Laparoscopic transperitoneal hernia repair (TAPP) in emergency: long-term follow-up in a high volume centre

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

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Long-term follow-up of abandoned transvenous defibrillator leads: a nationwide cohort study

EP Europace ◽

10.1093/europace/euaa086 ◽

2020 ◽

Vol 22 (7) ◽

pp. 1097-1102

Author(s):

Anders Fyhn Elgaard ◽

Jens Brock Johansen ◽

Jens Cosedis Nielsen ◽

Christian Gerdes ◽

Sam Riahi ◽

...

Keyword(s):

Clinical Success ◽

Extraction Procedure ◽

Clinical Success Rate ◽

High Volume ◽

Lead Extraction ◽

Related Data ◽

Major Complications ◽

Long Term Follow Up

Abstract Aims Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications. Methods and results All abandoned transvenous defibrillator leads were identified in the Danish Pacemaker and ICD Register from 1991 to 2019. The event-free survival of abandoned defibrillator leads was studied, and medical records of patients with interventions on abandoned defibrillator leads were audited for procedure-related data. We identified 740 abandoned defibrillator leads. Meantime from implantation to abandonment was 7.2 ± 3.8 years with mean patient age at abandonment of 66.5 ± 13.7 years. During a mean follow-up after abandonment of 4.4 ± 3.1 years, 65 (8.8%) abandoned defibrillator leads were extracted. Most frequent reason for extraction was infection (pocket and systemic) in 41 (63%) patients. Procedural outcome after lead extraction was clinical success in 63 (97%) patients. Minor complications occurred in 3 (5%) patients, and major complications in 1 (2%) patient. No patient died from complication to the procedure during 30-day follow-up after extraction. Conclusion More than 90% of abandoned defibrillator leads do not need to be extracted during long-term follow-up. The most common indication for extraction is infection. Abandoned defibrillator leads can be extracted with high clinical success rate and low risk of major complications at high-volume centres.

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Tasca retto-sigmoidea (Mainz Pouch II) modificata: Nostra esperienza

Urologia Journal ◽

10.1177/039156039406101s73 ◽

1994 ◽

Vol 61 (1_suppl) ◽

pp. 256-259

Author(s):

G. Sevin ◽

H. Gezeroglu ◽

R. Pacchiele ◽

A. Carbone

Keyword(s):

High Volume ◽

Blood Chemistry ◽

Urethral Strictures ◽

Mainz Pouch Ii ◽

Long Term Follow Up ◽

Colon And Rectum ◽

Male Patients ◽

Low Amplitude

Sigma-rectum pouch (Mainz Pouch II) operation, which is a detubularized modification of the well-known ureterosigmoidostomy is becoming a popular alternative of urinary diversion in selected patients. 12 male patients underwent this operation due to locally invasive bladder tumours or incurable urethral strictures and fistulas. The pouch was tailored using 12 cm of sigmoid colon and rectum and performing a side to side anastomosis of the detubularized bowel in an inverted U shape. The new formed pouch was fixed onto the posterior peritoneum so that traction affecting the pouch was minimized. Postoperative radiological analysis revealed no obstruction or ureteral reflux. Urodynamic studies revealed low pressure, high volume reservoirs. Only 1 patient had reservoir wall contractions of low amplitude during filling. Although early postoperative blood chemistry did not reveal any metabolic abnormality, at long-term follow-up some patients showed important electrolyte and acid-base disorders.

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