scholarly journals Evaluation of Four-Hand Reduction for Obturator Hernia with The Guidance of Sonography (FROGS) as a New Treatment Strategy for Obturator Hernia: A Retrospective Study

2021 ◽  
Author(s):  
Yuki Togawa ◽  
Kyohei Kamihata ◽  
Yoshio Nagahisa ◽  
Kazuyuki Kawamoto
Keyword(s):  
Emergency Surgery ◽  
Treatment Strategy ◽  
Bowel Resection ◽  
The Body ◽  
Obturator Hernia ◽  
Duration Of Symptoms ◽  
Delayed Treatment ◽  
Manual Reduction ◽  
Incarcerated Obturator Hernia ◽  
New Treatment

Abstract Background Obturator hernias are uncommon but are important causes of intestinal obstruction. Delayed treatment can be fatal. Emergency surgery is considered the most effective treatment; however, patients with obturator hernia usually have comorbidities, and this precludes them from emergency surgery. Previously, a few case studies reported successful manual reductions for an incarcerated obturator hernia. However, their efficacy was not statistically confirmed. We have devised a new manual reduction method for an incarcerated obturator hernia based on previous studies. We have named this method “Four-hand Reduction for Obturator hernia with the Guidance of Sonography” (FROGS). This study aimed to evaluate the effectiveness of FROGS as a new treatment strategy for obturator hernia. Methods Since November 2019, we have tried FROGS in all patients with obturator hernia at the emergency room. We retrospectively compared the clinical data of 14 patients who underwent FROGS (after-FROGS group) with those of 23 patients who did not (before-FROGS group). Results All patients were females. There were no significant differences in age, lesion side, duration of symptoms, the diameter of the prolapsed bowel, and predisposing factors. The body mass index was significantly lower in the after-FROGS group than in the before-FROGS group. Manual reduction was successfully performed in all 14 patients in the FROGS group, whereas in the before-FROGS group, 14 patients underwent manual reduction, of whom only one was successfully treated using the non-FROGS method. Bowel resection was avoided in all 14 patients in the after-FROGS group, whereas 8 patients underwent bowel resection in the before-FROGS group. There were no significant differences in postoperative complications and mortality within 30 days after hernia presentation between the two groups. Conclusion Manual reduction using the FROGS technique was found to be safe and reproducible and can be the first treatment choice for patients with obturator hernia.

scholarly journals Evaluation of Four-Hand Reduction for Obturator Hernia with the Guidance of Sonography (FROGS) as a new treatment strategy for obturator hernia: A retrospective study

2021 ◽  
Author(s):  
Yuki Togawa ◽  
Kyohei Kamihata ◽  
Yoshio Nagahisa ◽  
Kazuyuki Kawamoto
Keyword(s):  
Emergency Surgery ◽  
Treatment Strategy ◽  
Bowel Resection ◽  
The Body ◽  
Obturator Hernia ◽  
Duration Of Symptoms ◽  
Delayed Treatment ◽  
Manual Reduction ◽  
Lesion Side ◽  
New Treatment

Abstract Purpose: Obturator hernias are uncommon but are important causes of intestinal obstruction. Delayed treatment can be fatal. Emergency surgery is considered the most effective treatment; however, patients with obturator hernia usually have comorbidities, and this precludes them from emergency surgery. This study aimed to evaluate the effectiveness of Four-hand Reduction for Obturator hernia with the Guidance of Sonography (FROGS) as a new treatment strategy for obturator hernia.Methods: Since November 2019, we have tried FROGS in all patients with obturator hernia at the emergency room. We retrospectively compared the clinical data of 14 patients who underwent FROGS (after-FROGS group) with those of 23 patients who did not (before-FROGS group).Results: All patients were females. There were no significant differences in age, lesion side, duration of symptoms, the diameter of the prolapsed bowel, and predisposing factors. The body mass index was significantly lower in the after-FROGS group than in the before-FROGS group. Manual reduction was successfully performed in all 14 patients in the FROGS group, whereas in the before-FROGS group, 14 patients underwent manual reduction, of whom only one was successfully treated using the non-FROGS method. Bowel resection was avoided in all 14 patients in the after-FROGS group, whereas 8 patients underwent bowel resection in the before-FROGS group. There were no significant differences in postoperative complications and mortality within 30 days after hernia presentation between the two groups.Conclusion: Manual reduction using the FROGS technique was found to be safe and reproducible and can be the first treatment choice for patients with obturator hernia.

scholarly journals Evaluation of Four-Hand Reduction for Obturator Hernia with the Guidance of Sonography (FROGS) As a New Treatment Strategy for Obturator Hernia: A Single-Center Study

2021 ◽  
Author(s):  
Yuki Togawa ◽  
Kyohei Kamihata ◽  
Yoshio Nagahisa ◽  
Kazuyuki Kawamoto
Keyword(s):  
Emergency Surgery ◽  
Treatment Strategy ◽  
Bowel Resection ◽  
The Body ◽  
Obturator Hernia ◽  
Duration Of Symptoms ◽  
Delayed Treatment ◽  
Manual Reduction ◽  
Lesion Side ◽  
New Treatment

Abstract Background Obturator hernia is an uncommon but important cause of intestinal obstruction. Delayed treatment can be fatal. Emergency surgery is considered the most effective treatment; however, patients with obturator hernia usually have comorbidities, which precludes them from emergency surgery. This study aimed to evaluate the effectiveness of Four-hand Reduction for Obturator hernia with the Guidance of Sonography (FROGS) as a new treatment strategy for obturator hernia. Methods Since November 2019, we have tried FROGS in all patients with obturator hernia at the emergency room. All the patients were female. We retrospectively compared the clinical data of 14 patients who underwent FROGS (after-FROGS group) with those of 23 patients who did not (before-FROGS group). Results No significant differences were observed in age, lesion side, duration of symptoms, the diameter of the prolapsed bowel, and predisposing factors. The body mass index was significantly lower in the after-FROGS group than in the before-FROGS group. Manual reduction was successfully performed in all 14 patients in the FROGS group, whereas in the before-FROGS group, 14 patients underwent manual reduction, of whom only one was successfully treated using the non-FROGS method. Bowel resection was avoided in all 14 patients in the after-FROGS group, whereas 8 patients underwent bowel resection in the before-FROGS group. There were no significant differences in postoperative complications and mortality within 30 days after hernia presentation between the two groups. Conclusion Manual reduction with FROGS was found to be safe and reproducible and can be the first treatment choice for obturator hernia.

Therapeutic Strategy for Incarcerated Obturator Hernia Using Preoperative Manual Reduction and Laparoscopic Repair

2018 ◽  
Vol 226 (5) ◽  
pp. 891-901
Author(s):  
Hirofumi Kawanaka ◽  
Shoji Hiroshige ◽  
Nobuhide Kubo ◽  
Teijiro Hirashita ◽  
Takeshi Masuda ◽  
...  
Keyword(s):  
Laparoscopic Repair ◽  
Therapeutic Strategy ◽  
Obturator Hernia ◽  
Manual Reduction ◽  
Incarcerated Obturator Hernia

scholarly journals Diagnosis and Treatment of Obturator Hernia: Retrospective Analysis of 86 Clinical Cases at a Single Institution.

2020 ◽  
Author(s):  
ZHENGZHENG LI ◽  
Chaoyang Gu ◽  
Mingtian Wei ◽  
Xing Yuan ◽  
Ziqiang Wang
Keyword(s):  
Postoperative Complications ◽  
Emergency Surgery ◽  
Bowel Resection ◽  
Elective Surgery ◽  
Gastrointestinal Surgery ◽  
Intestinal Resection ◽  
Postoperative Mortality ◽  
Obturator Hernia ◽  
Diagnosis And Treatment ◽  
Surgery Group

Abstract Background: To explore the clinical characteristics, diagnosis and treatment of obturator hernia.Methods: Eighty-six patients who were diagnosed as obturator hernia by abdominal CT in the Department of Gastrointestinal Surgery of our hospital between 2009 and 2019 were enrolled in this study. Patient characteristics, surgical method, postoperative complications and mortalities were retrospectively reviewed, and the patients were followed by telephone or clinic visit to check for the recurrence.Results: 30 days mortality rate of 5.5% and 46.1% were observed in surgery group and non-surgery group, respectively. Surgery was performed as an emergency procedure in 59 cases and elective procedure in 14 cases depending on different hernia contents, intestinal necrosis and signs of peritonitis. In the emergency surgery group, segmental intestinal resection with anastomosis was performed in 24 patients(24/59, 40.7%). There were 4 deaths(4/59, 6.8%) in this group ,all of which occurred in patients undergoing SI resections. In contrast, no bowel resection, postoperative complications, or death occurred in the elective surgery group. 3 -year recurrence rates of 5.1% (3/59)and 7.1%(1/14) were observed in the emergency surgery and the elective surgery group, respectively. Conclusions: CT examination plays an important role in improving the diagnostic rate of obturator hernia. In elderly people with comorbidities, timely surgical treatment is the key to improve the efficacy of obturator hernia and prevent the deterioration of the condition. In addition, postoperative mortality is significantly associated with bowel resection and postoperative complications.

scholarly journals NON-INVASIVE MANUAL REDUCTION FOR INCARCERATED OBTURATOR HERNIA-REPORT OF FIVE CASES-

2009 ◽  
Vol 70 (5) ◽  
pp. 1572-1576 ◽  
Author(s):  
Naoki TANAKA ◽  
Jun KIKUCHI ◽  
Toru YUSA ◽  
Toshinori ANDO ◽  
Yuko SAITO
Keyword(s):  
Obturator Hernia ◽  
Non Invasive ◽  
Manual Reduction ◽  
Incarcerated Obturator Hernia

Immunotherapy and potential predictive biomarkers in the treatment of neuroendocrine neoplasia

2020 ◽  
Author(s):  
Guanghui Xu ◽  
Yuhao Wang ◽  
Hushan Zhang ◽  
Xueke She ◽  
Jianjun Yang
Keyword(s):  
Current Knowledge ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Predictive Biomarkers ◽  
The Body ◽  
Low Grade ◽  
Ablative Therapies ◽  
Cancer Types ◽  
New Treatment ◽  
Well Differentiated

Neuroendocrine neoplasias (NENs) are a heterogeneous group of rare tumors scattered throughout the body. Surgery, locoregional or ablative therapies as well as maintenance treatments are applied in well-differentiated, low-grade NENs, whereas cytotoxic chemotherapy is usually applied in high-grade neuroendocrine carcinomas. However, treatment options for patients with advanced or metastatic NENs are limited. Immunotherapy has provided new treatment approaches for many cancer types, including neuroendocrine tumors, but predictive biomarkers of immune checkpoint inhibitors (ICIs) in the treatment of NENs have not been fully reported. By reviewing the literature and international congress abstracts, we summarize the current knowledge of ICIs, potential predicative biomarkers in the treatment of NENs, implications and efficacy of ICIs as well as biomarkers for NENs of gastroenteropancreatic system, lung NENs and Merkel cell carcinoma in clinical practice.

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