scholarly journals MP33-17 MESHING AROUND: LONG-TERM OUTCOMES FOLLOWING VAGINAL RECONSTRUCTIVE SURGERY WITH SYNTHETIC MESH AUGMENTATION

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Sarah McAchran ◽  
Hayley Barnes ◽  
Elizabeth Meller ◽  
Caroline Kieserman-Shmokler ◽  
Dobie Giles ◽  
...  
Keyword(s):  
Reconstructive Surgery ◽  
Synthetic Mesh ◽  
Long Term Outcomes ◽  
Mesh Augmentation ◽  
Vaginal Reconstructive Surgery

scholarly journals The incidence of mesh extrusion after vaginal incontinence and pelvic floor prolapse surgery

2014 ◽  
Vol 3 (4) ◽  
pp. 76
Author(s):  
Seth Cohen ◽  
Elizabeth Kavaler
Keyword(s):  
Reconstructive Surgery ◽  
Survival Function ◽  
Pelvic Organ ◽  
Synthetic Mesh ◽  
Anterior Repair ◽  
Vaginal Reconstructive Surgery ◽  
Pelvic Floor Prolapse ◽  
One Year

Purpose: The advantages of using synthetic mesh in vaginal reconstructive surgery are significant. However, the concern about extrusion has led many to question its use. We wished to learn the extrusion rates and time to extrusion in patients undergoing vaginal stress incontinence and prolapse surgeries using polypropylene mesh. Materials and methods: Five hundred and seventy six women underwent vaginal reconstructive surgery with synthetic mesh between August 2000 and October 2009 for the treatment of stress urinary incontinence, with or without pelvic organ prolapse repair. 367 patients had at least one year follow-up. Procedures were: pubo-vaginal sling (PVS), PVS and anterior repair, PVS with anterior and/or posterior repairs, and PVS with hysterectomy and anterior and posterior repairs. Time to mesh extrusion was estimated using a survival function curve. Results: Forty-two (11.4%) patients sustained a mesh extrusion. The rate of mesh extrusion was (6.3%) in the PVS group, (14.7%) in the PVS and anterior repair group, (11.1%) in the PVS with anterior and posterior repairs group and (5%) in the PVS with hysterectomy and anterior and posterior repair. Percent extrusion free at one to four years post-op was (91%) and (85%). Conclusion: Our study provides a large series of prolapse cases performed by a single surgeon with follow-up that extends at least one year, with the longest follow-up at eight years. The incidence of long term mesh extrusion needs to be considered with respect to the support advantages of synthetic mesh in planning vaginal reconstructive surgery. 

Safety and Long-Term Outcomes After Hernia Repairs with Synthetic Mesh in Contaminated Fields

2020 ◽  
Vol 24 (12) ◽  
pp. 2849-2851
Author(s):  
María A. Casas ◽  
Nicolás H. Dreifuss ◽  
Francisco Schlottmann ◽  
Emmanuel E. Sadava
Keyword(s):  
Synthetic Mesh ◽  
Long Term Outcomes

scholarly journals Urothelial-based reconstructive surgery for upper- and mid-ureteral defects: Long-term results

2016 ◽  
Vol 10 (9-10) ◽  
pp. 290
Author(s):  
Barak Rosenzweig ◽  
Yoram Mor ◽  
Tomer Erlich ◽  
Menachem Laufer ◽  
Harry Winkler ◽  
...  
Keyword(s):  
Renal Function ◽  
Reconstructive Surgery ◽  
Long Term Results ◽  
Obstructive Nephropathy ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Renal Function Deterioration ◽  
The Mean ◽  
Long Term Preservation

<p><strong>Introduction:</strong> Ureteral strictures can result in obstructive nephropathy and renal function deterioration. Surgical management of ureteral defects, especially in the proximal- and mid-ureter, is particularly challenging. Our purpose was to analyze the long-term outcomes of urothelial-based reconstructive surgery for upper- and mid-ureteral defects.</p><p><strong>Methods:</strong> We conducted a retrospective analysis of a single tertiary centre’s database, including 149 patients treated for ureteral defects between 2001 and 2011. Thirty-one patients (21%) underwent complex urothelial-based surgical repairs for upper- and mid-ureter defects. Patients’ median age was 61 years. The mean length of the ureteral strictures was 2.5 cm, located in upper-, mid-ureter, or in between in 19 (61%), 10 (32%), and two (6%) patients, respectively. All patients were treated with a primary urothelial-based repair. Median followup time was 26 months. The primary outcome of the study was the long-term preservation of renal function and lack of clinical obstruction. The secondary endpoint of the study was the assessment of the intra- and postoperative complication rates.</p><p><strong>Results:</strong> Most of the lesions were benign (22, 71%), while nine strictures (29%) were malignant. Seven patients (23%) suffered from postoperative complications, five of which were infectious. The median pre- and postoperative calculated glomerular filtration rates were 66 ml/min/1.72m2 and 64ml/min/1.72m2, respectively. Success rate was 84%, defined as lack of need for re-operation or kidney drainage at the last followup.</p><p><strong>Conclusions:</strong> Upper- and mid-ureteral defects present a complex pathology necessitating experienced reconstructive surgical skills. Our data suggest good long-term results for primary urothelialbased reconstructions for these pathologies.</p>

scholarly journals BIOIMPLANTS — A NEW TREND IN RECONSTRUCTIVE SURGERY

2020 ◽  
Vol 66 (3) ◽  
pp. 228-232
Author(s):  
Denis Kulbakin ◽  
Dariya Yegorova ◽  
Daniil Azovskiy
Keyword(s):  
Reconstructive Surgery ◽  
Long Term Outcomes ◽  
Plastic And Reconstructive Surgery ◽  
Innovative Strategies ◽  
Durability Properties ◽  
Physical Density ◽  
Complete Treatment ◽  
Economic Necessity ◽  
Research Show

The review is devoted to the biomaterials and technology of the Plastic and Reconstructive Surgery, which have the main properties: biocompatibility, antibacterial, physical (density, rigidity) and mechanical (sufficient endurance, osteoconductivity, durability) properties. The presented biomaterials and technologies show that modern approaches of tissue engineering are aimed at simulating the extracellular matrix by means of change various forms, components (by adding growth factors, cytokines), which provide the ability to proliferate and differentiate. The introduction of innovative strategies can be a real breakthrough in the future, since there is a socio-economic necessity in the complete treatment and replacement of damaged or non-functional tissues. However, the existing low reproducibility of these methods does not allow judging on long-term outcomes. In particular, we are talking about the interaction of the implant with tissue, although current research show promising results.

scholarly journals Excision of elongated cervix during reconstructive surgery in patients with pelvic organ prolapse – pro et contra

2019 ◽  
Vol 4 (3) ◽  
pp. 34-40
Author(s):  
I. A. Eizenach ◽  
V. V. Vlasova ◽  
V. G. Mozes
Keyword(s):  
Pelvic Organ Prolapse ◽  
Reconstructive Surgery ◽  
Primary Outcome ◽  
Pelvic Organ ◽  
Cervical Length ◽  
Long Term Outcomes ◽  
Cervical Elongation ◽  
Mesh Surgery

Aim. To determine whether the cervical elongation affects long-term outcomes of reconstructive surgery of pelvic organ prolapse.Materials and Methods. We consecutively enrolled 99 patients with grade 2-3 pelvic organ prolapse (Pelvic Organ Prolapse Quantification System) who underwent vaginal mesh surgery. Volume and length of the cervix were measured using vaginal ultrasonography immediately before the surgery. Cervical elongation was defined as cervix > 6 cm in length (n = 55). Upon 1 year of follow-up, we evaluated the primary outcome (pelvic organ prolapse) and secondary outcomes (cervical length and volume).Results. After 1 year of follow-up, cervical elongation was still detected in 18.1% of patients with cervical elongation before the surgery but not in those without (p = 0.008). Dyspareunia was documented in 14.5% and 2.2% of women with and without cervical elongation, respectively (p = 0.034). In patients with cervical elongation, the length of the cervix before the surgery and after 1 year of follow-up was 7.6 (7; 7.9) cm and 8.4 (7.9; 8.9) cm, respectively (p = 0.001); the respective values of cervical volume were 23.7 (23.4; 24.4) cm3 and 26.9 (25.7; 31.9) cm3 , respectively (p = 0.001); however, these differences were insignificant in patients without cervical elongation.Conclusion. Cervical excision may be recommended for the patients with pelvic organ prolapse and concurrent cervical elongation (length of the cervix > 6 cm). Cervical preservation in such patients may lead to progression of the elongation even after the correction of pelvic organ prolapse. 

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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