Hernia最新文献

{"title":"Lichtenstein repair for giant inguinoscrotal hernia: a retrospective case-control study.","authors":"Jin Cuihong, Wang Fan, Shen Yingmo","doi":"10.1007/s10029-024-03248-w","DOIUrl":"https://doi.org/10.1007/s10029-024-03248-w","url":null,"abstract":"<p><strong>Purpose: </strong>Giant inguinoscrotal hernia (GISH) is a rare condition in high-income regions, and the management presents a significant challenge for surgeons. A retrospective analysis was conducted of a single center's experience in treating GISH by Lichtenstein approach. The objective was to gain insight into the characteristics of GISH and assess the clinical efficacy of the Lichtenstein approach, as well as the degree of improvement in patient quality of life (QoL).</p><p><strong>Methods: </strong>Data from consecutive GISH patients who had undergone Lichtenstein repair at our institution from December 2018 to December 2023 were prospectively collected. The control group for the 1:2 matched case-control study was selected from pure inguinal hernia patients who underwent Lichtenstein repair during the same period. The demographics and surgical characteristics were analyzed. QoL and surgical satisfaction were respectively evaluated using the Carolina Comfort Scale and Numerical Rating Scale.</p><p><strong>Results: </strong>A total of 51 patients with GISH who underwent Lichtenstein repair were identified, and 102 patients with a pure inguinal hernia who underwent Lichtenstein repair were included in the control group. Patients in the GISH group exhibited a higher BMI than those in the control group; they also had a significantly longer hernia duration and a higher incidence of irreducible bulge. Additionally, the GISH patients had significantly higher ASA scores. All the Lichtenstein procedures were uneventful. There were more additional surgical procedures in GISH group, including hernia sac resection in 50 patients (98%) and adhesion release in 23 patients (45.1%). Five patients with GISH underwent omentectomy and one patient underwent testicular resection due to severe adhesions. The GISH group exhibited a higher incidence of postoperative complications. Five patients experienced urinary retention, and one intestinal obstruction. Two patients underwent surgical drainage under local anesthesia at one month postoperatively and made a full recovery. At six months postoperatively, the mean CCS score for the patients was 0.5 ± 0.8, with 21 patients (20.6%) scoring ≥ 2 out of the 23 categories. The results of the surgical satisfaction survey indicated that 130 patients (85.0%) gave a score of 5, reflecting high levels of satisfaction after Lichtenstein hernioplasty.</p><p><strong>Conclusion: </strong>Patients with GISH typically have a long medical history, a high proportion of irreducible masses, and severe comorbidities, making surgery challenging. However, Lichtenstein repair remains a feasible and safe with high patient satisfaction and improved postoperative quality of life.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"48"},"PeriodicalIF":2.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is mesh pore size associated with the outcome in laparo-endoscopic inguinal hernia repair? - a registry-based multivariable analysis.","authors":"F Köckerling, J Wrede, D Adolf, D Jacob, H Riediger","doi":"10.1007/s10029-024-03235-1","DOIUrl":"https://doi.org/10.1007/s10029-024-03235-1","url":null,"abstract":"<p><strong>Introduction: </strong>In inguinal hernia repair, mesh weight and pore size are used to describe the mesh characteristics. One meta-analysis of laparo-endoscopic inguinal hernia repairs identified 12 prospective randomized controlled trials (RCTs) with 2,909 patients who had all been treated with lightweight (≤ 50 g/m²) or heavyweight (> 70 g/m²) meshes. None of the 12 RCTs gave details of the pore size. There were more recurrences when using lightweight meshes, in particular in the case of medial defects without mesh fixation and/or large defects. In terms of pain, no significant differences were seen. This retrospective analysis of data from the Herniamed Registry now aims to analyze whether mesh pore size is related to the outcome in laparo-endoscopic inguinal repair.</p><p><strong>Materials and methods: </strong>To analyze the association between mesh pore size and the outcome in laparo-endoscopic inguinal repair, it was necessary to select meshes with comparable properties. Polyester meshes and PTFE meshes had to be excluded and polypropylene and polyvinylidene fluoride meshes (PVDF) were included. 83,768 included patients were retrospectively analyzed. The meshes analyzed were eight small-pore and 13 large-pore meshes. Using a binary logistic regression model, it is possible to simultaneously analyze several factors being potentially associated with the outcome.</p><p><strong>Results: </strong>Higher BMI, lower weight meshes, higher ASA score and medial EHS classification were associated with a higher risk of recurrence. It was not possible to find any significant association between pore size and recurrences at one-year follow-up. This also applied for pain on exertion and pain requiring treatment.</p><p><strong>Conclusion: </strong>No association was identified between the pore size of the meshes used in laparo-endoscopic inguinal repair and the recurrence rate, pain on exertion rate or the rate of chronic pain requiring treatment at one-year follow-up.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"47"},"PeriodicalIF":2.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does inguinal hernia with ovary and/or fallopian tube in female children after herniotomy affect secondary sexual characteristics and/or fertility? A long-term retrospective study.","authors":"Kun Duan, Chao Jin, Rongchao Yang, Wei Zhang, Hui Hui","doi":"10.1007/s10029-024-03237-z","DOIUrl":"https://doi.org/10.1007/s10029-024-03237-z","url":null,"abstract":"<p><strong>Background: </strong>The risk of injury to the ovary and/or fallopian tube during herniotomy is notably high when these structures are involved in the hernial contents of female children. This study evaluates the impact of herniotomy involving the ovary and fallopian tube on secondary sexual characteristics and fertility.</p><p><strong>Methods: </strong>The medical records for all female children with inguinal hernia who underwent surgery from January 2000 to December 2010 were reviewed retrospectively (n = 1623).</p><p><strong>Results: </strong>A total of 20 female children aged between 2 years and 12 years (mean 5.5years) were diagnosed with ovary and/or fallopian tube contents within their inguinal hernia sacs. Preoperative B-ultrasound confirmed these findings in all 20 patients. Intraoperatively, 14 hernia sacs contained both ovaries and fallopian tubes and 6 contained only ovaries. There were 12 cases on the right side, 7 cases on the left side and 1 case on both sides. All underwent successful hernia reduction and sac repair without any recurrences. Follow-up periods ranged from 12 to 20 years, averaging 15.5 years. During follow-up, 13 patients had normal pregnancy, 7 patients had normal secondary sexual characteristics.</p><p><strong>Conclusion: </strong>Preoperative B-ultrasonography and careful discerning of the hernia contents during herniotomy may help avoid incision or excision of the ovary and/or fallopian tube.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"44"},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD. Author's reply.","authors":"Zhihao Zhu, Jinlei Mao, Menghui Zhou, Minjun Xia, Junjie Wu, Qi Chen, Fei Zhao, Hongxia Liang, Zhifei Wang","doi":"10.1007/s10029-024-03240-4","DOIUrl":"https://doi.org/10.1007/s10029-024-03240-4","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"46"},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthetic vs. biologic mesh for abdominal wall reconstruction in contaminated surgical fields. A meta-analysis of randomized controlled trials and observational studies.","authors":"Maximos Frountzas, Despoina Kanata, Eirini Solia, Dimitra Smerdi, Christina Nikolaou, Alexandros Chamzin, Dimitrios Linardoutsos, Dimitrios Theodorou, Konstantinos G Toutouzas, Grigorios Chatzimavroudis, Dimitrios Schizas","doi":"10.1007/s10029-024-03239-x","DOIUrl":"10.1007/s10029-024-03239-x","url":null,"abstract":"<p><strong>Purpose: </strong>Biologic meshes had been the first choice for abdominal wall reconstruction (AWR) in contaminated surgical fields. However, due to increased cost and questioned effectiveness, synthetic meshes have been also implemented. The aim of the present meta-analysis was to compare synthetic and biologic mesh in terms of recurrence and postoperative outcomes.</p><p><strong>Methods: </strong>The present meta-analysis was designed using the PRISMA guidelines. A search in Medline, Scopus, EMBASE, Clinicaltrials.gov, Google Scholar and Cochrane CENTRAL was conducted from inception until September 2024. Randomized clinical trials (RCTs) and observational studies which compared the use of biologic and synthetic mesh for AWR in contaminated surgical fields were included. Data were extracted by two experienced researchers in pre-defined electronic forms. Pooled odds ratios (OR) and mean differences (MD) were calculated using a random-effects model. Included RCTs were assessed using the Risk of Bias 2 (RoB2) tool and non-randomized trials with the Risk of Bias in non-Randomized Trials (RoBINS-I) tool.</p><p><strong>Results: </strong>Overall 11 studies were included which enrolled 1,945 patients. Subgroup analysis of RCTs indicated significantly lower recurrence rates for synthetic compared to biologic mesh (p < 0.0001) with a similar follow-up (p = 0.07). Nevertheless, no difference was demonstrated in surgical site infection (SSI) rates. Although synthetic mesh was associated with shorter length of stay, the other postoperative outcomes (surgical site occurrences, mesh infections, readmissions, reoperations) were similar among the two groups.</p><p><strong>Conclusion: </strong>Synthetic mesh should be considered as a safe and effective option for abdominal wall reconstruction in contaminated surgical fields compared to biologic mesh. Nevertheless, future research is expected to investigate cost-effectiveness of biosynthetic meshes, as alternative option in such surgical fields.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"43"},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating the Q1.6 Inguinal Hernia application using prospective data from a randomised clinical trial.","authors":"Ludo van Hout, Patrick W H E Vriens, Willem J V Bökkerink","doi":"10.1007/s10029-024-03238-y","DOIUrl":"10.1007/s10029-024-03238-y","url":null,"abstract":"<p><strong>Purpose: </strong>The Q1.6 Inguinal Hernia application remotely and continuously collects patient-reported outcomes from inguinal hernia patients. Previous research has explored its technical, legal, and ethical aspects, along with face, content, and construct validity assessments. This study aims to examine its concurrent validity by comparing prospective data with that from the ENTREPPMENT trial, a randomised study.</p><p><strong>Methods: </strong>A small cohort of patients participating in the ENTREPPMENT trial were asked to use the Q1.6 application in addition to their standard care. Corresponding prospective data points, in terms of content and timing relative to the operation date, were identified. Correlation coefficients were calculated for matching variables, and a repeated measures model was created to analyse pain and limitation measures during the first two postoperative weeks.</p><p><strong>Results: </strong>Twenty-eight patients were analysed. Preoperative variables, such as hernia side and painkiller use, demonstrated a predominantly high level of agreement between the two measurement methods, ranging from 'substantial' (0.61-0.8) to 'perfect' (1.0) agreement. Evaluating immediate postoperative outcomes, including pain and limitation scores, revealed a prevalent 'substantial' (0.61-0.8) to 'almost perfect' (0.81-1.0) agreement. In a repeated measures model, the overall within-subjects correlation demonstrated levels of agreement ranging from 'moderate' (0.41-0.6) to 'almost perfect' (0.81-1.0).</p><p><strong>Conclusion: </strong>This study demonstrates strong agreement between data from the Q1.6 Inguinal Hernia application and the ENTREPPMENT trial, supporting its concurrent validity. This makes the application a reliable tool for collecting PROs before and immediately after inguinal hernia repair, offering a promising alternative to traditional follow-up methods. Future research will focus on enhancing compliance and refining functionality.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"45"},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors related to successful mesh salvage with negative pressure wound therapy: a retrospective cohort study.","authors":"Alejandro González-Muñoz, Juan Carlos Vallejo-Soto, Juan Diego Barragán-Pinilla, Antonio Pesce, Camilo Ramírez-Giraldo","doi":"10.1007/s10029-024-03233-3","DOIUrl":"10.1007/s10029-024-03233-3","url":null,"abstract":"<p><strong>Background: </strong>Mesh salvage using negative pressure wound therapy (NPWT) in cases of mesh infection following hernia repair has emerged as an alternative to early mesh removal. However, the factors related to the success or failure of mesh salvage with NPWT remain unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included 61 patients with mesh infections after hernia repair treated with NPWT between 2018 and 2024. We analyzed demographic, clinical, and surgical variables, as well as the bacterial spectrum and antimicrobial susceptibility. A binary logistic regression model was used to identify factors associated with NPWT failure, defined as the need for mesh removal.</p><p><strong>Results: </strong>Mesh salvage was successful in 80.3% of cases. Active smoking was significantly associated with NPWT failure (OR = 7.82, CI 95% 1.05-64.8; p = 0.044). Other factors, such as age, body mass index, Charlson comorbidity index, mesh type, and mesh position, were not significantly related to failure. Most infections were caused by Staphylococcus aureus (24.6%) and Escherichia coli (22.9%).</p><p><strong>Conclusions: </strong>NPWT is an effective method for salvaging infected meshes, with a high success rate. Active smoking was identified as a risk factor for NPWT failure, highlighting the need for early identification of patients who may benefit from alternative approaches. Further studies are required to develop predictive models for NPWT success in mesh salvage.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"42"},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment to: Subcutaneous fat thickness predicts postoperative seroma following laparoscopic total extra-peritoneal hernioplasty.","authors":"Jingping Liu, Fei Ou","doi":"10.1007/s10029-024-03197-4","DOIUrl":"https://doi.org/10.1007/s10029-024-03197-4","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"39"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment to: Subcutaneous fat thickness predicts postoperative seroma following laparoscopic total extra-peritoneal hernioplasty.","authors":"Jianping Zhang, Yingying Guan, Jian Liao, Lan Yue, Shengzhang Li","doi":"10.1007/s10029-024-03199-2","DOIUrl":"https://doi.org/10.1007/s10029-024-03199-2","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"41"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of abdominal compliance on surgical stress and postoperative recovery in laparoscopic groin hernia repair: a retrospective cohort study.","authors":"Shoichi Kinoshita, Chisato Hara, Yayoi Matsumoto, Kohei Fukuoka, Kenji Nakagawa, Daisuke Hokuto, Hiroyuki Kuge, Tomohide Mukogawa","doi":"10.1007/s10029-024-03232-4","DOIUrl":"10.1007/s10029-024-03232-4","url":null,"abstract":"<p><strong>Purpose: </strong>The role of abdominal compliance in pneumoperitoneum is not fully understood. This study aimed to clarify the association between abdominal wall stretching tendency and surgical stress in laparoscopic groin hernia repair.</p><p><strong>Methods: </strong>We conducted a retrospective single-center cohort study, evaluating 51 patients who underwent elective transabdominal preperitoneal groin hernia repair. Abdominal compliance was assessed using the abdominal compliance index (ACI; insufflated intra-abdominal volume [L] / body surface area [m²]) at 8 mmHg intra-abdominal pressure. Surgical stress and recovery were evaluated with patient-reported outcome measures (PROMs), including QOR-15 and pain visual analog scale (VAS) scores. Associations between ACI, PROMs, and clinical outcomes were analyzed.</p><p><strong>Results: </strong>The median ACI was 1.229 L/m² (0.369-2.091). Eleven patients (21.6%) above the 75th percentile cutoff (1.576 L/m²) were categorized as high ACI. While body constitution was similar between groups, the high ACI group had significantly greater insufflated intra-abdominal volume (2.88 L vs. 1.89 L, P < 0.0001). Pre-operative QOR-15 scores were similar. However, on postoperative day 1, the high ACI group had significantly lower QOR-15 scores (90.2 vs. 110.1, P = 0.017), with subcategory analysis showing reduced physical well-being. Multivariate analysis indicated that high ACI was a significant predictor of poorer QOR. The high ACI group also reported higher, though not statistically significant, postoperative pain.</p><p><strong>Conclusion: </strong>Abdominal walls with greater elasticity, which stretch excessively under pneumoperitoneum, were more susceptible to surgical stress. Further studies are warranted to evaluate the efficacy of tailored pneumoperitoneum pressure adjustment based on abdominal compliance to mitigate surgical stress.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"40"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}