Hernia最新文献

{"title":"Recommendations for the diagnosis of occult inguinal hernias using a modified Delphi technique.","authors":"Krystle Henderson, Steven Chua, Joseph Hasapes, Kaustubh Shiralkar, Jonah Stulberg, Varaha Tammisetti, Chakradhar Thupili, Todd Wilson, Julie Holihan","doi":"10.1007/s10029-024-03177-8","DOIUrl":"10.1007/s10029-024-03177-8","url":null,"abstract":"<p><strong>Background: </strong>Occult inguinal hernias are inguinal hernias that are not felt on physical exam but can often be seen on imaging. Their diagnosis can be challenging, leading to unnecessary surgeon referrals, undue patient stress, and even unneeded surgery. The aim of this project was to develop recommendations for the diagnosis of occult inguinal hernias using a modified Delphi technique.</p><p><strong>Methods: </strong>Iterative rounds of surveys were administered to an expert panel of surgeons and radiologists. Panelists were asked to rate potential hernia-related topics by levels of importance. Items with 80% agreement were included for further discussion. Panelists were asked to provide their opinion on each included subject. A virtual meeting was conducted to discuss areas without agreement and determine final recommendations.</p><p><strong>Results: </strong>Three surgeons and five radiologists participated. There was strong agreement that dynamic ultrasound is a good first/confirmatory imaging choice. There was agreement that the radiology reports for studies assessing inguinal hernias should include hernia contents (80%) and hernia size (100%). Information that should be provided to the radiologist when ordering an imaging study include indication for study, patient symptoms, prior hernia surgery. Items that should be included in a radiology report include whether the presence of an inguinal hernia was assessed, hernia contents, size of defect, +/- hernia type.</p><p><strong>Conclusions: </strong>This collaboration between surgeons and radiologists creates a diagnostic imaging pathway and standardizing imaging reporting which will be used to improve the diagnosis of occult inguinal hernias. Future studies testing these recommendations in a prospective study are warranted.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2387-2391"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345673","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 surgeon-patient sex discordance on ventral hernia repair outcomes.","authors":"Claiborne J Lucas, M Wes Love, Jeremy A Warren, William S Cobb, Alfredo M Carbonell","doi":"10.1007/s10029-024-03100-1","DOIUrl":"10.1007/s10029-024-03100-1","url":null,"abstract":"<p><strong>Purpose: </strong>Concordance is an important dimension of the physician-patient relationship that may be linked to health care disparities. The purpose of this study was to determine if sex discordance between surgeon and patient impacts surgical outcomes.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data obtained from the Abdominal Core Health Quality Collaborative (ACHQC) registry was performed on all patients who underwent ventral hernia repair. Surgical site occurrences (SSO), surgical site infections (SSI), surgical site occurrence requiring procedural intervention (SSOPI) and 30-day readmission rates were recorded.</p><p><strong>Results: </strong>Female patients operated on by male surgeons have increased odds of having an SSI/SSO (OR 1.099, 95% CI 1.022-1.181), SSOPI (OR 1.156, 95% CI 1.031-1.297), and readmission (OR 1.259, 95% CI 1.128-1.406) when compared to male patients operated on by male surgeons. There was no significant difference in adverse outcomes between patient groups when operated on by female surgeons.</p><p><strong>Conclusion: </strong>Sex discordance between surgeon and patient is associated with increased odds adverse outcomes when male surgeons operate on female patients.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2159-2164"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286036","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":"Quality of life and abdominal wall functionality after abdominal wall reconstruction: A prospective single center follow-up study.","authors":"M Toma, V Oprea, Florentina Scarlat, Carmen Elena Bucuri, O Andercou, F Mihaileanu, O Grad, M Rosianu, C Molnar","doi":"10.1007/s10029-024-03143-4","DOIUrl":"10.1007/s10029-024-03143-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fascial breakdown with the occurrence of an incisional hernia (IH) is an important and challenging complication of any laparotomy. For a long time, the success of the abdominal wall reconstruction (AWR) was measured only from the surgeon's perspective by defining outcome measures such as wound morbidity and recurrence. The understanding that complete recovery is difficult to assess without considering patients has shifted the paradigm of optimal outcomes to Patient Reported Outcome Measures (PROMS) and Quality of Life (QoL), which are pivotal to evaluate the success and efficacy of AWR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a prospective follow-up study of 91 patients undergoing mesh-augmented abdominal wall reconstruction for primary or recurrent incisional hernia between January 2021 and December 2023. Demographic data, comorbidities, and hernia characteristics were recorded. All patients were evaluated preoperatively by a native abdomino-pelvic CT scan to assess the characteristics of hernia (length, width, surface, and volume of the incisional hernia sac and of peritoneal cavity), the presence of mesh (if previously inserted), and abdominal wall muscles status. All intervention were performed by the same surgical team according to the techniques described by Rives - Stoppa (RS), Ramirez (ACS), and Novitsky (PCS). Abdominal wall function was assessed using trunk raising (TR) and double leg lowering (DLL) measurements performed preoperatively, 1 month, 6 months, and 1 year postoperatively. At the same time, pre- and post-operative quality of life was analysed using the EQ-5D score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mean age of 59.42 ± 12.28 years and a male/female ratio of 35/56 were recorded, most of them being obese. There were 36 (42%) patients with defects larger than 10 cm. The distribution of the type of surgical intervention was: RS 35 patients, ACS 13 patients, and PCS 43 patients. The mean value of combined score for the preoperative abdominal wall functionality was 4.41 ± 1.67 (2-8) while the mean value of preoperative EQ-5D index was 0.652 ± 0.026 (-0.32-1.00). QoL was poor and very poor for 48% (44) of the patients who recorded index values less than 0.56 (50% percentile). Preoperative EQ-5D index was highly correlated with Combined AWF score (r = 0.620; p &lt; 0.0001) and the correlation was specific (AUC = 0.799; p &lt; 0.0001; asymptotic 95%CI = 0.711-0.923). At 12 months, the AWF score increased to 8.13 ± 2.58 (1-10) and the QoL total score to 0.979 ± 0.007 (0.71-1). Good and very good total scores for QoL were recorded for 47 patients (84%) compared to 33 (36%) in the preoperative evaluation (χ&lt;sup&gt;2&lt;/sup&gt; with Yates continuity correction for two degrees of liberty = 46.04; p &lt; 0.00001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our results suggest that patients can expect to see a significant overall improvement in all five components of QoL measured with the help of Eq. 5D questionnaire. This improveme","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2223-2234"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139916","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":"Robotic parastomal hernia repair in Ileal-conduit patients: short-term results in a single-center cohort study.","authors":"Tommaso Violante, Davide Ferrari, Ibrahim A Gomaa, Sara A Aboelmaaty, Richard Sassun, Annaclara Sileo, Jyi Cheng, Katherine T Anderson, Robert R Cima","doi":"10.1007/s10029-024-03153-2","DOIUrl":"10.1007/s10029-024-03153-2","url":null,"abstract":"<p><strong>Purpose: </strong>To describe and evaluate safety and feasibility of the robotic modified Sugarbaker technique with intraperitoneal underlay mesh (IPUM) for repairing parastomal hernias associated with ileal conduits (ICPSH).</p><p><strong>Methods: </strong>This retrospective, single-center cohort study analyzed data from 15 adult patients who underwent robotic ICPSH repair using the modified Sugarbaker IPUM technique between July 2021 and July 2023. The primary endpoints were hernia recurrence rates and 30-day morbidity. Secondary endpoints included length of stay, conversion to open surgery, 30-day readmission, and 30-day reoperation.</p><p><strong>Results: </strong>The mean patient age was 69.1 years, and 53.3% were female. Most patients (86.6%) had undergone radical cystectomy as the index surgery. The mean operative time was 249 min, with no conversions to open surgery. The 30-day complication rate was 26.7%, and the mean hospital stay was 3.6 days. No hernia recurrences, hydronephrosis, rise in creatinine or distended conduit on imaging suggesting poor drainage were observed during a mean follow-up of 15.2 months.</p><p><strong>Conclusions: </strong>The robotic modified Sugarbaker IPUM technique appears safe and feasible for PSH repair in IC patients, with promising short-term outcomes. Further studies with larger cohorts and longer follow-up are needed to confirm its long-term efficacy and establish its role in ICPSH management.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2245-2253"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139925","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: Ultrasound‑guided ilioinguinal‑iliohypogastric nerve block with local anesthesia and fentanyl analgesia versus local anesthesia and fentanyl analgesia prior to shouldice inguinal hernia repair in adults.","authors":"Xiangwei Fu, Wenting Wang","doi":"10.1007/s10029-024-03158-x","DOIUrl":"10.1007/s10029-024-03158-x","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2431-2432"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286033","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":"Polypropylene vs. stainless-steel wire suture: short-term recurrence rate after shouldice primary inguinal hernia repair, a non-inferior analysis among 1120 patients. A case-control study.","authors":"Christoph Paasch, Marguerite Mainprize, Richard Hunger, Fernando A C Spencer Netto","doi":"10.1007/s10029-024-03110-z","DOIUrl":"10.1007/s10029-024-03110-z","url":null,"abstract":"<p><strong>Introduction: </strong>Polypropylene material is commonly used for posterior wall reconstruction in hernia repair, in contrast with the classically described stainless-steel wire used at Shouldice Hospital. This study was conducted to evaluate possible differences in Shouldice Repair outcomes using polypropylene or stainless-steel wire sutures.</p><p><strong>Methods: </strong>A prospective follow-up of consecutive patients who underwent elective unilateral Shouldice primary inguinal hernia repair at Shouldice Hospital between December 6, 2021, and September 1, 2022, was conducted. Data was collected from follow-up telephone calls as well as manually reviewing patient's charts. The primary objective was to determine whether the use of polypropylene was non-inferior to the use of stainless-steel wire, regarding the recurrence rate reported by the patients with a minimum follow-up of 1 year after Shouldice primary inguinal hernia repair.</p><p><strong>Results: </strong>A total of 1120 patients were contacted by telephone (polypropylene: 560; stainless-steel wire: 560). The median follow-up period was 16 months (interquartile range: 15-18). In 22 (1.96%) cases a surgical site infection was diagnosed. There was a total of 18 recurrences reported by the patients (1.6%). There was no statistical difference between the groups (polypropylene: 7 (1.25%) vs. stainless steel wire: 11 (1.96%), p > 0.05) for the recurrence rate.</p><p><strong>Conclusion: </strong>The use of polypropylene is non-inferior to the use of stainless-steel wire regarding recurrence rate at a median follow-up period of 16 months after elective unilateral Shouldice primary inguinal hernia repair. This finding may encourage other centers where stainless-steel wire is not easily available to perform the Shouldice Repair.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2177-2186"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106945","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":"Videoendoscopic assisted Rives-Stoppa technique. \"Treatment for epigastric and umbilical hernias with diastasis recti\".","authors":"Osvaldo Santilli, Hernán Santilli, Nicolás Nardelli","doi":"10.1007/s10029-024-03151-4","DOIUrl":"10.1007/s10029-024-03151-4","url":null,"abstract":"<p><strong>Purpose: </strong>There are many surgical techniques for ventral hernias and diastasis recti, both conventional or video-endoscopic, with or without mesh placement, detailed in the literature. Using some details of the techniques proposed by Wolfgang Reinpold (Mini- or Less Open Sublay Operation, MILOS) and Federico Fiori (Totally Endoscopic Sublay Anterior Repair, TESAR) we found modifications that allowed repairing and reinforcement of the posterior fascia with a retro-muscular mesh and achieve primary fascial closure by minimally umbilical access and searching for the best anatomical, functional, and aesthetic results.</p><p><strong>Method: </strong>Describe the surgical technique step by step and analyze 629 surgical treatments. The cohort comprises the period January 2018 to January 2023. Our Database registered 318 men and 311 women who underwent video endoscopicassisted Rives-Stoppa techniques to treat umbilical and epigastric hernias with diastasis RESULTS: All patients were treated on an outpatient basis and discharged home on the same day. The most frequent complications were seromas with conservative management. Other complications recorded were omphalitis in 6 patients, and three patients presented hematomas, one of whom performed surgical evacuation. There were ten patients with recurrences.</p><p><strong>Conclusion: </strong>These hybrid approaches provide the advantages of mini-invasive techniques with a lower rate of complications and a high standard of quality of life, providing anatomical, functional, and aesthetic benefits.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2403-2409"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139928","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: Fascia defect closure versus non-closure in minimal invasive direct inguinal hernia mesh repair: a systematic review and meta-analysis of real-world evidence.","authors":"Junsheng Li","doi":"10.1007/s10029-024-03127-4","DOIUrl":"10.1007/s10029-024-03127-4","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2425-2426"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912402","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: Clinical outcomes of triclosan-coated barbed suture in open hernia repair.","authors":"Xiping Shen, Ji Wu","doi":"10.1007/s10029-024-03178-7","DOIUrl":"10.1007/s10029-024-03178-7","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2439"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345768","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":"The rate of ileostomy site incisional hernias: more common than we think?","authors":"Megan Obi, Lucas Beffa, Megan Melland-Smith, Nir Messer, Arielle Kanters, Sami Judeeba, Kevin Baier, Benjamin Miller, David Krpata, Ajita Prabhu, Scott R Steele, Michael Rosen, Stefan D Holubar, Clayton Petro","doi":"10.1007/s10029-024-03163-0","DOIUrl":"10.1007/s10029-024-03163-0","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernias (IH) rates after diverting loop ileostomy reversal (DLI-R) have been reported up to 24%. We aimed to characterize the incidence rate and risk factors associated with DLI-R site IH formation within 1-year in a large patient cohort.</p><p><strong>Methods: </strong>A retrospective review at a single quaternary referral center hospital of adult patients who underwent DLI-R over a 5-year period and abdominal computerized tomography (CT) imaging performed within 1-year for any indication postoperatively was conducted. All CTs scans were independently reviewed by staff surgeons to determine the presence of a fascial defect at the DLI-R site.</p><p><strong>Results: </strong>2,196 patients underwent DLI-R; of these, 569 (25.9%) underwent CT imaging for any indication. Mean patient age, 54.8 (± 14.9), BMI 27.6 kg/m². 87 (15%) patients had a parastomal hernia at time of DLI-R. After median follow-up of 10 months, 203 patients (35.7%) had IH at the DLI-R site. Age (p = 0.14), sex (p = 0.39), race (p = 0.75), and smoking status (p = 0.82) weren't associated with IH after DLI-R. Comorbidities weren't significantly associated with IH following DLI-R. In univariate analysis, increased BMI (p < 0.001), presence of a parastomal hernia (p = 0.008), and suture type (p = 0.01) were associated with IH development. On multivariate analysis, BMI remained significant, and polyglyconate compared to polydioxanone suture were associated with higher rates of IH (p < 0.001).</p><p><strong>Conclusion: </strong>We observed that the rate of incisional hernias within 1-year of diverting ileostomy reversal was indeed common at 36%. Granted, a high percentage of the population was excluded due to heterogeneity in radiographic evaluation that could be mitigated in future prospective studies. Our study suggests that IH preventative strategies include weight loss for overweight and obese patients prior to DLI-R and that the optimal suture for DLI-R is polydioxanone.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2311-2320"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345676","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}