Abdominal wall reconstruction after desmoid type fibromatosis radical resection: Case series from a single institution and review of the literature.

Abstract Introduction The pedicled anterolateral thigh (ALT) flap is considered as a suitable option in complex abdominal wall reconstruction. Its use as a reconstructive option is infrequent in the literature, and to date, there has been no systematic review evaluating its long-term outcomes. We report our experience with the pedicled anterolateral thigh flap for abdominal wall reconstruction in high-risk patients. Method A prospective database was created for patients with abdominal wall defects treated with pedicled ALT with extended fascia lata flaps between 2014 and 2017. Patient demographics, aetiology, size, location of defect and post-operative results were reviewed. Abdominal defects were classified into the following zones: 1A, upper midline; 1B, lower midline; 2, upper quadrant; 3, lower quadrant. A systematic review of the literature was conducted using PUBMED and EMBASE. Results 4 patients (mean age 59.5 years, range 50-65 years) underwent reconstruction with pedicled ALT flaps. 3 flaps developed partial necrosis secondary to infection; 1 flap required surgical debridement, and 2 were managed conservatively. There was one flap failure, due to avulsion of the pedicle during inset. At mean follow up of 2.75 years (range 1 to 4 years) 3 patients have clinical bulging or herniation. Conclusions Review of the literature demonstrated 52 patients from 17 case series or reports. The overall infection and partial flap loss rates were both 6%. There were no reported flap failures. Our study demonstrates that the pedicled anterolateral thigh flap is an effective flap option for the repair of large defects of the abdominal wall in high-risk patients.

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EP.TH.108A Descriptive Case Series of Incisional Hernia Repair Using Dual Mesh Technique

British Journal of Surgery ◽

10.1093/bjs/znab309.016 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Chloe Theodorou ◽

Zia Moinuddin ◽

David Van Dellen

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Abdominal Wall ◽

Abdominal Wall Reconstruction ◽

Surgical Techniques ◽

Case Series ◽

Incisional Hernia Repair ◽

Fistula Formation ◽

Mesh Technique ◽

Dual Mesh

Abstract Aims Incisional hernias are a common complication after surgery that cause significant patient morbidity. Symptomatic patients are offered repair but many surgical techniques exist, with abdominal wall reconstruction becoming preferable for large complex defects. This paper describes our experience of abdominal wall reconstruction using a dual mesh technique. Method 22 patients underwent incisional hernia repair between March 2019 and September 2020. All patients received dual mesh, placed in retrorectus or transversalis fascial/retromuscular space. Absorbable BIO-A GORE mesh was used with a polypropylene mesh above. All patients were followed up to assess for complications and recurrence. Results No patients experienced fistula formation, long-term pain or obstructive symptoms. We report one true hernia recurrence (4.5%) and one case of infected mesh (4.5%), these both await further treatment. One patient had a proven wound infection which resolved with conservative treatment. 4 patients (18.2%) experienced seromas, 3 of these resolved spontaneously, one requiring image-guided drainage. Conclusion Incisional hernia repair using combination polypropylene and bio-absorbable mesh provides a safe and effective repair with low recurrence and incidence of surgical site occurrences in the short term. Longer follow up and further studies are needed to evaluate this mesh technique to support ongoing use of absorbable meshes in complex hernia repair.

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Reversal of Blood Flow in the Internal Jugular Vein - A Case Series and Review of the Literature

American Journal of Sonography ◽

10.25259/ajs-42-2018 ◽

2018 ◽

Vol 1 ◽

pp. 17

Author(s):

Akshaar Brahmbhatt ◽

Rachel Miceli ◽

Kamila Skalski ◽

Vikram Dogra

Keyword(s):

Blood Flow ◽

Upper Extremity ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Case Series ◽

Flow Reversal ◽

Review Of The Literature ◽

Single Institution ◽

Ultrasound Evaluation ◽

Endovascular Devices

Objective The objectives of this study were to identify the causes of internal jugular vein (IJV) blood flow reversal revealed on ultrasound imaging. Methods In this retrospective review, 4796 upper extremity venous ultrasounds completed at a single institution between January 2012 and December 2017 were reviewed to identify cases of flow reversal in the IJV. Fourteen patients were identified with IJV flow reversal. Medical charts of these 14 patients were reviewed to identify the etiology of blood flow reversal. Results Intraluminal causes were the most common and were most frequently seen in patients with vascular damage secondary to placement of endovascular devices. Flow reversal most commonly occurred in the left IJV and was equally represented in men and women. Ages ranged from 41.38 to 82.76 years, with an average age of 61.92 years. Conclusion Reversal of flow in the IJV is a rare finding which is most often diagnosed on ultrasound evaluation of the upper extremity. Further investigation should be performed when flow reversal is identified, as the underlying cause may have serious clinical implications.

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