Hernia最新文献

{"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}

{"title":"Increased length of incarcerated small bowel as a risk factor for intestinal necrosis in obturator hernia.","authors":"Yoshiyuki Kiyasu, Naoki Oka, Makio Mike, Hiroshi Kusanagi","doi":"10.1007/s10029-024-03234-2","DOIUrl":"https://doi.org/10.1007/s10029-024-03234-2","url":null,"abstract":"<p><strong>Background: </strong>Incarcerated obturator hernia (OH) is a rare type of pelvic wall hernia. With the increasing adoption of reduction techniques for incarcerated OH, it is crucial to assess the extent of damage to the incarcerated intestine. This study aimed to identify objective risk factors for intestinal necrosis based on computed tomography (CT) findings.</p><p><strong>Methods: </strong>From October 2004 to June 2013, data from consecutive patients diagnosed with incarcerated OH at Kameda Medical Center were collected. All patients underwent laparotomy and were classified into either the viable group (no incarceration-related intestinal damage) or the necrosis group (incarceration-related intestinal damage present). Patient characteristics and CT findings were retrieved retrospectively, including incarcerated intestine length, obturator canal width, and precise location of incarceration. Multivariate logistic regression with backward elimination was performed to identify risk factors for intestinal necrosis.</p><p><strong>Results: </strong>A total of 37 patients were included, with 25 in the viable group and 12 in the necrosis group. Multivariate analysis revealed that increased incarcerated intestine length on CT was significantly associated with necrosis (p = 0.004; odds ratio, 1.19 per 1-mm increase; 95% confidence interval, 1.06-1.34), outweighing other factors such as white blood cell count, C-reactive protein levels, and time from onset to hospital arrival.</p><p><strong>Conclusion: </strong>Length of the incarcerated small bowel on CT may be a potential risk factor for intestinal necrosis in patients with OH.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"38"},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768500","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":"Indications for treatment of incidental obturator hernia encountered during transabdominal preperitoneal repair (TAPP).","authors":"Akihiro Nakamura, Yoshikuni Harada, Hideyuki Oyama, Kaori Tadamura, Hiroshi Moro, Gaku Kigawa, Takahiro Umemoto, Kenichi Matsuo, Kuniya Tanaka","doi":"10.1007/s10029-024-03224-4","DOIUrl":"https://doi.org/10.1007/s10029-024-03224-4","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify indications for treating incidental obturator hernia (IOH) detected during laparoscopic groin hernia repair by comparing features of IOH with obturator hernia (OH) complicated by incarceration.</p><p><strong>Methods: </strong>Twenty patients who underwent laparoscopic OH repair between January 2017 and July 2024 were included in this retrospective study. They were divided into groups with incarceration or a past history of incarceration (the OH group) or without incarceration (the IOH group). Univariate analysis was performed, and ROC curves were constructed with the cut-off values representing indications for treating IOH.</p><p><strong>Results: </strong>Thirteen patients comprised the IOH group (bilateral in one), while seven comprised the OH group (all unilateral). Univariate analysis selected high age, low body mass index (BMI), and a large orifice as risk factors for incarceration. Cut-off values of these variables were age 89 years (area under curve, 0.816), BMI 17.7 kg/m² (0.939), and orifice diameter 12 mm (0.796). Age of at least 89 years and BMI of 18 or less were more common in the incarceration group (P = 0.004, P = 0.007), and all patients in the incarceration group had orifices at least 12 mm in diameter. Assigning the 3 variables 1 point each, the OH group had significantly higher scores of at least 2 points (P < 0.001).</p><p><strong>Conclusion: </strong>High age, low BMI, and large orifice diameter may be considered useful indicators for treating IOH. Two or more of these factors could place a patient at high risk for incarceration and show need for treatment of IOH.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"37"},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768501","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 impact of smoking on ventral and inguinal hernia repair: a systematic review and meta-analysis.","authors":"Carlos André Balthazar da Silveira, Ana Caroline Rasador, Diego L Lima, Julia Kasmirski, João P G Kasakewitch, Raquel Nogueira, Flavio Malcher, Prashanth Sreeramoju","doi":"10.1007/s10029-024-03122-9","DOIUrl":"10.1007/s10029-024-03122-9","url":null,"abstract":"<p><strong>Purpose: </strong>Individual studies indicate poorer outcomes for smokers after hernia repair. Previous meta-analyses have examined the impact of smoking on specific outcomes such as recurrence and surgical site infection, but there has been a lack of comprehensive consensus or systematic review on this subject. Addressing this gap, our study undertakes a systematic review and meta-analysis to assess the impact of smoking on the outcomes of ventral hernia repair (VHR) and inguinal hernia repair.</p><p><strong>Source: </strong>A thorough search of Cochrane Central, Scopus, SciELO, and PubMed/MEDLINE, focusing on studies that examined the effect of smoking on inguinal and VHR outcomes was conducted. Key outcomes evaluated included recurrence, reoperation, surgical site occurrences (SSO), surgical site infection (SSI), and seroma.</p><p><strong>Principal findings: </strong>Out of 3296 screened studies, 42 met the inclusion criteria. These comprised 25 studies (69,295 patients) on VHR and 17 studies (204,337 patients) on inguinal hernia repair. The analysis revealed that smokers had significantly higher rates of recurrence (10.4% vs. 9.1%; RR 1.48; 95% CI [1.15; 1.90]; P < 0.01), SSO (13.6% vs. 12.7%; RR 1.44; 95% CI [1.12; 1.86]; P < 0.01) and SSI (6.6% vs. 4.2%; RR 1.64; 95% CI [1.38; 1.94]; P < 0.01) following VHR. Additionally, smokers undergoing inguinal hernia repair showed higher recurrence (9% vs. 8.7%; RR 1.91; 95% CI [1.21; 3.01]; P < 0.01), SSI (0.6% vs. 0.3%; RR 1.6; 95% CI [1.21; 2.0]; P < 0.001), and chronic pain (9.9% vs. 10%; RR 1.24; 95% CI [1.06; 1.45]; P < 0.01) rates. No significant differences were observed in seroma (RR 2.63; 95% CI [0.88; 7.91]; P = 0.084) and reoperation rates (RR 1.48; 95% CI [0.77; 2.85]; P = 0.236) for VHR, and in reoperation rates (RR 0.99; 95% CI [0.51; 1.91]; P = 0.978) for inguinal hernias between smokers and non-smokers. Analysis using funnel plots and Egger's test showed the absence of publication bias in the study outcomes.</p><p><strong>Conclusion: </strong>This comprehensive meta-analysis found statistically significant increases in recurrence rates, and immediate postoperative complications, such as SSO and SSI following inguinal and VHR. Also, our subgroup analysis suggests that the MIS approach seems to be protective of adverse outcomes in the smokers group. However, our findings suggest that these findings are not of clinical relevance, so our data do not support the necessity of smoking cessation before hernia surgery. More studies are needed to elucidate the specific consequences of smoking in both inguinal and ventral hernia repair.</p><p><strong>Prospero registration: </strong>ID CRD42024517640.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":" ","pages":"2079-2095"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859628","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}