Hernia最新文献

{"title":"Laparoscopic repair of parahiatal hernia: surgical techniques and literature reviews.","authors":"Haifeng Han, Mingjian Zhao, Shuo Yang, Xuefeng Liu, Chengxu Miao, Xingyu Wu, Jinghui Lu","doi":"10.1007/s10029-024-03244-0","DOIUrl":"https://doi.org/10.1007/s10029-024-03244-0","url":null,"abstract":"<p><strong>Purpose: </strong>Parahiatal hernia (PHH) is a rare type of diaphragmatic hernia that protrudes through a defect adjacent to, but distinct from, the esophageal hiatus. Current literature on PHH is extremely limited. In this study, we present our experience with laparoscopic repair of PHH and provide a comprehensive review of existing literature.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical data from eight patients diagnosed with PHH at Qilu Hospital, Shandong University, between October 2021 and March 2024. Collected data included patient demographics, hernia characteristics, and perioperative details. The primary outcomes assessed were the safety and feasibility of the procedure, along with postoperative complications such as pleural effusion, hemorrhage, fistula, and mesh infection.</p><p><strong>Results: </strong>Laparoscopic surgery was successfully performed in all patients. Two patients underwent simultaneous sleeve gastrectomy. Concurrent hiatal hernia was diagnosed in two patients, while seven patients required esophageal hiatus repair due to an enlarged hiatus following PHH repair. The mean hernia ring width was 3.69 ± 1.22 cm. Mesh reinforcement was employed in six patients. The mean operative time was 205.63 ± 62.36 min, and the mean hospital stay was 7.75 ± 1.49 days. With a median follow-up of 11.5 (interquartile range: 7.75-29.5) months, no major complications, recurrences, or mortality were reported.</p><p><strong>Conclusion: </strong>Laparoscopic repair of PHH is a safe and effective procedure. Nonetheless, the techniques for defect closure, hiatus repair, mesh placement, and fundoplication should be customized based on the individual patient's characteristics.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"85"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255631","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 funnel mesh for preventing parastomal hernia in patients with permanent end stoma: a systematic review and meta-analysis.","authors":"Bernardo Fontel Pompeu, Lucas Soares de Souza Pinto Guedes, Bruna Maffei Bossi, Lucas Monteiro Delgado, Camila Sigaud Frizzo, Isabelle Rocha Gauch, Fernanda Bellotti Formiga, Sergio Mazzola Poli de Figueiredo","doi":"10.1007/s10029-025-03262-6","DOIUrl":"https://doi.org/10.1007/s10029-025-03262-6","url":null,"abstract":"<p><strong>Purpose: </strong>The high incidence of parastomal hernia (PSH) has led surgeons to study strategies to minimize PSH, including prophylactic mesh placement during permanent stoma creation. There are several studies on prophylactic mesh for preventing PSH with conflicting results and there is limited information on using 3D funnel meshes and their effectiveness in preventing PSH.</p><p><strong>Methods: </strong>A search was performed on PubMed, Scopus, Cochrane Central Register of Clinical Trials, and Web of Science for studies published up to September 2024. Odds ratios (ORs) and mean differences (MD) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed with I² statistics. Statistical analysis was performed using R Software version 4.4.1 (R Foundation for Statistical Computing).</p><p><strong>Results: </strong>One randomized controlled trial and six observational studies were included, totaling 585 patients who underwent colorectal surgeries requiring a permanent stoma. Of these, 278 patients (47.5%) received prophylactic funnel meshes, and 307 (52.5%) underwent conventional stoma procedures. Compared to conventional procedures without mesh, the funnel mesh group showed significantly lower rates of PSH (9% vs. 54%; OR 0.07, 95% CI 0.03-0.17, p < 0.001). However, no significant differences were observed in time to PSH development, stoma prolapse, Clavien-Dindo grade 3b complications, stricture, ileus, leak, wound infection, small bowel obstruction, 30-day mortality, operative time, or hospital stay.</p><p><strong>Conclusion: </strong>In patients undergoing colorectal surgery with a permanent end stoma, prophylactic funnel mesh was associated with lower rates of PSH, but findings remain exploratory and limited by current evidence.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"84"},"PeriodicalIF":2.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189236","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":"Preoperative progressive pneumoperitoneum: insights on implementation in an ambulatory care setting. How I do it?","authors":"Alix Donadieu, Fahad Alhammadi, Alicia Mettoudi, Annie Garois, Reza Kianmanesh, Ahmad Tashkandi, Yohann Renard","doi":"10.1007/s10029-024-03253-z","DOIUrl":"https://doi.org/10.1007/s10029-024-03253-z","url":null,"abstract":"<p><strong>Introduction: </strong>Incisional hernias with loss of domain (IHLD) are challenging to treat. Preoperative techniques like botulinum toxin injection (BTA) and preoperative progressive pneumoperitoneum (PPP) are highly effective, potentially preventing the need for perioperative component separation in the vast majority of cases. PPP involves preoperative introduction of gas into the abdominal cavity to increase the abdominal wall volume, aiding diaphragmatic prehabilitation and hernia reintegration. This study aimed at explaining our technique in performing PPP in ambulatory setting.</p><p><strong>Description of the technique: </strong>The first insufflation and BTA injection occur during a 3-day hospitalization. Subsequently, patients are managed on an ambulatory basis with three sessions per week for at least three weeks. Each hospital visit lasts about 1 to 2 h. Patients can remain at home or in a residential center of our hospital. No preventive anticoagulation nor prophylactic antibiotics are needed.</p><p><strong>Discussion: </strong>Performing PPP in outpatient care does not compromise its efficacy. Instead, it allows for longer preparation, potentially improving efficacy. Patients maintain daily activities, possibly yielding better results than traditional physiotherapy. It reduces hospital stay costs and nosocomial infection risks. Each ambulatory hospitalization offers better patient attention.</p><p><strong>Conclusions: </strong>PPP is a valuable preoperative technique for IHLD repair, particularly in combination with botulinum toxin, offering potential benefits for selected patients. Performing it in outpatient care may enhance patient satisfaction and offers several advantages.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"82"},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079709","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 on: Does onlay mesh placement in emergency laparotomy prevent incisional hernia? A prospective randomized double-blind study.","authors":"Junsheng Li","doi":"10.1007/s10029-025-03272-4","DOIUrl":"https://doi.org/10.1007/s10029-025-03272-4","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"83"},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079704","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":"Narrative review of long-standing groin pain in athletes. Retrospective analysis of over 12 000 patients.","authors":"Osvaldo Santilli, Hernán Santilli","doi":"10.1007/s10029-024-03229-z","DOIUrl":"https://doi.org/10.1007/s10029-024-03229-z","url":null,"abstract":"<p><strong>Purpose: </strong>This article critically examines long-standing groin pain (LSGP) in physically active adults related to sports overload by analyzing terminology, pathophysiology, and treatment.</p><p><strong>Method: </strong>This review is based on data from over 10,000 patients managed through a multidisciplinary algorithm. (LSGP) has been variably labeled, using terms that have led to inconsistencies in understanding its origin and management. Terms such as \"Pubic Inguinal Pain Syndrome,\" \"Sportsman's Groin,\" and \"Athletic Pubalgia\" have been proposed to standardize terminology and unify the classification of (LSGP). Pathophysiologically, (LSGP) is often due to tendinopathies affecting major tendons in the groin region, such as the adductors, iliopsoas, conjoint tendon, and inguinal ligament, often associated with weakness in the posterior wall of the inguinal canal. This condition frequently arises in sports involving abrupt directional changes and high-energy loads in the groin. Tendinopathies progress through reactive, reparative, or degenerative stages of tendinosis.</p><p><strong>Results: </strong>Literature supports a multidisciplinary approach involving surgeons, physiotherapists, sports medicine physicians, and orthopedists for accurate diagnosis and effective treatment. Our algorithm focuses on both anatomical and functional factors in managing (LSGP). Initial conservative therapies aim to support tendon regeneration and load correction, while surgical interventions, such as laparoscopic hernioplasty, are reserved for non-responsive cases. From 2004 to 2024, 12,144 patients completed this protocol, with only 14% requiring surgery. Long-term follow-up demonstrated a low recurrence rate of tendinopathy and an absence of severe complications.</p><p><strong>Conclusion: </strong>Standardizing terminology, understanding pathophysiology, and utilizing a multidisciplinary approach are essential for optimizing the diagnosis and management of sports-related (LSGP).</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"81"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046665","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 learning curve for the Shouldice Repair: a pilot analysis of post-training specialized surgeons at the Shouldice Hospital.","authors":"Christoph Paasch, Richard Hunger, Peter Szasz, Ayse Yilbas, Fernando A C Spencer Netto, Rene Mantke, Marguerite Mainprize","doi":"10.1007/s10029-024-03252-0","DOIUrl":"10.1007/s10029-024-03252-0","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to evaluate operative time and postoperative complications of 4 post-training specialized surgeons.</p><p><strong>Methods: </strong>This was a pilot retrospective chart review to determine the learning curve of a Shouldice primary inguinal hernia repair (Shouldice Repair) of 4 post-training specialized surgeons, at the Shouldice Hospital. The first 300 Shouldice Repairs (early learning block) were compared to their 900-1,000 repairs as the primary operating surgeon (late learning block). Data was collected from the hospital's database. The learning curve was examined using cumulative sum analysis (CUSUM).</p><p><strong>Results: </strong>During the early learning block cases, the surgeons had a mean operating time of 59.2 ± 11.2 min. The late learning block cases had significantly reduced operative time (53.4 ± 10.5 min, p = 0.001). According to the CUSUM analysis all four surgeons had a plateau after 78 to 88 operations in terms of operative time. A nonsignificant reduction in the rate of reported recurrences (n = 16 vs. n = 0) and surgical site occurrences (haematoma, seroma, infection; n = 27 vs. n = 2) was found between the early and late learning block cases.</p><p><strong>Conclusion: </strong>The operating time plateaued after 78-88 Shouldice Repairs for the 4 surgeons trained and working at the Shouldice Hospital. A nonsignificant trend towards fewer complications were noted among late learning block cases.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"70"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023016","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":"Protocol for the AFTERHERNIA Project: patient-reported outcomes of groin and ventral hernia repair.","authors":"Anders Gram-Hanssen, Jason Joe Baker, Hugin Reistrup, Klaus Kaae Andersen, Jacob Rosenberg","doi":"10.1007/s10029-025-03259-1","DOIUrl":"10.1007/s10029-025-03259-1","url":null,"abstract":"<p><strong>Purpose: </strong>The AFTERHERNIA Project aims to shift the focus of hernia surgery towards patient-reported outcomes by examining the impact of surgical methods and long-term complications on a national level. Groin and ventral hernia repairs are common surgical procedures with significant impact on patient quality of life and healthcare costs. Most large-scale studies focus on clinical outcomes like reoperation and readmission rates, rather than patient-reported outcomes.</p><p><strong>Methods: </strong>This nationwide survey involves Danish patients who have undergone groin or ventral hernia repair over a ten-year period. Patients will be identified in the Danish National Patient Registry, and they will receive either the Abdominal Hernia-Q or Groin Hernia-Q questionnaire to collect data on patient-reported outcomes. Data from the questionnaire will be linked with clinical and patient-related data from the Danish Hernia Database. The Danish National Patient Registry also contains information on long-term surgical complications. Thereby, it will be possible to link specific perioperative details with patient-reported outcomes and long-term surgical complications.</p><p><strong>Conclusion: </strong>The AFTERHERNIA Project aims to redefine the understanding of hernia surgery outcomes by emphasizing patient-reported outcomes on a nationwide basis. By capturing a broad spectrum of patient experiences and outcomes, the project expects to inform and possibly transform clinical guidelines and patient care practices.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"79"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023258","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: Use of prophylactic mesh to prevent parastomal hernia formation.","authors":"Tayfun Bisgin, Aras Emre Canda","doi":"10.1007/s10029-025-03268-0","DOIUrl":"https://doi.org/10.1007/s10029-025-03268-0","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"71"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023292","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":"Management and outcome of mesh infection after abdominal wall reconstruction in a tertiary care center.","authors":"Victor Franchi, Claire Triffault-Fillit, Sophie Jarraud, Jean-Yves Mabrut, Clément Javaux, Olivier Monneuse, Anne Conrad, Tristan Ferry, Maud Robert, Florence Ader, Guillaume Passot, Florent Valour","doi":"10.1007/s10029-025-03265-3","DOIUrl":"10.1007/s10029-025-03265-3","url":null,"abstract":"<p><strong>Purpose: </strong>Abdominal wall reconstruction is a common surgical procedure, with a post-operative risk of mesh-associated infection of which management is poorly known. This study aims to comprehensively analyze clinical and microbiological aspects of mesh infection, treatment modalities, and associated outcomes.</p><p><strong>Methods: </strong>Patients with abdominal mesh infection were included in a retrospective observational cohort (2010-2023). Patients characteristics and management were described, and determinants for failure were assessed by logistic regression and treatment failure-free survival curve analysis (Kaplan-Meier).</p><p><strong>Results: </strong>Two hundred and nine patients (median age, 62 [IQR, 55-71] years) presented a mesh infection occurring within 15 (IQR, 7-31) days after surgery, mainly as an abdominal wall or deep abscess (n=189, 90.4%). Infection was polymicrobial in 89/166 (79.4%) cases, S. aureus (n=60, 36.1%), Enterobacteriaceae (n=60, 36.1%) and anaerobes (n=40, 24.1%) being the most prevalent pathogens. Surgery was performed in 130 (62.2%) patients, associated with a 13.5 (IQR, 8-21) day course of antimicrobial therapy in 172/207 (83.1%) cases. Sixty-three (30.1%) treatment failures occurred, associated with previous multiple abdominal surgeries (OR, 3.305; 95%CI, 1.297-8.425), complete mesh removal (OR, 0.145; 95%CI, 0.063-0.335) and antimicrobial therapy (OR, 0.328; 95%CI, 0.136-0.787). The higher failure rate of conservative strategies was associated with symptom duration >1 month (OR, 3.378; 95%CI, 1.089-4.005) and retromuscular mesh position (OR, 0.444; 95%CI, 0.199-0.992).</p><p><strong>Conclusion: </strong>Mesh infection is associated with high treatment failure rates. Complete mesh removal coupled with targeted antibiotic therapy is associated with better outcomes. Conservative treatment strategies must rely on careful patient selection based on symptom duration and mesh placement.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"76"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023253","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":"Outcomes after surgical repair of primary parastomal hernia.","authors":"Nulvin Djebbara-Bozo, Nellie B Zinther, Anette Søgaard, Hans Friis-Andersen","doi":"10.1007/s10029-025-03267-1","DOIUrl":"10.1007/s10029-025-03267-1","url":null,"abstract":"<p><strong>Purpose: </strong>Parastomal hernia is a frequent complication after stoma construction, with increasing incidence over time. Surgical repair is reported with a high recurrence rate and the evidence on the topic is limited. We conducted a retrospective study to evaluate the incidence of recurrence after parastomal hernia repair and assessed the risk factors and predictors for recurrence at the Regional Hernia Center at Horsens Regional Hospital, Denmark.</p><p><strong>Methods: </strong>119 patients underwent primary parastomal hernia repair from January 2017 until April 2021. Mean follow-up period was 72 months. Information including demographic data, non-modifiable risk factors and modifiable risk factors were assessed and analyzed using LASSO to select relevant predictors and GLM was employed hereafter.</p><p><strong>Results: </strong>Multivariate analysis showed that age, diabetes, IBD, constipation, and fecal incontinence were strong pre-operative predictors, with age, IBD, ileostomy, and colorectal cancer also reaching significance in univariate analyses. Post-operatively, EHS classification 1, and Clavien Dindo Grade 3b were identified as strong predictors in univariate analyses.</p><p><strong>Conclusion: </strong>Recurrence after parastomal hernia repair was 17.64% during a follow-up period of minimum 3.5 years.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"72"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023255","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}