scholarly journals P022 OUTCOMES OF ABDOMINAL WALL REPAIR ASSOCIATED WITH INTESTINAL TRANSIT RECONSTRUCTION SURGERY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Joaquin Munoz-Rodriguez ◽  
Javier López Monclús ◽  
Alvaro Robin Valle de Lersundi ◽  
Luis Blázquez Hernando ◽  
Miguel Ángel García Ureña
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Colorectal Anastomosis ◽  
Intestinal Transit ◽  
Long Term Results ◽  
Reconstruction Technique ◽  
Reconstruction Surgery ◽  
Short And Long Term ◽  
Mesh Reconstruction

Abstract Aim Analyze and evaluate the results obtained in patients undergoing transit reconstruction surgery in which an abdominal wall reconstruction (AWR) is associated using a multidisciplinary approach. Material and Methods All patients who underwent an intestinal transit reconstruction associated with an AWR surgery were identified from a prospectively maintained multicenter database. Short and long-term results have been analyzed, especially AWR outcomes. Results 10 patients were identified. 60% were men. Mean time since previous surgery was 1.66 years. 8 cases (80%) associated a midline incisional hernia with the parastomal hernia. 3 (30%) bilateral posterior component separation (PCS) Madrid transverse abdominis muscle release (Madrid TAR) modification, 5 (50%) unilateral Madrid TAR, 1 (10%) PCS Carbonell, and 1 (10%) Rives-Stoppa techniques were performed. A double mesh reconstruction technique was used in 60% of the patients, associating absorbable mesh with a permanent mesh. One patient presented a paucisymptomatic colorectal anastomosis fistula, that could be managed conservatively. A case of postsurgical ileus was also evidenced. Surgical site ocurrences (SSO) were recorded in 4 patients (40%), all of them related to surgical site infection that required a bedside wound opening. During a mean follow-up of 24 (+/- 15) months, there was no evidence of hernia recurrence. No cases of bulging, chronic mesh infection or chronic pain were reported. No case of mortality was recorded in the series. Conclusions Intestinal transit reconstruction surgery associated with an AWR, with a multidisciplinary team managed, presents acceptable long-term results, despite the high SSO associated.

scholarly journals P017 COMPLEX ABDOMINAL WALL RECONSTRUCTION IN ELDERLY PATIENTS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Joaquin Munoz-Rodriguez ◽  
Javier López Monclús ◽  
Carlos San Miguel ◽  
Luis Blázquez Hernando ◽  
Alvaro Robin Valle de Lersundi ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Surgical Site Infections ◽  
The Elderly ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Preperitoneal Approach ◽  
Short And Long Term

Abstract Aim Our study aims to analyze and evaluate the results obtained in patients older than 80 years old who underwent complex abdominal wall reconstruction (CAWR) in a multicenter abdominal wall unit using different surgical approaches. Material and Methods Patients were identified from a prospective maintained multicenter database. Demographic characteristics, incisional hernias’ (IH) characteristics, as well as postoperative outcomes, including short and long-term complications have been analyzed. Results 21 patients were identified. The mean age was 82.5 (+/- 2.4) years old . There were 10 (47.6%) midline IH, 5 (23.8%) lateral IH, 4 (19%) synchronous midline and lateral IHs, and 2 (9.6%) parastomal hernias (PH). 9 (42.8%) Madrid TAR modification technique, 5 (23.8%) Rives-Stoppa, 3 (14.3%) lateral preperitoneal approaches, 1 (4.8%) midline preperitoneal approach and 1 (4.8%) anterior component separation were performed. In patients with PH, a modification of the Pauli technique (4.8%), and a unilateral TAR with a keyhole repair associated (4.8%) were performed. There were 7 (33,3) surgical site occurrences (SSO), 1 (4.8%) seroma, 3 (14.3%) hematomas and 3 (14.3%) surgical site infections. Only 3 (14.3%) SSO required procedural intervention. During a mean follow-up of 20.6 (+/- 15.9) months, 1 (4.8%) hernia recurrence was diagnosed. No cases of postoperative bulging were recorded. There were also no cases of chronic pain in the sample. During follow-up, 3 patients died from surgery unrelated causes. Conclusions CAWR in the elderly patient, after an adequate preoperatively selection of patients, presented acceptable short- and long-term results, despite the advanced population age.

Abdominal Wall Expanding System. Intraoperative Abdominal Wall Expansion as a Technique to Repair Giant Incisional Hernia and Laparostoma. New and Long-Term Results From a Three-Center Feasibility Study

2021 ◽  
pp. 155335062110414
Author(s):  
Dietmar Eucker ◽  
Nadine Rüedi ◽  
Clinton Luedtke ◽  
Oliver Stern ◽  
Henning Niebuhr ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Long Term Results ◽  
Anatomical Reconstruction ◽  
Time Saving ◽  
Lateral Abdominal Wall ◽  
Hernia Size ◽  
Midline Closure

Background The abdominal wall expanding system (AWEX) was first applied in 2012 and published in 2017. This novel technique was developed to reconstruct complex incisional hernias and residual skin-grafted laparostoma after treatment of an open abdomen, when primary midline closure was impossible. The main aim was the anatomical reconstruction of the abdominal wall and the avoidance of dissecting techniques (component separation). Methods Between 2012 and 2019, 33 patients underwent AWEX hernia repair in three certified hernia centers. The retracted abdominal wall was stretched with the AWEX system intraoperatively for approximately 30 min. Hernia size was measured preoperatively, on CT, and intraoperatively. The gain in length on the lateral abdominal wall (decrease in width of the defect) after stretching and any residual midline gap were determined in the OR. Results 33 patients underwent AWEX procedures. Six cases were evaluated separately because of additional procedures (TAR, four cases) and preoperative application of botulinum toxin (two cases). The median (95% confidence interval) measured width of hernia defects was 13 (12–16) cm, the median gain in length on the lateral abdominal wall was 12 (10–15) cm. After median follow-up of 29 (12–54) months, one recurrence from the broken mesh was observed. No method-related complications occurred. Conclusion Based on the 2017 and current results, the AWEX system represents an alternative or supplemental procedure to current techniques for complex abdominal wall reconstruction. The system proved again to be time-saving, safe, effective, and easy to learn. Further studies with enhanced technology are in progress.

scholarly journals P005 POSTERIOR COMPONENT SEPARATION WITH TRANSVERSUS ABDOMINIS RELEASE FOR COMPLEX VENTRAL HERNIA REPAIR: A CASE SERIES

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Camillo Leonardo Bertoglio ◽  
Marianna Maspero ◽  
Bruno Alampi ◽  
Lorenzo Morini ◽  
Carmelo Magistro ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Component Separation ◽  
Transversus Abdominis ◽  
Long Term Results ◽  
Transversus Abdominis Release ◽  
Median Length ◽  
Posterior Component Separation ◽  
Short And Long Term

Abstract Aim To assess the short- and long-term outcomes of posterior component separation with transversus abdominis release (PCS-TAR) at our Centre. Material and methods From 2016, our abdominal wall unit started with PCS-TAR for the treatment of patients with complex abdominal wall hernias. We report our prospectively collected preliminary results. Results Sixty-six patients underwent PCS-TAR. Twenty patients had already received at least one previous hernia repair, 16 with mesh implantation. The median width of the defect was 12 cm (range 3 - 35), the median length 15 (range 4 - 40). Defects were multiple in 13 cases, swiss cheese in 2 cases. Eleven defects had both a midline and a lateral component, 3 had a concomitant parastomal hernia. Thirty-eight cases were located near the abdominal wall borders. The median duration of surgery was 255 minutes (range 84 - 740). TAR was partial in 24 cases and monolateral in 24. Twelve cases involved previous mesh removal. Fifty patients received implantation of more than one mesh: the most common combination was a PVDF mesh on top of a biosynthetic mesh. The mesh seldom needed to be fixed. The median length of stay was 6 days (range 3 - 61). Postoperative complications occurred in 22 patients (3 were major). Surgical site occurrences happened in 7 cases. After at least 12 months of follow up per patient, there was 1 recurrence, 1 case of chronic pain and no chronic seromas. Conclusions Posterior component separation with transversus abdominis release offers a versatile solution for a variety of complex ventral hernias, with good short- and long-term results.

scholarly journals THE USE OF THE SUBMENTAL FLAP IN RECONSTRUCTION OF HEAD AND NECK DEFECTS

2018 ◽  
Vol 17 (3) ◽  
pp. 51-57
Author(s):  
O. A. Saprina ◽  
R. I. Azizyan ◽  
V. Zh. Brzhezovsky ◽  
A. M. Mudunov ◽  
I. S. Romanov ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flaps ◽  
Oncologic Outcomes ◽  
Long Term Results ◽  
Reconstruction Technique ◽  
New Techniques ◽  
Neck Lymph Node ◽  
Aesthetic Results ◽  
Short And Long Term

Reconstruction of head and neck defects after surgery for cancer remains challenging. The choice of the reconstruction technique  depends on the tumor size and localization, type of the defect,  patient’s age, concomitant diseases, and disease prognosis.  Surgeons have currently a broad range of material for reconstructive surgery, from free flaps to revascularized flaps. Microsurgical  reconstruction has made a revolution in treatment of patients with  complex head and neck defects. However, the use of this technique may not be advisable for some patients. The search for  new techniques is needed to improve functional and aesthetic results and reduce traumatism without compromising oncologic outcomes.  Thirty-six patients underwent surgery with reconstruction using the  submental island flap, a new alternative in the reconstruction of  various head and neck defects. The graft was taken after making a  neck incision for neck lymph node dissection. A few patients develop  total and marginal necrosis of the graft. Short- and long-term results showed no worsening of oncologic outcomes in the selected group of patients.

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Short- and Long-Term Results of the Surgical Management of Frontobasal Fractures

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Boštjan Lanišnik ◽  
Vojko Didanovič ◽  
Bogdan Čizmarevič
Keyword(s):  
Surgical Management ◽  
Long Term Results ◽  
Short And Long Term

Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Survival Rates ◽  
Long Term Results ◽  
Term Survival ◽  
Kaplan Meier ◽  
Risk Patients ◽  
Short And Long Term ◽  
Good Treatment Option ◽  
Matched Comparison

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>

Long-Term Clinical Outcomes of an Antibiotic-Coated Non–Cross-linked Porcine Acellular Dermal Graft for Abdominal Wall Reconstruction for High-Risk and Contaminated Wounds

2021 ◽  
pp. 000313482110233
Author(s):  
Jordan Robinson ◽  
Jesse K. Sulzer ◽  
Benjamin Motz ◽  
Erin H. Baker ◽  
John B. Martinie ◽  
...  
Keyword(s):  
High Risk ◽  
Abdominal Wall ◽  
Clinical Outcomes ◽  
Open Abdomen ◽  
Abdominal Wall Reconstruction ◽  
Dermal Graft ◽  
Elective Repair ◽  
Acellular Dermal

Background Abdominal wall reconstruction in high-risk and contaminated cases remains a challenging surgical dilemma. We report long-term clinical outcomes for a rifampin-/minocycline-coated acellular dermal graft (XenMatrix™ AB) in complex abdominal wall reconstruction for patients with a prior open abdomen or contaminated wounds. Methods Patients undergoing abdominal wall reconstruction at our institution at high risk for surgical site occurrence and reconstructed with XenMatrix™ AB with intent-to-treat between 2014 and 2017 were included. Demographics, operative characteristics, and outcomes were collected. The primary outcome was hernia recurrence. The secondary outcomes included length of stay, surgical site occurrence, readmission, morbidity, and mortality. Results Twenty-two patients underwent abdominal wall reconstruction using XenMatrix™ AB during the study period. Two patients died while inpatient from progression of their comorbid diseases and were excluded. Sixty percent of patients had an open abdomen at the time of repair. All patients were from modified Ventral Hernia Working Group class 2 or 3. There were a total of four 30-day infectious complications including superficial cellulitis/fat necrosis (15%) and one intraperitoneal abscess (5%). No patients required reoperation or graft excision. Median clinical follow-up was 38.2 months with a mean of 35.2 +/− 18.5 months. Two asymptomatic recurrences and one symptomatic recurrence were noted during this period with one planning for elective repair of an eventration. Follow-up was extended by phone interview which identified no additional recurrences at a median of 45.5 and mean of 50.5 +/−12.7 months. Conclusion We present long-term outcomes for patients with high-risk and contaminated wounds who underwent abdominal wall reconstruction reinforced with XenMatrix™ AB to achieve early, permanent abdominal closure. Acceptable outcomes were noted.

Large Gaps of Midline Abdominal Incisions and Their Management

2008 ◽  
Vol 74 (11) ◽  
pp. 1094-1099
Author(s):  
Mahmoud N. Kulaylat ◽  
Constantine P. Karakousis
Keyword(s):  
Abdominal Wall ◽  
Surgical Procedures ◽  
Skin Grafting ◽  
Operative Management ◽  
Full Thickness ◽  
Tension Free ◽  
Abdominal Malignancy ◽  
One Step ◽  
Short And Long Term

The operative management of midline full-thickness abdominal wall gaps is difficult, often requires several surgical procedures and is associated with significant short- and long-term complications. A rectus abdominis-posterior sheath (RAPS) flap with skin grafting provides a tension-free one-step repair which was used in three patients successfully with midline abdominal wall (including the skin) gaps who had multiple previous operations related to intra-abdominal malignancy. No complications occurred in these patients in relation to this procedure.

Sign in / Sign up

Export Citation Format

Share Document