Hernia最新文献

{"title":"Comment to: Drain versus no drain in elective open incisional hernia operations.","authors":"Uday Singh Dadhwal","doi":"10.1007/s10029-024-03209-3","DOIUrl":"https://doi.org/10.1007/s10029-024-03209-3","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"9"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644109","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":"Delayed vs single-staged abdominal wall reconstruction in contaminated ventral hernia.","authors":"Sara M Maskal, Raha Al Marzooqi, Ouen Mali, Li-Ching Huang, Ryan C Ellis, Kimberly Woo, Daphne Remulla, Benjamin T Miller, Lucas R A Beffa, Clayton C Petro, Ajita S Prabhu, Michael J Rosen","doi":"10.1007/s10029-024-03195-6","DOIUrl":"https://doi.org/10.1007/s10029-024-03195-6","url":null,"abstract":"<p><strong>Introduction: </strong>When faced with contaminated ventral hernia repairs, surgeons must decide to repair the defect in a single-stage or delay the definitive repair until a clean scenario has been achieved. We sought to compare wound complications, long-term hernia recurrence and quality of life for patients who underwent delayed versus single-staged abdominal wall reconstruction (AWR) in the setting of clean-contaminated and contaminated wounds.</p><p><strong>Methods: </strong>The Abdominal Core Health Quality Collaborative was used to identify adult patients at our institution who underwent open AWR with retromuscular synthetic mesh placement between January 2014 and August 2023. The delayed group included patients who underwent clean-contaminated or contaminated abdominal operation in the setting of a ventral hernia without placement of permanent synthetic mesh, then underwent AWR with permanent synthetic mesh placement in a separate operation. The single-staged group had clean-contaminated or contaminated wounds concomitant with AWR. Outcomes of the AWR were compared.</p><p><strong>Results: </strong>63 patients underwent a delayed AWR and 375 patients underwent a single-staged AWR with a median(IQR) follow-up of 3(2,5)years. Most common concomitant procedures involved small intestine(30%) or hepatobiliary(30%). Most common index operations in delayed AWR were ileostomy(52.4%) and colostomy(14.2%) reversals. Median(IQR) time between initial operation and definitive AWR was 1.0 (0.7, 1.9)years. Median(IQR) hernia width was 11.35(8.4, 15.0)cm at initial operation and 16.0(15.0,20.0)cm at AWR for the delayed group(p < 0.001). Three patients (19%) in the delayed group and 14(12%) in the single-staged underwent wound debridement within 30-days(p = 0.46); a single patient in each required partial mesh excision within 30-days(p = 0.098). Wound morbidity, reoperation and hernia recurrence were similar (p > 0.05).</p><p><strong>Conclusion: </strong>In patients with a ventral hernia and separate indication for abdominal operation with a clean-contaminated or contaminated wound, either delayed or single-stage approaches to AWR may be viable.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"8"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644115","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":"Causes of chronic pain unrelated to surgical trauma after groin hernia repair: a prospective cohort study.","authors":"Lovisa Kroon, Kristina Ticehurst, Jukka Ahonen, Jonny Norrby, Fernando Ruiz-Jasbon","doi":"10.1007/s10029-024-03201-x","DOIUrl":"10.1007/s10029-024-03201-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic inguinal pain (CIP) can be caused by musculoskeletal or neurological pathologies and by surgical trauma after inguinal hernia repair among other. The aim of this prospective cohort observational study was to find the incidence and causes of CIP unrelated to surgical trauma 12 months after inguinal hernia repair.</p><p><strong>Methods: </strong>During sixteen months patients consulting a hernia center for groin-related symptoms were included in the study. Patients were evaluated by surgeons and filled out preoperatively the Inguinal Pain Questionnaires and a Numerical Rating Scale pain-questionnaire. For patients undergoing inguinal hernia repair, postoperative questionnaires similar to the pre-operative ones were sent out at 12 months. Patients scoring pain on pain questionnaires were evaluated by phone and physical examination.</p><p><strong>Results: </strong>289 patients (78.1%) of 370 repaired patients filled in the postoperative questionnaires. 62 (21.4%) patients scored pain, of these patients 5 (1.7%, 5/289) answered incorrectly in the pain questionnaires and 14 (4.8%, 14/289) had non-surgical trauma causes of pain: 5 musculoskeletal, 4 neurological and 3 other medical pathologies.</p><p><strong>Conclusions: </strong>This cohort study found CIP unrelated to surgical trauma in 4.8% of patients undergoing a groin hernia repair. Most causes of pain unrelated to surgical trauma were musculoskeletal and neurological pathologies. Nearly a third of patients scoring inguinal pain on pain-questionnaires did not have chronic post-surgical pain (CPSP), therefore incidence of CPSP should not be based solely on pain questionnaires. Clinical assessment of patients with pain is necessary to excluded CIP unrelated to the surgical trauma.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"13"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644107","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":"The missed diagnosis of femoral hernias in females undergoing inguinal hernia repair - A systematic review and proportional meta-analysis.","authors":"Ana Caroline Dias Rasador, Carlos André Balthazar da Silveira, Gabriele Eckerdt Lech, Bruno Veronez de Lima, Diego Laurentino Lima, Flavio Malcher","doi":"10.1007/s10029-024-03196-5","DOIUrl":"10.1007/s10029-024-03196-5","url":null,"abstract":"<p><strong>Background: </strong>Given the 4-times higher prevalence of femoral hernias among females compared to males, this diagnosis may be missed during inguinal hernia repair (IHR), causing risk of reoperation for pseudo recurrence of femoral hernias (FH). Minimally invasive approaches are suggested as potential reducers of missed FH since they provide a posterior view of all defect areas, despite studies suggesting that women receive less MIS than men. We aim to assess the missed FH during IHR and after reoperation for recurrence following IHR in women.</p><p><strong>Methods: </strong>PubMED, Cochrane, and EMBASE databases were searched for studies assessing patients undergoing recurrent IHR, analyzing the incidence of reoperation for FH and occult femoral hernias during IHR. Statistical analysis was performed using R software.</p><p><strong>Results: </strong>From 6,226 records, 10 retrospective observational studies were included, totaling 15,863 patients (20% females). We found that 19.56 per 100 women (95% CI 8.34, 39.37) who are reoperated for an inguinal hernia are found as having a FH during the new repair. Compared to men, women were at a significantly higher risk to be reoperated for FH after IHR (RR 8.97; 95% CI 7.35, 10.93; P < 0.001). Our analysis also showed that 20.7% of females received MIS approaches for groin hernia repair, while 79.3% received open procedures. Furthermore, our study found a pooled incidence of occult FH during the initial IHR of 6.85 per 100 patients for both genders (95% CI 2.78, 15.90), which increased to 21.42 per 100 patients when assessing females only (95% CI 15.46, 28.89).</p><p><strong>Conclusions: </strong>Females have a higher incidence of FH following reoperation for recurrence of inguinal hernia repair. Added to the high rate of occult FH encountered during inguinal procedures, this suggests a missed diagnosis of FH during IHR. The adoption of MIS IHR for women is fundamental to reduce the underdiagnosis of FH.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"17"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644137","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 glucagon-Like peptide-1 agonists in optimizing abdominal wall Reconstruction patients.","authors":"Daniel Tran, Daylon A Farias, Mathew Tanner, Monica Marroquin, Rachel S Jefferies, Gerald O Ogola, Santiago Quevedo, William J Hlavinka, Steven G Leeds, Marc A Ward, Bola G Aladegbami","doi":"10.1007/s10029-024-03214-6","DOIUrl":"https://doi.org/10.1007/s10029-024-03214-6","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-optimization of obese patients prior to abdominal wall reconstruction (AWR) is essential in mitigating their increased preoperative risks. Traditionally diet, exercising, bariatric surgery are the tools typically prescribed for weight loss. The advent of glucagon-like peptide-1 agonists (GLP-1A) which stimulate insulin secretion and inhibit gastric emptying have improved the weight loss armamentarium. However, there is a limited amount of literature on GLP-1A effectiveness and postoperative outcomes in AWR patients. This study compares the efficacy of GLP-1A to Bariatric Surgery (BAS) in perioperative AWR patient.</p><p><strong>Methods: </strong>A prospectively maintained database was retrospectively reviewed to identify all patients undergoing AWR at our institution between January 2021 and March 2024. We included patients who required GLP-1A or BAS for weight optimization prior to AWR. We excluded patients on GLP1-A or history BAS not performed for AWR preoptimization. Basic demographics such as age, sex, race, weight and BMI at initial clinic visit and at surgery were compared. Primary endpoints included time to surgery, time to bowel recovery and length of stay (LOS). Time to surgery was defined as the number of months between the initial clinic visit and AWR. Time to bowel recovery was defined as the number of days it took for the first postoperative bowel function. Secondary endpoints included standard 30-days postoperative variables. Nominal variables were analyzed using a Fisher exact test and continuous variables were analyzed with Student's T test.</p><p><strong>Results: </strong>35 patients were included in this study (GLP-1A: 17, BAS: 18). The GLP-1A cohort had a lesser BMI at the initial clinic visit (40.8 vs 43.4, p = 0.188). GLP-1A cohort made it to the operating room faster (9.1 months vs 13.5 months, p = 0.06) from the first clinic visit; and (7.9 months vs 9.7 months, p = 0.4) from initiation of weight loss intervention. Albeit losing less weight (14.9 kg vs 27.1 kg, p = 0.008) with a lesser reduction in the BMI (4.69 vs 9.23, p = 0.004). The GLP-1A cohort showed a non-significant elevated LOS (5.2 days vs 3.6 days, p = 0.25) and an increased ileus rate (17.6% vs 0%, p = 0.1). However, there were no differences noted in time to bowel recovery (2.9 days vs 3.1 days, p = 0.76).</p><p><strong>Conclusion: </strong>GLP-1A is effective in optimizing patients needing weight loss before AWR. They shorten the timeline to AWR intervention and have comparable peri-operative outcomes to BAS patients.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"19"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644123","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: Watchful waiting to surgery in men with mildly symptomatic or asymptomatic inguinal hernia.","authors":"Harsha Jayamanne, Brian M Stephenson","doi":"10.1007/s10029-024-03190-x","DOIUrl":"https://doi.org/10.1007/s10029-024-03190-x","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"12"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644111","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":"Effect of an abdominal binder on postoperative outcomes after ventral hernia repair: a systematic review and meta-analysis of randomized controlled trials.","authors":"Augusto Graziani E Sousa, Enrico Prajiante Bertolino, Amanda Godoi, Cynthia Florêncio de Mesquita, Stalin Isaias Canizares Quisiguina, Sergio Mazzola Poli de Figueiredo","doi":"10.1007/s10029-024-03193-8","DOIUrl":"10.1007/s10029-024-03193-8","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal binders consist of a wide compression belt that encircles the abdomen, theoretically supporting the abdominal wall. However, their use after ventral hernia repair is debated. Therefore, this meta-analysis evaluates their efficacy.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) comparing the effects of abdominal binders after ventral hernia repair. Outcomes included postoperative pain using the visual analog scale (VAS), surgical site infection (SSI), seroma formation and size, general well-being, activity limitation, forced expiratory volume in the first second (FEV1), and a 6-min walk test. Statistical analysis was performed with Review Manager 5.4.1 using a random-effects model.</p><p><strong>Results: </strong>We included five RCTs encompassing 297 patients. Overall analysis showed decreased SSI rates (RR 0.21; 95% CI 0.07 to 0.59; p = 0.003; I² = 0%) and reduced pain two weeks after surgery (MD -0.89; 95% CI -1.41 to -0.37; p = 0.0008; I² = 0%) using abdominal binders. For patients undergoing open ventral hernia repair, it also demonstrated reduced SSI, pain four weeks after surgery (MD -0.60; 95% CI -0.88 to -0.32; p < 0.0001; I² = 66%) and increased 6-min walk test performance four weeks after the procedure (MD 32.78 m; 95% CI 15.28 to 50.29 m; p = 0.0002; I² = 0%).</p><p><strong>Conclusion: </strong>Abdominal binders may decrease SSI, postoperative pain, and increase physical condition, particularly in open ventral hernia repair. Further studies are still required to evaluate the role of abdominal binders in minimally invasive techniques.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"20"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644118","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":"Prophylactic mesh versus primary closure in emergency and elective surgeries: a systematic review and meta-analysis of randomized clinical trials.","authors":"Ana Paula Valério-Alves, Caio Leonardo Dos Santos Saggin, João Marcos Escórcio de Aguiar Portela, Patricia Viana, Gabriela Branquinho Guerra, Camila Mariana de Paiva Reis, Rafael Morriello","doi":"10.1007/s10029-024-03202-w","DOIUrl":"10.1007/s10029-024-03202-w","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernia is one of the most common post-operative complications. Previous studies showed that prophylactic mesh placement in laparotomy closure is safe and reduces the incidence of incisional hernia. We aimed to perform a meta-analysis comparing post-operative complications after the use of prophylactic permanent mesh placement versus primary closure in patients undergoing elective or emergency laparotomies.</p><p><strong>Methods: </strong>A systematic review of Cochrane Central Register of Controlled Trials, Embase and PubMed was performed in April 2024. Only randomized clinical trials were included. 1,234 studies were imported for screening. 280 were duplicated reports, 923 were excluded for irrelevancy and 16 were excluded after full-text review. Data were extracted in accordance with PRISMA guidelines and pooled by a random-effects model. The primary outcome was incidence of incisional hernia. Secondary outcomes included post-operative complications and period of hospitalization.</p><p><strong>Results: </strong>Fifteen studies and 2,108 patients were included. Incisional hernia incidence was different between groups (risk ratio [RR] 0.30; 95% CI 0.21-0.43; p < 0.00001; I²=39%). This finding was confirmed in a subgroup analysis of elective (RR 0.29; 95% CI 0.18-0.46; p < 0.00001; I²=48%) versus emergency laparotomies (RR 0.28; 95% CI 0.19-0.43; p = 0.0001; I²=0%). There was no significant difference in incisional hernia incidence by locals of mesh placement. Secondary outcomes had shown no statistically significant difference between groups, except for seroma wherein primary closure had lower events (RR 1.80; CI 95% 1.21-2.68; p = 0.38; I²=7%).</p><p><strong>Conclusion: </strong>In patients undergoing laparotomy, prophylactic permanent mesh placement is associated with a significant reduction on incidence of incisional hernia as compared to primary closure.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"14"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644128","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":"Peritoneal flap hernioplasty for large ventral hernias: a systematic review and meta-analysis : PFH for large ventral hernia.","authors":"Parbatraj Regmi, Vijay Pratap Sah, Bikash Kumar Sah, Bhawani Khanal, Abhijeet Kumar, Rakesh Kumar Gupta","doi":"10.1007/s10029-024-03194-7","DOIUrl":"10.1007/s10029-024-03194-7","url":null,"abstract":"<p><strong>Background: </strong>Primary closure of large ventral hernia is difficult and is usually complicated by postoperative mesh bulge, migration, and higher recurrence. Techniques like component separation and bridging mesh, transversus abdominus release, da Silva triple-layer repair, and peritoneal flap hernioplasty (PFH) are common treatment options.</p><p><strong>Objective: </strong>To evaluate the early postoperative and long-term outcomes of PFH for large ventral hernias.</p><p><strong>Methods: </strong>A systematic literature search was performed on the electronic databases of PubMed, Web of Knowledge, and Scopus till July 28, 2024. We performed a single-arm meta-analysis of non-comparative studies using OpenMeta[Analyst] software (Center for Evidence-Based Medicine, Brown University, Rhode Island, USA).</p><p><strong>Results: </strong>Five studies including 432 patients (238 male and 194 female patients in a ratio of 1.23:1.0) underwent PFH for large ventral hernia. The estimated proportion of patients who may experience skin necrosis, seroma, hematoma, superficial surgical site infection, and deep mesh infection were 1.2% (95% CI: 0.001, 0.022; I²: 0.53%) 5.8% (95% CI: 0.036, 0.080; I²: 0%), 3.7% (95% CI: 0.007, 0.067; I²: 59.32%), 10.6% (95% CI: 0.077, 0.135; I²: 0%), and 0.9% (95% CI: -0.004, 0.022; I²: 15.99%) respectively. Similarly, the estimated recurrence rate and chronic pain following PFH was 1.9% (95% CI: 0.005, 0.033; I²: 2%) and 11.6% (95% CI: 0.032, 0.200; I²: 83.43%) respectively during the mean follow-up time of 33 months (95% CI: 1.9, 64.1).</p><p><strong>Conclusion: </strong>PFH seems to be a safe and feasible procedure for the repair of complex or large ventral hernias where it is difficult to perform primary fascial closure. Further studies with a direct comparison of PFH with component separation techniques are necessary to validate the results of our study.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"18"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644126","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: Is surgeon annual case volume related with intra and postoperative complications after ventral hernia repair?","authors":"Gang Wang, Zhichun Liu","doi":"10.1007/s10029-024-03185-8","DOIUrl":"https://doi.org/10.1007/s10029-024-03185-8","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"6"},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644110","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}