The rare travellers

Hernia surgery constitutes one of the major daily operative procedures in the general surgery department. Using of mesh with tension free repair is the most widely used technique. Mesh migration and subsequent perforation account as one of the very rare complications following laparoscopic or open hernia repair. The complications following surgery present with symptoms at different time intervals and are sometimes very difficult to diagnose. We present here a couple of cases of mesh migration resulting in varied clinical symptoms and a diagnostic dilemma. With more emphasis being on non-fixation of meshes in the recent literatures, a lower clinical and diagnostic threshold should be incorporated in diagnosing such complications.

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Use of Synthetic Protetic Materials in Surgical Abdominal Defects. Analysis of the Advantages and Lack of the Liechtenstein Method

Revista de Chimie ◽

10.37358/rc.18.7.6407 ◽

2018 ◽

Vol 69 (7) ◽

pp. 1740-1743

Author(s):

Vlad Dumitru Baleanu ◽

Denis Vlad Constantin ◽

Anca Pascal ◽

Dragos Ovidiu Alexandru ◽

Simona Bobic ◽

...

Keyword(s):

Relative Risk ◽

Recurrence Rate ◽

General Surgery ◽

Prosthetic Material ◽

Emergency Hospital ◽

Rural And Urban ◽

Abdominal Interventions ◽

Defects Analysis ◽

Surgery Department

Liechtenstein procedure represents the most frequent technique used for surgical abdominal interventions. Although, it is a modern and inovative procedure, it still has a relative risk for complications. A number of 93 subjects were included in our research. We develop our study in General Surgery Department of County Emergency Hospital of Craiova, Romania between 1st July 2017-31th March 2018. From the total of 93 patients, 88% were men. Most of subjects had ages between 70 and 79 years old, were operated by Liechtenstein technique and they were coming from quite equal percent from rural and urban areas.The incidence for complications(seroma, hematoma, infection, abscess) was generally lower for the patients diagnosticated with Liechtenstein procedure comparing with the subjects operated by other technique. Liechtenstein procedureis recommended especially for its simplicity and efficiency, reproducibility and safety. It is very important to choose the perfect synthetic prosthetic material to have a good evolution of the disorder and a small recurrence rate.

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EVALUATION OF THE PROTECTIVE EFFECTS OF LOW DOSE NALTREXONE AGAINST 2,4 TOLUENE DIISOCYANATE INDUCED TOXICITY IN ALBINO RATS Amin D1; El Teliti A2 forensic medicine and toxicology, faculty of medicine zagazig university1; general surgery department faculty of medicine zagazig university2

Zagazig Journal of Forensic Medicine ◽

10.21608/zjfm.2018.30399 ◽

2018 ◽

Vol 16 (1) ◽

pp. 18-28

Keyword(s):

Forensic Medicine ◽

General Surgery ◽

Low Dose ◽

Toluene Diisocyanate ◽

Albino Rats ◽

Protective Effects ◽

Surgery Department ◽

Low Dose Naltrexone ◽

Department Faculty

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Trans-hiatal herniation following esophagectomy or gastrectomy: retrospective single-center experiences with a potential surgical emergency

Hernia ◽

10.1007/s10029-021-02380-1 ◽

2021 ◽

Author(s):

P. U. Oppelt ◽

I. Askevold ◽

R. Hörbelt ◽

F. C. Roller ◽

W. Padberg ◽

...

Keyword(s):

Hernia Repair ◽

Hiatal Hernia ◽

Surgical Repair ◽

Clinical Symptoms ◽

Gastrointestinal Symptoms ◽

Case Series ◽

Gastric Surgery ◽

Hiatal Hernia Repair ◽

Single Center ◽

Asymptomatic Patients

Abstract Purpose Trans-hiatal herniation after esophago-gastric surgery is a potentially severe complication due to the risk of bowel incarceration and cardiac or respiratory complaints. However, measures for prevention and treatment options are based on a single surgeon´s experiences and small case series in the literature. Methods Retrospective single-center analysis on patients who underwent surgical repair of trans-hiatal hernia following gastrectomy or esophagectomy from 01/2003 to 07/2020 regarding clinical symptoms, hernia characteristics, pre-operative imaging, hernia repair technique and perioperative outcome. Results Trans-hiatal hernia repair was performed in 9 patients following abdomino-thoracic esophagectomy (40.9%), in 8 patients following trans-hiatal esophagectomy (36.4%) and in 5 patients following conventional gastrectomy (22.7%). Gastrointestinal symptoms with bowel obstruction and pain were mostly prevalent (63.6 and 59.1%, respectively), two patients were asymptomatic. Transverse colon (54.5%) and small intestine (77.3%) most frequently prolapsed into the left chest after esophagectomy (88.2%) and into the dorsal mediastinum after gastrectomy (60.0%). Half of the patients had signs of incarceration in pre-operative imaging, 10 patients underwent emergency surgery. However, bowel resection was only necessary in one patient. Hernia repair was performed by suture cruroplasty without (n = 12) or with mesh reinforcement (n = 5) or tension-free mesh interposition (n = 5). Postoperative pleural complications were most frequently observed, especially in patients who underwent any kind of mesh repair. Three patients developed recurrency, of whom two underwent again surgical repair. Conclusion Trans-hiatal herniation after esophago-gastric surgery is rare but relevant. The role of surgical repair in asymptomatic patients is disputed. However, early hernia repair prevents patients from severe complications. Measures for prevention and adequate closure techniques are not yet defined.

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Natural course of long-term postherniorrhaphy pain in a population-based cohort

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2009.09.012 ◽

2010 ◽

Vol 1 (1) ◽

pp. 55-59 ◽

Cited By ~ 6

Author(s):

Gabriel Sandblom ◽

Maija-Liisa Kalliomäki ◽

Ulf Gunnarsson ◽

Torsten Gordh

Keyword(s):

Multivariate Analysis ◽

Postoperative Pain ◽

Hernia Repair ◽

Groin Hernia ◽

Population Based ◽

Persistent Pain ◽

Natural Course ◽

Hernia Surgery ◽

Persistent Postoperative Pain ◽

Postherniorrhaphy Pain

AbstractBackgroundPersistent pain after hernia repair is widely recognised as a considerable problem, although the natural course of postoperative pain is not fully understood. The aim of the present study was to explore the natural course of persistent pain after hernia repair in a population-based cohort and identify risk factors for prolonged pain duration.MethodsThe study cohort was assembled from the Swedish Hernia Register (SHR), which has compiled detailed information on more than 140 000 groin hernia repairs since 1992. All patients operated on for groin hernia in the County of Uppsala, Sweden, 1998–2004 were identified in the SHR. Those who were still alive in 2005 received the Inguinal Pain Questionnaire, a validated questionnaire with 18 items developed with the aim of assessing postherniorrhaphy pain, by mail. Reminders were sent to non-responders 5 months after the first mail. The halving time was estimated from a linear regression of the logarithmic transformation of the prevalence of pain each year after surgery. A multivariate analysis with pain persisting more than 1 month with a retrospective question regarding time to pain cessation as dependent variable was performed.ResultsAltogether 2834 repairs in 2583 patients were recorded, 162 of who had died until 2005. Of the remaining patients, 1763 (68%) responded to the questionnaire. In 6.7 years the prevalence of persistent pain had decreased by half for the item “pain right now” and in 6.8 years for the item “worst pain last week”. The corresponding figures if laparoscopic repair was excluded were 6.4 years for “pain right now” and 6.4 years for “worst pain past week”. In a multivariate analysis, low age, postoperative complication and open method of repair were found to predict an increased risk for pain persistence exceeding 1 month.ConclusionPersistent postoperative pain is a common problem following hernia surgery, although it often recedes with time. It is more protracted in young patients, following open repair and after repairs with postoperative complications. Whereas efforts to treat persistent postoperative pain, in particular neuropathic pain, are often fruitless, this group can at least rely on the hope that the pain, for some of the patients, gradually decreases with time. On the other hand, 14% still reported a pain problem 7 years after hernia surgery. We do not know the course after that.Although no mathematical model can provide a full understanding of such a complex process as the natural course of postoperative pain, assuming an exponential course may help to analyse the course the first years after surgery, enable comparisons with other studies and give a base for exploring factors that influence the duration of the postoperative pain. Halving times close to those found in our study could also be extrapolated from other studies, assuming an exponential course.

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Clinical Analysis of Surgical Treatment of 90 Patients with Hepatolithiasis in General Surgery Department

10.47939/mh.v2i11.231 ◽

2021 ◽

Keyword(s):

Surgical Treatment ◽

General Surgery ◽

Clinical Analysis ◽

Surgery Department

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Consequences Assessment of Destructive Informational Effects on the Basis of Complex Analysis of Biomarker System and its Overcoming

Journal of Quality in Health Care & Economics ◽

10.23880/jqhe-16000245 ◽

2021 ◽

Vol 4 (5) ◽

Author(s):

Yuriy Danyk

Keyword(s):

Posttraumatic Stress Disorder ◽

Effective Treatment ◽

Posttraumatic Stress ◽

Biological Markers ◽

Complex Analysis ◽

Stress Disorder ◽

Clinical Symptoms ◽

Negative Effects ◽

Diagnostic Threshold ◽

Crisis Situations

The article is based on the concept of forming various stress-related disorders in crisis situations. It is proved that destructive informational effects in modern conditions are an integral part in the formation of crisis situation syndromes and posttraumatic stress disorder. In the course of research, the possibility of using the system of biological markers for timely detection and effective treatment of stress-associated and informational disorders was established (before other clinical symptoms or their reaching diagnostic threshold). It also allows timely assessment of the subjective adaptation threshold of people at risk, to identify and reduce the negative effects of stress-related disorders. The use of the biomarkers was also researched for the diagnosis, treatment, rehabilitation, prevention of stress-related disorders among participants of crisis situations.

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EP.TH.747Audit of antibiotic prophylaxis in groin hernia repair

British Journal of Surgery ◽

10.1093/bjs/znab309.080 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Maitreyi Patel ◽

Aleem O'Balogun ◽

Naveed Kirmani

Keyword(s):

Hernia Repair ◽

Surgical Site Infection ◽

Antibiotic Prophylaxis ◽

Groin Hernia ◽

Open Repair ◽

Risk Category ◽

Site Infection ◽

Groin Hernia Repair ◽

Hernia Surgery ◽

International Guidelines

Abstract Aims To review practice of antibiotic prophylaxis in patients undergoing groin hernia repair against the International guidelines for groin hernia management 2018, in order to improve compliance with International Guidelines. We also assessed the risk category of patients. Methods Retrospective data of all patients undergoing groin hernia repair from November 2019 to March 2020 was collected using hospital software. Data collected included patient demographics, details of hernia repair including; primary/recurrent hernia, emergency/elective, laparoscopic/open repair and use of mesh. The details of antibiotic prophylaxis were recorded. Descriptive statistics was used. Data was analyzed using Microsoft Excel. Results 67 patients were included, of which 38(57%) were high risk. 62 (92.5%) primary repairs were done, of which 48(72%) were open. 62(92.5%) were operated electively. 46(69%) patients underwent open repair with mesh, 6(9%) had open repair without mesh, while 15(22%) had laparoscopic repair with mesh. A total of 45 (67%) patient received antibiotic prophylaxis. Adherence to International guidelines for groin hernia in open hernia surgery was 82.67%, while that for laparoscopic surgery was 60%. Overall adherence to the Guidelines was 56.67%. Conclusions The audit reflects the need for improved understanding and adherence to the International Guidelines. Data collection of surgical site infection can help inform and influence practice to minimize the risk for surgical site infection and assist in better communication with patients regarding risk. Risk assessment for surgical site infection of patients prior to procedure helps to identify those with indication of antibiotic prophylaxis.

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