Laparoscopic transabdominal preperitoneal mesh repair of two posterior rectus sheath hernias: A first case series in the published literature

Abstract Aim We describe in detail the step by step technique of the first case of TES repair at our institution. Methods We selected the case of a M2W3L3 hernia associated to xipho-umbilical diastasis recti in a young woman symptomatic for a progressively worsening back pain and local bulky sensation. Results The intervention is started directly with a suprapubic transverse incision of 2.5 cm and a circumferential, atraumatic retraction is inserted after a small incision of the anterior rectus sheath. Blunt dissection is further continued through this access by luxating the underlying rectus muscles to separate the preperitoneal space below the arcuate line. The pneumo-preperitoneum is then inducted through this port. Laparoscopic dissection allows for enlargement of the avascular space laterally and then two 5-mm trocars are placed on the bilateral aspects of rectus muscles. By means of a lap bipolar dissector the edge of posterior rectus sheath are incised from the arcuate line following the diastasis laterally up to the subxiphoid space. The Rives plane is recovered without opening of the linea alba. After reduction of the M2 hernia both the posterior sheath and the diastatic anterior fascia are sutured with a running long-resorbable 2/0 barbed suture. Polyvinylidene fluoride (PVDF) mesh fixed with the use of an hystoacrilic glue. Conclusion Minimally invasive extraperitoneal repair of small/medium hernia defects of the linea alba is gaining wide acceptance. Concomitant presence of rectum diastasis recti seems to be the ideal indication to approach the learning curve of such a technically demanding procedure

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Cystoisospora belli infection: the first case series in Thailand

10.26226/morressier.56d5ba2fd462b80296c953a9 ◽

2016 ◽

Author(s):

Benjawan Skulsujirapa

Keyword(s):

Case Series ◽

First Case

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Postoperative Pain in Laparoscopic Transabdominal Preperitoneal Versus Lichtenstein Open Mesh Repair Techniques for Inguinal Hernia

Journal of Surgery Pakistan ◽

10.21699/jsp.22.3.3 ◽

2017 ◽

Vol 22 (3) ◽

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Mesh Repair ◽

Transabdominal Preperitoneal ◽

Open Mesh Repair ◽

Open Mesh ◽

Repair Techniques

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Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Hereditary Podocytopathies, Alport Syndrome, and FSGS: A Case Series to Better Plan a Large-Scale Study

Cells ◽

10.3390/cells10071815 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1815

Author(s):

Jan Boeckhaus ◽

Oliver Gross

Keyword(s):

Glomerular Filtration ◽

Alport Syndrome ◽

Large Scale ◽

Case Series ◽

Hereditary Diseases ◽

Glomerular Filtration Barrier ◽

Early Effect ◽

Filtration Barrier ◽

First Case ◽

Sodium Glucose Cotransporter

Hereditary diseases of the glomerular filtration barrier are characterized by a more vulnerable glomerular basement membrane and dysfunctional podocytes. Recent clinical trials have demonstrated the nephroprotective effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in chronic kidney disease (CKD). SGLT2-mediated afferent arteriole vasoconstriction is hypothesized to correct the hemodynamic overload of the glomerular filtration barrier in hereditary podocytopathies. To test this hypothesis, we report data in a case series of patients with Alport syndrome and focal segmental glomerulosclerosis (FSGS) with respect of the early effect of SGLT2i on the kidney function. Mean duration of treatment was 4.5 (±2.9) months. Mean serum creatinine before and after SGLT-2i initiation was 1.46 (±0.42) and 1.58 (±0.55) mg/dL, respectively, with a median estimated glomerular filtration rate of 64 (±27) before and 64 (±32) mL/min/1.73 m2 after initiation of SGLT2i. Mean urinary albumin-creatinine ratio in mg/g creatinine before SGLT-2i initiation was 1827 (±1560) and decreased by almost 40% to 1127 (±854) after SGLT2i initiation. To our knowledge, this is the first case series on the effect and safety of SGLT2i in patients with hereditary podocytopathies. Specific large-scale trials in podocytopathies are needed to confirm our findings in this population with a tremendous unmet medical need for more effective, early on, and safe nephroprotective therapies.

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Clinical, Laboratory and Histological Features of Dipeptidyl Peptidase-4 Inhibitor Related Noninflammatory Bullous Pemphigoid

Journal of Clinical Medicine ◽

10.3390/jcm10091916 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1916

Author(s):

Ágnes Kinyó ◽

Anita Hanyecz ◽

Zsuzsanna Lengyel ◽

Dalma Várszegi ◽

Péter Oláh ◽

...

Keyword(s):

Bullous Pemphigoid ◽

Clinical Laboratory ◽

Case Series ◽

Dipeptidyl Peptidase ◽

Area Index ◽

Histological Features ◽

Dipeptidyl Peptidase 4 ◽

First Case ◽

Dipeptidyl Peptidase 4 Inhibitor ◽

The Mean

Bullous pemphigoid (BP) is an autoimmune blistering disease of elderly patients that has shown increasing incidence in the last decades. Higher prevalence of BP may be due to more frequent use of provoking agents, such as antidiabetic dipeptidyl peptidase-4 inhibitor (DPP4i) drugs. Our aim was to assess DPP4i-induced bullous pemphigoid among our BP patients and characterize the clinical, laboratory and histological features of this drug-induced disease form. In our patient cohort, out of 127 BP patients (79 females (62.2%), 48 males (37.7%)), 14 (9 females and 5 males) were treated with DPP4i at the time of BP diagnosis. The Bullous Pemphigoid Disease Area Index (BPDAI) urticaria/erythema score was significantly lower, and the BPDAI damage score was significantly higher in DPP4i-BP patients compared to the nonDPP4i group. Both the mean absolute eosinophil number and the mean periblister eosinophil number was significantly lower in DPP4i-BP patients than in nonDPP4i cases (317.7 ± 0.204 vs. 894.0 ± 1.171 cells/μL, p < 0.0001; 6.75 ± 1.72 vs. 19.09 ± 3.1, p = 0.0012, respectively). Our results provide further evidence that DPP4i-associated BP differs significantly from classical BP, and presents with less distributed skin symptoms, mild erythema, normal or slightly elevated peripheral eosinophil count, and lower titers of BP180 autoantibodies. To our knowledge, this is the first case series of DPP4i-related BP with a non-inflammatory phenotype in European patients.

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Mesh repair under the anterior lamina of the rectus sheath (MUAR) for abdominal incisional hernia

Surgery Today ◽

10.1007/s00595-021-02282-w ◽

2021 ◽

Author(s):

Yuichiro Miyake ◽

Souta Watanabe ◽

Gaku Mizojiri ◽

Kentaro Maruyama ◽

Kyowon Lee ◽

...

Keyword(s):

Incisional Hernia ◽

Mesh Repair ◽

Rectus Sheath

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Challenging Presentations of Seven Cases of Gastrointestinal Basidiobolomycosis in Sudan: Clinical Features, Histology, Imaging, and Recommendations

Journal of Laboratory Physicians ◽

10.1055/s-0040-1721149 ◽

2020 ◽

Vol 12 (04) ◽

pp. 281-284

Author(s):

Sawsan A. Mohammed ◽

Azza A. Abdelsatir ◽

Mohamed Abdellatif ◽

Suliman Hussein Suliman ◽

Omer Mohammed Ibrahim Elbasheer ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Fungal Infection ◽

Clinical Features ◽

Subcutaneous Tissue ◽

Case Series ◽

First Case

AbstractsBasidiobolomycosis is a fungal infection caused by Basidiobolus ranarum which affects the skin and subcutaneous tissue and rarely the gastrointestinal tract. We report seven cases of gastrointestinal basidiobolomycosis with interesting clinical, radiological, and histological presentations. To our knowledge, this is the first case series of abdominal basidiobolomycosis to be reported from Sudan.

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FIRST CASE SERIES OF VENOUS SINUS STENTING IN IIH PATIENTS IN WALES

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.25 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.113-e4

Author(s):

Gauhar Abbas Malik ◽

Yogish Joshi

Keyword(s):

Intracranial Hypertension ◽

Case Series ◽

Headache Disorder ◽

Venous Sinus ◽

First Line ◽

Venous Stenting ◽

First Case ◽

Sinus Stenosis

BackgroundIdiopathic Intracranial Hypertension (IIH), is defined by increased cerebral spinal fluid (CSF) pressure in the absence of other causes of intracranial hypertension. There has been recent interest in the role of intracranial venous sinus stenosis in IIH. The raised pressures in IIH are argued to worsen by the secondary appearance of the venous sinus stenosis.Objective5 patients have undergone endovascular pressure measurement in Wales and their clinical details including history, examination, initial management, neuroimaging pre- and post venous stenting, and follow-up (6–24 months) to provide the first case study of patients undergoing Venous sinus stenting in Wales.Methods5 patients with IIH refractory to first line treatments underwent venography and manometry and 4 patients underwent stenting of the venous sinuses after this procedure had shown a pressure gradient proximal to stenosis in the lateral sinuses.ResultsThree patients were rendered asymptomatic, two were improved including one patient unmasking a different headache disorder following treatment.ConclusionsStenting in venous stenosis provides a further treatment option to patients refractory to first line treatments with IIH. This case series highlights in selected cases treatment is promising with good outcomes.

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Modified technique of extraperitoneal colostomy without incision of the posterior rectus sheath

Scientific Reports ◽

10.1038/s41598-021-82626-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tao Zhang ◽

Daye Yang ◽

Gongping Sun ◽

Dewei Zhang

Keyword(s):

Rectal Cancer ◽

Abdominoperineal Resection ◽

Parastomal Hernia ◽

Retrospective Studies ◽

Rectus Sheath ◽

Lower Rectal Cancer ◽

Modified Technique ◽

Posterior Rectus Sheath ◽

Rectal Sheath ◽

Extraperitoneal Colostomy

AbstractExtraperitoneal colostomy is a widely used technique during abdominoperineal resection (APR) operation for lower rectal cancer. This technique has been reported to be effective to prevent the postoperative parastomal hernia in some retrospective studies, however, there is still a certain incidence of parastomal hernia. A modification of the extraperitoneal colostomy technique is described in this paper that keeps posterior rectal sheath intact instead of having a conventional incision, to further reduce the risk of parastomal hernia. Until now, this modified technique has been performed in 15 patients, no occurrence of parastomal hernia was observed.

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Calcaneal Reconstruction With Free Deep Circumflex Iliac Artery Osseocutaneous Flap Following Aggressive Benign Bone Tumor Resection

Foot & Ankle International ◽

10.1177/10711007211025280 ◽

2021 ◽

pp. 107110072110252

Author(s):

Mohamad Aizat Rosli ◽

Wan Faisham Wan Ismail ◽

Wan Azman Wan Sulaiman ◽

Nor Azman Mat Zin ◽

Syurahbil Abdul Halim ◽

...

Keyword(s):

Iliac Artery ◽

Donor Site ◽

Tumor Resection ◽

Case Series ◽

Benign Tumors ◽

Reconstruction Method ◽

Short Term ◽

Deep Circumflex Iliac Artery ◽

First Case ◽

Donor Site Pain

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.

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