Comparison of Post-Operative Complications Between Sublay and Onlay Mesh Repair in Incisional Hernia

2021 ◽  
Vol 15 (12) ◽  
pp. 3384-3386
Author(s):  
Azizullah Khan Sherani ◽  
Saleem Javed ◽  
Muhammad Idrees Achackzai
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Seroma Formation ◽  
Onlay Technique ◽  
Sublay Technique ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Objective: To compare the post-operative complications between sublay and onlay mesh repair in incisional hernia. Materials & Methods: This randomized controlled trial was conducted at Department of Surgery, Sandeman Provincial Hospital Quetta from May 2019 to November 2019. Total 250 patients with incisional hernias for more than 3 months, having age 20-40 years either male or female were selected. Then selected patients were placed randomly into two groups i.e. Group A (Sublay group) & Group B (Onlay group), by using lottery method. Patients were called for follow up 15th day for post-operative complications in term of wound infection and seroma formation. Results: The mean age of patients in group A was 34.73 ± 4.32 years and in group B was 34.51 ± 4.67 years. Out of these 250 patients, 161 (64.40%) were female and 89 (35.60%) were males with female to male ratio of 1.8:1. Wound infection was seen in 07 (5.60%) patients in group A (Sublay technique) and 17 (13.60%) patients in group B (Onlay technique) with p-value of 0.033. Seroma formation was seen in 09 (7.20%) patients in group A (Sublay technique) and 26 (20.80%) patients in group B (Onlay technique) with p-value of 0.002. Conclusion: This study concluded that rate of wound infection and seroma formation is less after sublay mesh repair for incisional hernia as compared to onlay repair. Keywords: Hernia, incisional, onlay, sublay, seroma.

A COMPARATIVE STUDY BETWEEN ONLAY AND RETRORECTUS MESH REPAIR IN THE TREATMENT OF INCISIONAL HERNIAS

2021 ◽  
pp. 65-69
Author(s):  
S. Yashwanth ◽  
S. Dayakar
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hospital Stay ◽  
Wound Infection ◽  
Mesh Repair ◽  
Duration Of Surgery ◽  
Group A ◽  
Onlay Mesh ◽  
The Mean ◽  
Group B

INTRODUCTION: Over the years, surgeons tried the placement of mesh at different locations like On-lay, Under-lay, Sub-lay and pre-peritoneal, retroperitoneal intraperitoneal, Inter-muscular, etc. with each procedure having its advantages and disadvantages. Commonly Onlay and sub lay mesh repairs are done. Though the literature says, sub lay procedures have fewer complications and a high success rate. However, in a few studies, the ideal position for mesh repair appears to be retro muscular, where the force of abdominal pressure holds the mesh against deep surfaces of muscles. In this study, a comparison of both Onlay and retro rectus procedures with regards to the duration of surgery, postoperative complications like seroma, wound infection, wound dehiscence, and also the period of postoperative stay in the hospital. The aim of the study is To compare 'Onlay' versus 'retro rectus' mesh repair in inuencing the outcome in incisional hernia with regards to Duration of surgery, Postoperative complications like seroma formation, wound infection, Postoperative stay, Recurrences. PATIENTS AND METHODOLOGY: Type of Study: A Prospective comparative study Study Setting: Department of general surgery, Narayana Medical College & Hospital, Nellore.Study Period: November 2018 to September 2020 Study Sample: 50 cases, divided into two groups by random allocation technique. Groups A and B with 25 patients in each group. RESULTS: The mean age of cases in Group A is 40.48 years. The mean age of patients in Group B is 44.08 years. Youngest was 31 years and 36 years in group A and group B, respectively, and the eldest was 51 years and 53 years in group A and group B, respectively. In Group A, 11 were male, and 14 were female, and in Group B, 11 were male, and 14 were female. The male to female ratio in the study was 1:1.27. The mean Operative Time in Group A was 1.93 Hrs, and that in Group B was 2.98Hrs. Nine patients (36%) in group A and one patient (4%) in group B had seroma formation. Eight patients (32%) in group A and one patient (4%) in group B had a wound infection. The mean Hospital Stay in Group A was 5.44 Days, and Group B was 4.88 days. No short-term recurrences were noted in either of the two groups when followed for six months. CONCLUSION : Retrorectus mesh repair is an excellent alternative to Onlay mesh repair that may apply to incisional hernia. The mesh-related overall complication rate like seroma wound infections and hospital stay is less than Onlay mesh repair.

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

scholarly journals COMPARISON OF OUTCOMES BETWEEN EARLY AND DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CALCULOUS CHOLECYSTITIS

2021 ◽  
Vol 71 (3) ◽  
pp. 796-800
Author(s):  
Muhammad Ismail ◽  
Nasir Mehmood Wattoo ◽  
Muhammad Qasim Butt ◽  
Fareeha Naz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operation Time ◽  
Acute Calculous Cholecystitis ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Calculous Cholecystitis ◽  
Post Operative Complications

Objective: To compare early versus delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of mean operative time, hospital stay, conversion rate to open surgery and post-operative complications. Study Design: Quasi experimental study. Place and Duration of Study: Army Liver Transplant Unit, Department of Surgery, Pak-Emirates Military Hospital Rawalpindi, from Jul to Dec 2018. Methodology: A total of 170 patients (85 in each group) diagnosed as a case of acute calculous cholecystitis who met the sample selection criteria were included. Group A patients underwent early laparoscopic cholecystectomy within 72 hours of admission while group B patients underwent conservative management followed by delayed laparoscopic cholecystectomy after 6 weeks. All patients were followed for operative time, hospital stay, per-operative difficulties encountered and post-operative complications. Results: Group A had a mean operation time of 43.9 ± 11.1 minutes, while group B had a mean operation time of 45.8 ± 10.1 minutes (p=0.83). The mean duration of hospitalization was 2.8 ± 1.1 days in group A and 5.3 ± 0.8 days in group B (p<0.001). Complications were measured at a frequency of 14.1% in group A and 5.9% in group B (p=0.07). Conclusion: Early laparoscopic cholecystectomy is better than delayed laparoscopic cholecystectomy in acute calculous cholecystitis in terms of hospital stay and per-operative difficulties faced. The post-operative complications between the two groups are comparable.

scholarly journals HERNIOPLASTY

2009 ◽  
Vol 16 (02) ◽  
pp. 224-227
Author(s):  
MUHAMMAD FAISAL BILALL ◽  
MUHAMMAD AKRAM ◽  
SUMERA KANWAL ◽  
Jawaid Iqbal
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Enterocutaneous Fistula ◽  
Tertiary Care ◽  
Rectus Sheath ◽  
Fistula Formation ◽  
Open Mesh Repair ◽  
Sublay Technique ◽  
Open Mesh

Incisional hernia is a common complication of abdominal surgery and an important source of morbidity. It may be repairedusing open suture, open mesh or laparoscopic mesh techniques. O b j e c t i v e s : To examine the results of open mesh repair using "sublaytechnique" of hernioplasty. Setting: Surgical Unit-I, Department of Surgery at Allied Hospital, a tertiary care teaching hospital affiliated withPunjab Medical College, Faisalabad. Patient & M e t h o d s : Sixty patients (male:16, female:44) were operated for incisional hernia. Openmesh repair was done. Polypropylene mesh was placed over closed posterior rectus sheath layer and over the rectus abdominis, wereavailable. Anterior rectus sheath was closed in front of the implanted mesh. All the patients received injectable third generation cephalosporinfor 48hrs postoperatively. Postoperative recovery in terms of seroma formation, wound infection, intraabdominal adhesions leading tointestinal obstruction, enterocutaneous fistula formation and recurrence were the main factors noted and analyzed statistically. Results:Mean postoperative hospital stay was 03 days. Only one patient developed wound infection. None of the patients developed seromaformation, intestinal obstruction or enterocutaneous fistula. Maximum follow up till this study is 14 months. No recurrence has been reportedso far. C o n c l u s i o n s : Open mesh repair using "sublay technique" does not carry risk of enterocutaneous fistula, carries low risk of seromaformation and wound infection. Proper technique is not associated with recurrence.

Frequency of Early Post-Operative Complications following Modified Radical Mastectomy (MRM) in patients with Breast Carcinoma

2021 ◽  
Vol 15 (6) ◽  
pp. 1623-1625
Author(s):  
Sadia Shah ◽  
Rahmat Ullah Shah ◽  
Adnan Badar ◽  
Monawar Shah ◽  
Shabir Ahmad ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Wound Infection ◽  
Skin Flap ◽  
Radical Mastectomy ◽  
Wound Dehiscence ◽  
Seroma Formation ◽  
Flap Necrosis ◽  
Modified Radical Mastectomy ◽  
Operative Complications ◽  
Post Operative Complications

Objective: Breast carcinoma is the commonest cancer affecting female gender and is the second major cause of mortality in females globally. Among different surgical options, modified radical mastectomy (MRM) with or without neoadjuvant therapy is the most frequent surgery carried out globally for breast carcinoma. In this study we aimed to determine the frequency of early post-operative complications following modified radical mastectomy (MRM) in patients with breast carcinoma. Material and methods: This dual setting retrospective descriptive study was conducted at General surgery departments of Kuwait Teaching Hospital and MTI-Lady Reading Hospital Peshawar between January, 2018 and June, 2019. A total of 60 patients aged >18 years with biopsy proven stage-I to stage-III breast carcinoma who underwent modified radical mastectomy were included.All patients were followed on weekly basis for six weeks at the out-patient department (OPD) and evaluated for the development of early complications such as seroma/hematoma, flap necrosis and wound infections. Results: Seroma formation found in 9 patients (15%) and wound infection seen in 5 patients (8.3%) were the commonest complications. Conclusion: In our study seroma formation was the most common complication followed by wound infection. Skin flap necrosis, wound dehiscence, hematoma formation and development of early lymphoedema were less common. None of our patients presented with muscle paralysis secondary to nerves injury. Keywords: Breast carcinoma, modified radical mastectomy, complications, seroma, wound infection.

Round Block Technique versus Grisotti Technique in Juxta Areolar Breast Cancer

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ahmed Helmy Shehab ◽  
Karim Fahmy Abd Elmoaty ◽  
Mahmoud Refaat Mohamed Elsebaai
Keyword(s):  
Breast Cancer ◽  
Operating Time ◽  
Breast Cancer Patients ◽  
Areola Complex ◽  
Operative Complications ◽  
Group A ◽  
Cosmetic Outcomes ◽  
Group B ◽  
Slight Advantage ◽  
Post Operative Complications

Abstract Background Breast cancer is the most common cancer in women all over the world representing 18% of all women reported cases of cancer. It represents the leading cause of women mortality as representing 23% of all women cancer deaths. Objectives To compare aesthetic and surgical outcome of Round block technique and Grisotti technique in juxta areolar breast cancer. Patients and Methods In our study 20 breast cancer patients are subdivided into group (A) 10 females which underwent round block technique and group (B) 10 femaleswhich underwent grisotti technique. Patient and tumor criteria including age, co morbidities, tumor size and distance between tumor and nipple-areola complex were considered to be nonsignificant between 2 groups so the only difference is the surgical technique. Results The study shows that the round block technique and grisotti technique have the same results regarding operative time, intra-operative blood loss, post operative complications and re-excision rates with slight advantage to round block technique because of its slightly better cosmetic outcomes. So, the round block technique is slightly preferred for selected cases. Conclusion When to compare between round block technique and grisotti technique In treatment of juxta areolar breast cancer, there in no evident difference in operating time, post operative complications or need of re-excision between these two groups of patients

125I Seed-Loaded Stents and 125I Seed Strips for the Treatment of Unresectable Malignant Obstructive Jaundice

2020 ◽  
Vol 12 (3) ◽  
pp. 418-425
Author(s):  
Wenhui Wang ◽  
Shuangxi Li ◽  
Baohua Li
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
125I Seed ◽  
Malignant Obstructive Jaundice ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Single Blind ◽  
Post Operative Complications

Brachytherapy can provide longer obstruction-free time and prolonged survival in patients with unresectable malignant biliary obstruction (MBO). A randomized, single-blind, single-center trial was performed to compare the safety and efficacy of 125I seed-loaded stents to 125I seed strips for the treatment of unresectable MBO. Subjects diagnosed with MBO were divided randomly into two groups. Patients in group A were treated with 125I seed-loaded stents, patients in group B were treated with 125I seed strips. Study outcomes included post-operative complications, quality of life (QOL), time without biliary obstruction and survival. There were no significant differences in complications and morbidity that developed perioperatively. However, the incidence of post-operative complications was significantly higher in group B (n = 20) compared to group A (n = 19) (P < 0.05). Apart from those assessing pain (P = 0.91) and nausea and vomiting (P = 0.07), EORTC-QLQC30 scores in patients in group A were significantly higher than those reported for group B. The median time to relief of biliary obstruction was 144 ± 107 days (95% CI, [92.5–195] days) for group A and 231 ± 150 days (95% CI, [160.92–301.58] days) for group B (P = 0.045). Median survival time was 272.58 ± 258.73 days (95% CI, [147–397] days) for group A and 268 ± 143 days (95% CI, [201–335] days) for group B (P = 0.992). We observed no significant differences with respect to survival were. Although administration of 125I seed strips resulted in a prolonged period without biliary obstruction, use of the 125I seed-loaded stent implant was associated with a lower rate of complications and significantly improved QOL.

scholarly journals Comparison of Intra-Operative and Post-Operative Complications between Non-Descent Vaginal Hysterectomy and Total Abdominal Hysterectomy

2018 ◽  
Vol 8 (3) ◽  
pp. 128-134
Author(s):  
Sayma Afroz ◽  
Gulshan Ara
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Operative Blood Loss ◽  
Operative Complications ◽  
Abdominal Route ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologists and can be done through abdominal and vaginal routes. Vaginal hysterectomy technique has been introduced and performed centuries back, but is less popular due to lack of experience and misconception that the abdominal route is easier and safer. Worldwide gynaecologists continue to use abdominal route for hysterectomy that could be performed vaginally which is less invasive and has minimal complications.Objective: To compare the complications during intra-operative and post-operative period between vaginal hysterectomy and abdominal hysterectomy in non-descent uterus.Materials and Methods: This prospective randomised study was performed in Enam Medical College & Hospital, Savar, Dhaka during a period of one year. Sixty consecutive patients requiring hysterectomy for benign diseases were included in this study. Group A (n=30) underwent vaginal hysterectomy (non-descent vaginal hysterectomy) and were compared with Group B (n=30) who underwent abdominal hysterectomy. The primary outcome measures were operative time, intra-operative blood loss, post-operative complications like wound infection, febrile morbidity, post-operative systemic infection and hospital stay. Secondary outcome measures were conversion of vaginal to abdominal route and re-laparotomy. Data were collected in structured questionnaire and analysed by computer using R programming version 3.4.3.Results: Baseline characteristics were similar in two groups. There were no intra-operative complications in either group. Intra-operative blood loss was significantly more in Group B than in Group A. The overall complication rate was significantly higher with abdominal hysterectomy with a rate of 56.67% against 30% for vaginal hysterectomy. Wound infection (23.33%) was significantly higher in Group B as compared to Group A (0%). Post-operative hospital stay was significantly higher in Group B (7.03 days) than in Group A (4.57 days).Conclusion: Considering intra-operative blood loss, post-operative complications and hospital stay, vaginal route was found safer than abdominal route in this study.J Enam Med Col 2018; 8(3): 128-134

scholarly journals Outcome of Laser Urethrotomy in Comparison with Optical Internal Urethrotomy in Recurrent Stricture Urethra Following Perineal Anastomotic Urethroplasty for PUDD

2020 ◽  
Vol 23 (2) ◽  
pp. 181-187
Author(s):  
Ripan Debnath ◽  
Md Nabid Alam ◽  
Md Towhid Belal ◽  
Prodyut Kumar Saha ◽  
Uttam Karmaker ◽  
...  
Keyword(s):  
Internal Urethrotomy ◽  
Average Hospital ◽  
Recurrent Stricture ◽  
Stricture Urethra ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Optical Internal Urethrotomy ◽  
Anastomotic Urethroplasty ◽  
Post Operative Complications

Objective: To compare the outcome of laser urethrotomy and optical internal urethrotomy(OIU) for the treatment of recurrent stricture urethra following perineal anastomotic urethroplasty for posterior urethral distraction defect. Materials and methods: The study was conducted in Dhaka Medical College Hospital from January 2013 to December 2014.Male patients presented with obstructed voiding symptoms following perineal anastomotic urethroplasty were evaluated by their history, physical findings and investigations (urinalysis, uroflowmetry, retrograde urethrogram and micturiting cystourethrogram ) & primarily 64 patients are selected by purposive sampling. Patients are divieded again by random allocation into group A and group B and underwent for OIU and laser urethrotomy respectively. Results: Comparison was made to find out the better method between optical urethrotomy and laser urethrotomy. Overall per-operative complications (bleeding, extravasations of irrigating fluid, false passage and broken knife) in the former group were 31.3% compared to none in the latter group. Post-operative complications like bleeding, haematoma, penile oedema and erectile dysfunction were found only in Group-A (p=0.002). The mean duration of postoperative catheterization and average hospital stay were observed to be much higher in Group-A than that in Group-B (p=0.000008; p=0.0006). Comparison of final outcome (development of stricture) between groups at 1 year of evaluation in Group-A and Group-B was not significant (p= 0.320). Conclusion: Laser urethrotomy is better than optical urethrotmy in regards of peroperative and post-operative complications. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.181-187

scholarly journals Preperitoneal mesh repair in incisional hernia: a prospective study

2020 ◽  
Vol 7 (12) ◽  
pp. 3994
Author(s):  
Uma Dhanasekaran ◽  
Ramesh Arumugam
Keyword(s):  
Incisional Hernia ◽  
Prospective Study ◽  
Polypropylene Mesh ◽  
Mesh Repair ◽  
Incisional Hernias ◽  
Post Surgery ◽  
Operative Complications ◽  
A Prospective Study ◽  
Post Operative Complications

Background: Incisional hernia is a common surgical condition encountered in day to day practice. Based on national operative statistics, incisional hernias account for 15 to 20% of all abdominal wall hernias. Of all hernias encountered incisional hernias can be the most frustrating and challenging to treat. This prospective study aims to assess the efficacy of preperitoneal mesh repair technique using polypropylene mesh in the management of incisional hernia.Methods: A total of 40 patients with incisional hernia undergone open preperitoneal polypropylene mesh repair. It had evaluated for post-operative complications and recurrence for six months to one-year post-surgery. The results had tabulated statistically analysed and compared with other published reports in the literature.Results: Out of 40 patients, the size of the defect, 10 patients had less than 2 cm, 28 patients had between 2.1-4 cm, 1 patient between 4.1-6 cm and 1 patient between 6.1-8 cm. The type of hernia, 32 patients had infra umbilical hernia, and 8 patients had a supraumbilical hernia. Post-operative complication 3 patients had seroma, 1 patient had edge necrosis, 1 patient had post-op ileus, and 1 patient had chronic pain. Based on follow up, 4 patients had followed until 6 months, 10 patients till 9 months and 26 patients till one year.Conclusions: Post-operative complications following open preperitoneal polypropylene mesh repair are considerably less compared to other techniques of mesh repair and showed no recurrence among its subjects during the follow-up period, and longer follow-up is required to draw a definitive conclusion.

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