroschisis, and his defect had been closed using Gore-tex after silo reduction. VAC was applied for 14 days, and the baby was discharged at 67 days old. The VAC system can be effectively used to assist with visceral reduction, promote granulation tissue development, and skin epithelialization. This method represents a life-saving treatment for neonates with giant omphalocele and large gastroschisis.
Topics: Female; Humans; Infant; Infant, Newborn; Male; Abdominal Wall; Gastroschisis; Hernia, Umbilical; Negative-Pressure Wound Therapy; Plastic Surgery Procedures; Polytetrafluoroethylene; Treatment Outcome
PubMed: 34247210
DOI: 10.7417/CT.2021.2331 -
Hernia : the Journal of Hernias and... Dec 2022The aim of this study was to analyse the risk for reoperation following primary ventral hernia repair.
BACKGROUND
The aim of this study was to analyse the risk for reoperation following primary ventral hernia repair.
METHODS
The study was based on umbilical hernia and epigastric hernia repairs registered in the population-based Swedish National Patient Register (NPR) 2010-2019. Reoperation was defined as repeat repair after primary repair.
RESULTS
Altogether 29,360 umbilical hernia repairs and 6514 epigastric hernia repairs were identified. There were 624 reoperations registered following primary umbilical repair and 137 following primary epigastric repairs. In multivariable Cox proportional hazard analysis, the hazard ratio (HR) for reoperation was 0.292 (95% confidence interval (CI) 0.109-0.782) after open onlay mesh repair, 0.484 (CI 0.366-0.641) after open interstitial mesh repair, 0.382 (CI 0.238-0.613) after open sublay mesh repair, 0.453 (CI 0.169-1.212) after open intraperitoneal onlay mesh repair, 1.004 (CI 0.688-1.464) after laparoscopic repair, and 0.940 (CI 0.502-1.759) after other techniques, when compared to open suture repair as reference method. Following umbilical hernia repair, the risk for reoperation was also significantly higher for patients aged < 50 years (HR 1.669, CI 1.389-2.005), for women (HR 1.401, CI 1.186-1.655), and for patients with liver cirrhosis (HR 2.544, CI 1.049-6.170). For patients undergoing epigastric hernia repair, the only significant risk factor for reoperation was age < 50 years (HR 2.046, CI 1.337-3.130).
CONCLUSIONS
All types of open mesh repair were associated with lower reoperation rates than open suture repair and laparoscopic repair. Female sex, young age and liver cirrhosis were risk factors for reoperation due to hernia recurrence, regardless of method.
Topics: Female; Humans; Herniorrhaphy; Reoperation; Hernia, Umbilical; Surgical Mesh; Hernia, Ventral; Liver Cirrhosis; Recurrence
PubMed: 35802262
DOI: 10.1007/s10029-022-02645-3 -
African Journal of Paediatric Surgery :... 2021The peri-operative management of omphalocoele in low- and middle-income countries is challenging owing to non-availability of neonatal intensive care units and equipment...
BACKGROUND
The peri-operative management of omphalocoele in low- and middle-income countries is challenging owing to non-availability of neonatal intensive care units and equipment needed for the care of this anomaly.
AIM
This study examined our experience in the management of omphalocoele and compared the pattern and outcome with a similar study from the same centre conducted four decades ago.
METHODS
A retrospective study of neonates managed for omphalocoele from 2003 to 2017 (Group A) was performed. Their demographic characteristics, clinical presentation, management modality and outcome were obtained and statistical analysis was performed to determine the predictors of mortality. The findings were also compared with the findings of a similar study (Group B) published from this centre four decades ago from 1973 to 1978.
RESULTS
A total of 95 patients were managed in Group A and 33 in Group B. Their ages ranged from 1 to 15 days with a median age of 1 day and a median gestational age at birth of 37 weeks (range - 36-43 weeks) in Group A and 5-72 h in Group B. There were 54 (56.8%) boys and 41 (43.2%) girls in Group A and 17 (51.5%) boys and 16 (48.5%) girls in Group B. Rupture of the sac was observed in 18 (18.9%) patients in Group A and 13 (39.4%) in Group B. Operative management was adopted for 55 (57.9%) patients in Group A compared to 14 (42.4%) in Group B. Mortality was recorded in 16 (16.8%) patients in Group A and 16 (48.5%) in Group B. Following further analysis in Group A, management outcome was noted to be significantly associated with the state of the sac (P = 0.011), presence of associated sepsis (P = 0.002) at presentation and management modality (P = 0.048) with only associated sepsis independently predicting mortality.
CONCLUSION
Although epidemiological trend and clinical presentation are still similar, management outcome has improved over the years.
Topics: Female; Gestational Age; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Intensive Care Units, Neonatal; Male; Retrospective Studies; Tertiary Care Centers
PubMed: 34341197
DOI: 10.4103/ajps.AJPS_7_21