337 MESH REINFORCEMENT OF THE HIATOPLASTY. PROTECTING THE ACHILLES' HEEL

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Andre Brandalise ◽  
Claudia Lorenzetti ◽  
Nilton Aranha ◽  
Nelson Brandalise
Keyword(s):  
Fibrin Glue ◽  
Late Recurrence ◽  
Hernia Recurrence ◽  
Long Term Results ◽  
Short Term ◽  
Mesh Reinforcement ◽  
Hiatal Closure

Abstract   Disruption of hiatoplasty is one of the main causes of anti reflux surgeries failure. There are some conditions that are associated with higher risks of disruption, leading to hernia recurrence. Bioabsorbable meshes have a safer profile compared to the permanent ones and we show in this video its use aiming to prevent early and possibly, late recurrence. Methods We present a video about different indications for reinforcement of hiatal closure with bioabsorbable mesh. With the security of bioabsorbable materials and previous experiences with these kind of meshes used in an U configuration, we are suggesting that it can be used as an inverted C over the posterior and anterior sutures placed to close the hiatal defect. The mesh is cut during the surgery to better accommodate as an onlay protection. It can be fixed to the diaphragm in different ways, but we used fibrin glue in this series. Results Sixteen patients were operated with this technique. The long term results are not available at this point, but short term results are very encouraging. We have noticed a slightly higher complaint of dysphagia among these patient compared to what we use to observe in our non-mesh patients, but dilatation was not necessary in any patient. Conclusion The use of bioabsorbable mesh in the hiatus is safe and can be used with more frequently to prevent hiatal recurrences in specific groups of patients. Video https://www.dropbox.com/s/jsblif0pfjcuicu/BIOMESH.mov?dl=0.

Long-Term Results of Radioscapholunate Fusion Following Fractures of the Distal Radius

1997 ◽  
Vol 22 (6) ◽  
pp. 705-710 ◽  
Author(s):  
L. NAGY ◽  
U. BÜCHLER
Keyword(s):  
Long Term Results ◽  
Short Term ◽  
Non Union ◽  
Partial Fusion ◽  
Traumatic Lesions ◽  
Residual Motion ◽  
Radioscapholunate Fusion ◽  
Wrist Fusion

Fifteen patients with radioscapholunate (RSL) fusion for traumatic lesions of the radiocarpal junction, whose short-term results have been previously reported, were reassessed after an average follow-up time of 8 years. Five patients had undergone wrist fusion because of non-union or early progressive arthritis. Of the ten wrists with retained mobility, eight continued to function satisfactorily. Two wrists were painful for reasons other than secondary midcarpal arthritis. Patient satisfaction was comparable in both groups with the wrist score better for wrists with residual motion. The survival of RSL partial wrist fusion corresponded inversely with the number of preceding operations and the range of motion before partial fusion. Secondary midcarpal arthritis, if present, arose early and was well tolerated. Failures were strongly linked to technical mistakes and complications.

Long-Term Deformations of Strengthened Reinforced Concrete Linear Elements

2016 ◽  
Vol 691 ◽  
pp. 51-60 ◽  
Author(s):  
Martin Krizma ◽  
Lubomir Bolha
Keyword(s):  
Reinforced Concrete ◽  
Long Term Results ◽  
Short Term ◽  
Limit States ◽  
Linear Elements ◽  
Repeated Load ◽  
The Moment ◽  
Concrete Elements ◽  
Fiber Fabric

The issue of strengthening the damaged linear reinforced concrete elements have been engaged since 2008. We focused on the analysis of resistance and the characteristics of limit states of serviceability in the damaged and subsequently strengthened elements at a short-term loading. In the introduction phase, the strengthening of the elements was carried out with the following procedures – installation of an overlayer on the coupling board or a combination of the board and use of glass – fiber fabric (GFRP). The strengthening was also affected by the type of contact (reinforced/non-reinforced) – the deformed element/coupling board and its effect on resistance, type of deformation and serviceability. In the non-reinforced contact, we applied some of the types of adjustments to the surface of the strengthened element. At the moment, we are dealing with the effects of time and repeated load on the strengthened elements. The results correspond to the reinforced contact. The values are compared with the short-term results of the strengthened beams and with the long-term results of the beams prepared for strengthening.

632 SUTURED VERSUS MESH-AUGMENTED HIATUS HERNIA REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Josipa Petric ◽  
Tim Bright ◽  
David Liu ◽  
Melissa Wee ◽  
David Watson
Keyword(s):  
Systematic Review ◽  
Hiatus Hernia ◽  
Mesh Repair ◽  
Meta Analysis ◽  
Hernia Recurrence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Absorbable Mesh ◽  
Hiatal Closure

Abstract   Repair of large hiatus hernias is increasingly being performed. However, there is no consensus for the optimal technique for hiatal closure between sutured versus mesh-augmented (absorbable or non-absorbable) repair. This meta-analysis systematically reviewed published randomized control trials (RCTs) comparing sutured versus mesh-augmented hiatus hernia (HH) repair. Our primary endpoint was HH recurrence at short- and long-term follow-up. Secondary endpoints were: surgical complications, operative times, dysphagia and quality of life. Methods A systematic review of Medline, Scopus (which encompassed Embase), Cochrane Central Register of Controlled Trials, Web of Science and PubMed was performed to identify relevant studies comparing mesh-augmented versus sutured HH repair. Data were extracted and compared by meta-analysis, using odds ratio and mean differences with 95% confidence intervals. Results Seven RCTs were found which compared mesh-augmented (non-absorbable mesh: n = 296; absorbable mesh: n = 92) with sutured repair (n = 347). There were no significant differences for short-term hernia recurrence (defined as 6–12 months, 10.1% mesh versus 15.5% sutured, P = 0.22), long-term hernia recurrence (defined as 3–5 years, 30.7% mesh vs 31.3% sutured, P = 0.69), functional outcomes and patient satisfaction. The only statistically significant difference was that the mesh repair required a longer operation time (P = 0.05, OR 2.33, 95% CI 0.03–24.69). Conclusion Mesh repair for hiatus hernia does not offer any advantage over sutured hiatal closure. As both techniques deliver good and comparable clinical outcomes, a suture only technique is still an appropriate approach.

The Response of the Neurotic Personality to Abreaction

1952 ◽  
Vol 98 (413) ◽  
pp. 630-639 ◽  
Author(s):  
Anthony Hordern
Keyword(s):  
Long Term Results ◽  
Short Term ◽  
Initial Results

The purpose of this paper is to draw attention to results achieved in selected neurotic cases treated by short-term abreactive techniques in St. Clement's Hospital during recent months. Patients usually stay in for about two months; as yet it is too early to assess long-term results of this form of treatment, but it is felt that some of the initial results are extremely encouraging.

scholarly journals Preoperative Somatostatin Analogues in Patients with Newly-diagnosed Acromegaly: A Systematic Review and Meta-analysis of Comparative Studies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chengxian Yang ◽  
Ge Li ◽  
Shenzhong Jiang ◽  
Xinjie Bao ◽  
Renzhi Wang
Keyword(s):  
Systematic Review ◽  
Comparative Studies ◽  
Meta Analysis ◽  
Somatostatin Analogues ◽  
Long Term Results ◽  
Current Evidence ◽  
Cochrane Library ◽  
Cure Rate ◽  
Short Term

Abstract Biochemical remission after transsphenoidal surgery is still unsatisfied in acromegaly patients with macroadenomas, especially with invasive macroadenomas. Concerning the impact of preoperative somatostatin analogues (SSAs) on surgical outcomes, previous studies with limited cases reported conflicting results. To assess current evidence of preoperative medical treatment, we performed a systematic review and meta-analysis of comparative studies. A literature search was conducted in Pubmed, Embase, and the Cochrane Library. Five randomized controlled trials (RCT) and seven non-RCT comparative studies were included. These studies mainly focused on pituitary macroadenomas though a small number of microadenoma cases were included. For safety, preoperative SSAs were not associated with elevated risks of postoperative complications. With respect to efficacy, the short-term cure rate was improved by preoperative SSAs, but the long-term cure rate showed no significant improvement. For invasive macroadenomas, the short-term cure rate was also improved, but the long-term results were not evaluable in clinical practice because adjuvant therapy was generally required. In conclusion, preoperative SSAs are safe in patients with acromegaly, and the favorable impact on surgical results is restricted to the short-term cure rate in macroadenomas and invasive macroadenomas. Further well-designed RCTs to examine long-term results are awaited to update the finding of this meta-analysis.

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