The Outcome of the Combined Procedure of Abdominoplasty and Repair of Umbilical Hernia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Refaat Refaat Kamel ◽  
Amr Reda Mabrouk ◽  
Mena Akladuos Moussa
Keyword(s):  
Hernia Repair ◽  
Umbilical Hernia ◽  
University Hospital ◽  
Recurrence Rates ◽  
Combined Procedure ◽  
Mesh Reinforcement ◽  
Patients Satisfaction ◽  
Self Confidence ◽  
Group A ◽  
Group B

Abstract Background Umbilical hernias (UH) are common in patients seeking abdominal contouring surgery and the question of simultaneous abdominoplasty and UH repair is raised. This presents, however, a risk to the umbilicus vascularization with possible umbilical necrosis. As a result, the umbilicus maintains its only blood supply from the underlying fascial attachments via the umbilical stalk. Abdominoplasty in the setting of a hernia repair can improve patients satisfaction, particularly appearance, hygiene, self-confidence and decrease the incidence of recurrence. Objective To assess the outcome of the combined procedure of abdominoplasty and repair of umbilical hernia. Patients and Methods This study Included 26 patients (18 females and 8 males) who were selected from those who presented to the department of general surgery at EL Demerdash University Hospital and Nasr city insurance hospital during the period between april2019 and october 2019. All patients had a physical examination of the UH and diastasis. Divided into two groups, each group formed of 13 patients. First group (group A) with patients underwent herniorrphy alone and the other group (group B) with patients underwent hernioplasty with combined abdominoplasty. Results It may be concluded that (1) during an abdominoplasty, midline fascial plication and ventral hernia repair can be performed in defects <3 cm without mesh reinforcement with no increase in hernia recurrence rates, (2) in patients with defects > 3 cm, mesh reinforcement is indicated after suture hernia repair and midline plication,, yields lower recurrence of abdominal deformity and less refashioning procedures with minimal complications. Conclusion Finally, it may help to reduce the incidence of recurrence by enabling removal of a large pannus and the resultant weight on the anterior abdominal wall, though this has not been proven. Also it improves the quality of life and obtains patients satisfaction with this approach.

scholarly journals Markers of Aggressiveness in Craniopharyngiomas

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A646-A646
Author(s):  
Diego Jesús Del Can-Sanchez ◽  
Diego Jesus Del Can Sanchez ◽  
Antonio Jesús Martínez-Ortega ◽  
Alvaro Flores-Martínez ◽  
Eva Venegas-Moreno ◽  
...  
Keyword(s):  
Progesterone Receptor ◽  
Tissue Sample ◽  
Age Groups ◽  
Receptor Expression ◽  
University Hospital ◽  
Recurrence Rates ◽  
Ki 67 ◽  
Group A ◽  
Group B ◽  
Estrogen And Progesterone Receptor

Abstract Craniopharyngiomas (CP) are rare tumors that may be locally aggressive. The presence of functional estrogen receptors (ER) has been reported in CP and might be related to risk of recurrence. Our aim is to ascertain if the expression estrogen and progesterone receptor (PR) might be associated with to recurrence in CP. Material and Methods: Descriptive retrospective observational study of patients with confirmed histology of CP and tissue sample available admitted to Virgen Del Rocio University Hospital (Seville, Spain) from January 1967 to October 2020 were included. Estrogen and progesterone receptor expression was analyzed by Immunohistochemistry. Ki-67 levels were also analyzed. Two CP groups were considereded according to Ki67 levels: Group A (Ki67<10%) and group B (Ki67>10%). As all variables followed a non-parametric distribution, U Mann Whitney, Chi-Square, and Z-test with Benjamini-Hochberg correction were used when needed. Results: Our study population includes 80 patients (46 male and 34 female), with a median age at diagnosis of 34 years [10-50.00]. Twenty-six patients were under 18 years old (children) with a median age of 7 years [4.5-10.00], and 54 were adults (aged 18 and above) with a median age of 45 years [33-58.50]. Our data shows higher recurrence rates when Ki67 levels staining were higher than 10%: 8/14 (57.2%) in comparison with Ki67<10% (6/14, 42.9%, p=0.018). In children we found 6 samples with Ki67<10% and 6 samples with Ki67 >10%; recurrences were observed in 2/6 (33,3%) in the first group and in 6/6 (100%) in the second, respectively (p= 0,199). In adults, we found 9 and 3 patients for high and low Ki67 levels, respectively. Recurrences were observed in 4/9 (44,4%) in the group A and in 2/3 (66,7%) in the group B, respectively (p= 0,28). There were no differences between age groups. In patients with positive ER, we observed an increased rate of recurrence: 12/23 (52.17%) versus 2/13 (15,38%) in patients with negative ER stain but it was no significant. (p=0,21). No association between PR and recurrence was observed. Conclusions: In our series, patients with CP with high Ki67 levels are more likely to recur. No clear association between ER, PR expression and recurrence was observed. These findings support the use of Ki67 as a marker of recurrence in CP. Sources of Research Support: Spanish Ministry of Health, ISCIII co-funded with Fondos FEDER (PI16/00175) and Novartis Oncology Spain.

scholarly journals INGUINAL HERNIOPLASTY

2015 ◽  
Vol 22 (06) ◽  
pp. 782-786
Author(s):  
Mujeeb Rehman Abbasi ◽  
Razzak Shaikh ◽  
Ahmed Khan Sangrasi ◽  
Noshad A Shaikh ◽  
Ubedullah Shaikh
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Hernia ◽  
Operation Time ◽  
University Hospital ◽  
Inguinal Hernioplasty ◽  
Surgical Department ◽  
Group A ◽  
Group B

Objective: To compare laparoscopic TEP Inguinal hernioplasty with & withoutdissection balloon. Study Design: Observational study. Setting: Minimal Invasive SurgicalCentre Jamshoro and General Surgical Department at Dow University Hospital, Ojha CampusKarachi. Period: May 2011 and Dec 2012. Subjects and methods: Twenty (20) male patientswith uncomplicated unilateral or bilateral inguinal hernia were prospectively randomized in twogroups; group A Commercially available dissection balloon & group B. Telescopic dissectionfor creating TEP working space. Results: We had 20 male patients for this study. The averageage was 43.6 & ranging between 17 to 64 years. Only 2 patients 10% had bilateral groin hernia,4 patients 40% had direct inguinal hernia in group A & 5 patients 50% had direct hernia in groupB. Peritoneum was breached in 5 (50%) patients with telescopic dissection. One patient (10%)with bilateral groin hernia in group B had large tear in peritoneum converted to TAPP whileother group normal. The incidence of scrotal edema/seroma was greater in group B then groupA. 40% patient in group B developed seroma while 0nly 1 (10%) patient with bilateral groinhernia in group A developed seroma. Pain was scored on VAS at 1 & 4 hours after surgerywas higher in group B. The mean operation time was 55 min (45-100) in the group with theballoon and 73 min (50-120) in the group without the balloon (p = 0.004). Conclusion: TEPlaparoscopic inguinal hernia repair is probably the best option amongst the two techniquesused in laparoscopic inguinal hernia repair & dissection with balloon is though costly but morehelpful in dissection & safer.

scholarly journals A prospective comparative study of Lichtenstein procedure with and without mesh-fixation for inguinal hernia repair

2021 ◽  
Vol 9 (2) ◽  
pp. 390
Author(s):  
Ravinder Kumar ◽  
Hilal A. Wani ◽  
Anshuman Mahesh ◽  
Irfan N. Mir
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Operative Time ◽  
Mesh Fixation ◽  
P Value ◽  
Recurrence Rates ◽  
Fixation Group ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Repair of inguinal hernia is one of the most common elective operations performed in general surgery worldwide. Mesh-hernioplasty became the gold standard, because of its low recurrence rate in comparison with tissue repairs. The ideal repair must be simple, safe easy to perform and require minimal dissection which provides enough space, should be cost effective with less hospital stay, less pain and less recurrence. The present study aimed at comparing the effect of mesh fixation and non-fixation in Lichtenstein technique for inguinal hernia repair.Methods: Hundred (100) patients with primary uncomplicated, unilateral inguinal hernia were treated between April 2019 and September 2020. Patients with inguinal hernia underwent Lichtenstein repair with mesh-fixation (group A) (n=50) and non-fixation (group B) (n=50). The mean operative time, post-operative pain score, average hospital study, post-operative complications and recurrence rates were compared between the two groups.Results: Mean operative time in non-fixation group- (group B) (32.24 min) was shorter as compared to fixation group-(G1) (49.36 min) with a p value of 0.002. Post-operative pain score was lower in (group B) at 12 and 24 hours (3.71±1.409 and 2.2±0.8169) as compared to G1 at 12 and 24 hours (4.77±1.196 and 2.98±1.295) with a p value of <0.0001. The analgesia required in (group B) was less as compared to (group A). The post-operative complication and recurrence rates were almost identical in both the groups, with lesser incidence of groin pain and paresthesias in group B.Conclusions: In Lichtenstein inguinal hernia repair, non-fixation of mesh is safe and preferable option, with less operative time and less postoperative pain.

Comparison of Transversus Abdominis Plane Block versus Local Wound Infiltration in Reducing Postoperative Pain in Patients Undergoing Infraumblical Hernia Repair

2021 ◽  
Vol 15 (5) ◽  
pp. 1130-1133
Author(s):  
A. Jamil ◽  
Z. Ahmad ◽  
F. Farooq ◽  
H. A. Khan ◽  
R. Ansari ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Hernia Repair ◽  
Umbilical Hernia ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Wound Infiltration ◽  
Group A ◽  
Group B

Objective: To compare the outcomes of TAP block versus local wound infiltration in reducing postoperative pain in patients undergoing infra-umbilical hernia repair. Study design: Randomized controlled trial Place and Duration of Study: Department of Anaesthesiology, Surgical Intensive Care Unit & Pain Management, Dow Medical College & Civil Hospital Karachi from 1st August 2020 to 31st January 2021. Methodology: One hundred patients with undergoing infra-umbilical hernia mesh repair were randomly allocated into two groups. Fifty patients in group A were treated with transversus abdominis plane block and 50 were in group B for local infiltration. Anaesthetic technique was standardized. The drug was administered according to the weight of the patient. Visual analogue score (VAS), graduated from 0-10 was recorded. Results: The mean age was 41.08±10.36 years. There were 61% males and 39% females. Mean time of analgesia was significantly high in group A than groups B [413.2±63.83 vs 274.16±41.28; p=0.0005]. Mean VAS pain score at rest and movement was also significantly low in group A than group B. Conclusion: Transversus abdominis plane block seemed preferable to local anesthetic wound infiltration in postoperative analgesia. Current evidence is insufficient to suggest that the transversus abdominis plane block will minimize post-operative morphine requirements and associated side effects in comparison with local anesthetic infiltration. Key Words: Hernia repair, Transversus abdominis plane (TAP) block, Local wound infiltration, Postoperative morphine

COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shrikant . ◽  
R.D. Mehta ◽  
B.C. Ghiya
Keyword(s):  
Partial Response ◽  
Comparative Study ◽  
Recurrence Rate ◽  
Vitamin D3 ◽  
Complete Response ◽  
Recurrence Rates ◽  
Additional Advantage ◽  
Cost Effective Treatment ◽  
Group A ◽  
Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

PLACE EFFECT: MOTOR, COGNITIVE AND SELF CONFIDENCE BEHAVIORS

2019 ◽  
Author(s):  
Naveed Shibli ◽  
Fariha Zahid
Keyword(s):  
Motor Performance ◽  
Human Being ◽  
Human Beings ◽  
Significant Information ◽  
Academic Confidence ◽  
Cognitive Behaviors ◽  
Self Confidence ◽  
Group A ◽  
Group B ◽  
Academic Self Efficacy

<p></p><p>Human beings live in various places. Place affects human being. A few experiments were conducted on 200 students, including 100 male and 100 female. Participants were the students of a selected school. Place effect on participants’ motor, cognitive behaviors and academic confidence studied. The subjects were divided into two groups. Group-A was consisted of students those were in the school for more than 5 years, whereas in group-B students with less than 5 years stay in the school were there. It was assumed that duration as stay in the school representing place effect may provide some relationship link? Following instruments were used; Taping Board (Electronic) 10 trails for both groups as motor performance, Star Mirror Drawing (Electronics) 10 trails with preferred hand both groups for transfer as cognition and Academic Self-efficacy Scale for all groups for academic confidence implied in similar controlled conditions. The results provided useful significant information about the place effect; some emic proposition regarding gender also emerged. More studies recommended.</p><br><p></p>

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

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.

Comparison of Outcome of one Versus two Drains Insertion for Seroma Formation Following Modified Radical Mastectomy in Breast Carcinoma

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
Shiraz Shaikh ◽  
Ambreen Munir ◽  
Shahnawaz Abro ◽  
Shahida Khatoon ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
General Surgery ◽  
Stable Condition ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
University Hospital ◽  
P Value ◽  
Modified Radical Mastectomy ◽  
Group A ◽  
Group B

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019.  Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups.  Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and   10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost.

A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Hussein Kamel ◽  
Amr Lotfy Farag ◽  
Dr/Sherif Hassanin Ahmed ◽  
Chresteen Talaat Samy Hanna
Keyword(s):  
Colorectal Cancer ◽  
Comparative Study ◽  
Disease Free Survival ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinicopathologic Features ◽  
Free Survival ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

scholarly journals Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

2019 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Routine Activities ◽  
Group A ◽  
Group B ◽  
Open Hernia Repair ◽  
Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

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