scholarly journals Comparative results of hernia repair from surgeons with different approaches at a tertiary medical center

2021 ◽  
Vol 8 (9) ◽  
pp. 526-530
Author(s):  
Ahmet Alyanak
Keyword(s):  
Chronic Pain ◽  
Hernia Repair ◽  
Medical Center ◽  
Recurrence Rates ◽  
Patient Dissatisfaction ◽  
Significant Difference ◽  
Vas Scores ◽  
The Difference ◽  
Comparative Results ◽  
The One

Objective: At present, there is still no method that can be called the gold standard in hernia repair. The main objective of this study was to review the rates, including pain and recurrence, of the most important complications for patient dissatisfaction across different methods applied by different surgeons. Material and Methods: Four hundred twenty one patients who were operated on by three surgeons were retrospectively reviewed with respect to the main complications of pain and recurrence. Self-adhesive mesh and Lichtenstein repairs were performed by the same surgeon, whereas Bassini and transabdominal preperitoneal (TAPP) repairs were performed by separate surgeons. Results: In all repair types, there were a significant difference between visual analogue scale (VAS) pain scores on the first postoperative day compared to VAS scores at the one-month mark (p<0.001). The difference between VAS scores in the first month according to repair types was statistically significant (p<0.001). There was a significant difference between repair types and development of chronic pain (p<0.001). Recurrence rates also showed a statistically significant difference amongst repair types (p=0.001). Conclusion: Although the Lichtenstein and laparoscopic methods are superior in terms of recurrence compared to the Bassini method, chronic pain complications from the Bassini method appear to be acceptable

scholarly journals Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
M. M. J. Van Rooijen ◽  
T. Tollens ◽  
L. N. Jørgensen ◽  
T. S. de Vries Reilingh ◽  
G. Piessen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hernia Recurrence ◽  
Recurrence Rates ◽  
Elective Repair ◽  
Significant Difference ◽  
Grade 3

Abstract Introduction Information on the long-term performance of biosynthetic meshes is scarce. This study analyses the performance of biosynthetic mesh (Phasix™) over 24 months. Methods A prospective, international European multi-center trial is described. Adult patients with a Ventral Hernia Working Group (VHWG) grade 3 incisional hernia larger than 10 cm2, scheduled for elective repair, were included. Biosynthetic mesh was placed in sublay position. Short-term outcomes included 3-month surgical site occurrences (SSO), and long-term outcomes comprised hernia recurrence, reoperation, and quality of life assessments until 24 months. Results Eighty-four patients were treated with biosynthetic mesh. Twenty-two patients (26.2%) developed 34 SSOs, of which 32 occurred within 3 months (primary endpoint). Eight patients (11.0%) developed a hernia recurrence. In 13 patients (15.5%), 14 reoperations took place, of which 6 were performed for hernia recurrence (42.9%), 3 for mesh infection (21.4%), and in 7 of which the mesh was explanted (50%). Compared to baseline, quality of life outcomes showed no significant difference after 24 months. Despite theoretical resorption, 10.7% of patients reported presence of mesh sensation in daily life 24 months after surgery. Conclusion After 2 years of follow-up, hernia repair with biosynthetic mesh shows manageable SSO rates and favorable recurrence rates in VHWG grade 3 patients. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report lasting presence of mesh sensation. Results of biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations. Trial registration Registered on clinicaltrials.gov (NCT02720042), March 25, 2016.

scholarly journals Identification and Characterization of Unique Subgroups of Chronic Pain Individuals with Dispositional Personality Traits

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
S. Mehta ◽  
D. Rice ◽  
A. McIntyre ◽  
H. Getty ◽  
M. Speechley ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Personality Traits ◽  
Clinical Outcomes ◽  
High Risk Group ◽  
Comprehensive Treatment ◽  
Cluster Membership ◽  
Significant Difference ◽  
Secondary Objective ◽  
The Difference ◽  
And Coping

Objective.The current study attempted to identify and characterize distinct CP subgroups based on their level of dispositional personality traits. The secondary objective was to compare the difference among the subgroups in mood, coping, and disability.Methods.Individuals with chronic pain were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted in order to identify distinct subgroups of patients based on their level of personality traits. Differences in clinical outcomes were compared using the multivariate analysis of variance based on cluster membership.Results.In 229 participants, three clusters were formed. No significant difference was seen among the clusters on patient demographic factors including age, sex, relationship status, duration of pain, and pain intensity. Those with high levels of dispositional personality traits had greater levels of mood impairment compared to the other two groups (p<0.05). Significant difference in disability was seen between the subgroups.Conclusions.The study identified a high risk group of CP individuals whose level of personality traits significantly correlated with impaired mood and coping. Use of pharmacological treatment alone may not be successful in improving clinical outcomes among these individuals. Instead, a more comprehensive treatment involving psychological treatments may be important in managing the personality traits that interfere with recovery.

scholarly journals The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Ali G. Mohammed Redha ◽  
Adil A. Jaber ◽  
Aqeel M. Nasser
Keyword(s):  
Hernia Repair ◽  
Mesh Fixation ◽  
Good Alternative ◽  
P Value ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.  

scholarly journals Analgesic Effect of Apotel Versus Pethidine After Hemilaminectomy

2019 ◽  
Vol 5 (4) ◽  
pp. 185-189
Author(s):  
Mohammadreza Emamhadi ◽  
◽  
Hamid Behzadnia ◽  
Seifollah Jafari ◽  
Mohammadreza Zamanidoust ◽  
...  
Keyword(s):  
Recovery Process ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Vas Score ◽  
Relieve Pain ◽  
Present Cross Sectional Study ◽  
Significant Difference ◽  
Vas Scores ◽  
The Difference

Background: Postoperative pain is a common phenomenon, and its management affects considerably on the recovery process, and patients’ satisfaction. Apotel and pethidine are two conventional medicines used to relieve pain after operation. Objectives: The present study aimed to compare the effect of intravenous injection of Apotel and intramuscular injection of pethidine in relieving pain after hemilaminectomy. Materials & Methods: In the present cross-sectional study, 150 patients who underwent hemilaminectomy were recruited between May 2015 and November 2015. They were taking either Apotel (n=75) or pethidine (n=75) after the operation, which was done at Poursina Hospital affiliated to Guilan University of Medical Sciences, Rasht City, Iran. The patients’ pain levels were measured using visual analog scale (VAS), and the results were compared between the 2 groups. Results: There was no significant difference in the total VAS score between the Apotel and pethidine groups (P=0.189). However, there was a significant reduction in VAS score hours 2 (P=0.03) and 4 (P=0.004) hours after the injection of Apotel in this group, compared with those scores in the pethidine group. Also, VAS scores at other times (8, 12, 20, 28 hours after the injection) were lower than those in the pethidine group, but the difference was not significant. Conclusion: Apotel was better pain-killer in the early hours after the first injection compared to pethidine. But its effect was similar to pethidine at the late hours after the first injection. Therefore it seems that Apotel is better painkiller after laminectomy, especially in the early hours after the operation.

scholarly journals O12 OPEN PREPERITONEAL INGUINAL HERNIA REPAIR, TREPP VERSUS TIPP IN A RANDOMIZED CLINICAL TRIAL

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Willem Bökkerink ◽  
Giel Koning ◽  
Patrick Vriens ◽  
Roland Mollen ◽  
Willem Akkersdijk ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Learning Curve ◽  
Randomized Clinical Trial ◽  
Inguinal Hernia Repair ◽  
Recurrence Rates ◽  
Significant Difference ◽  
Related Quality

Abstract Aim The preperitoneal mesh position for inguinal hernia repair showed beneficial results regarding Chronic Postoperative Inguinal Pain (CPIP) with low recurrence rates. Two open preperitoneal techniques, the TransREctus Sheath PrePeritoneal (TREPP) and the TransInguinal PrePeritoneal (TIPP) technique, were compared in a randomized clinical trial with the hypothesis of less patients with CPIP after TREPP due to complete avoidance of nerve contact. Materials and Methods Adult patients with a primary unilateral inguinal hernia were randomized to either TREPP or TIPP in four hospitals. Prior to the trial’s start the study protocol was ethically approved and published. Outcomes included CPIP after 1 year (primary outcome) and recurrence rates, adverse events and Health related Quality of Life (secondary outcomes). Follow-up was performed at 2 weeks, 6 months and 1 year. Results Baseline characteristics were comparable in both groups. Pain was less often present after TREPP at 2 weeks and 6 months, but the CPIP at rest at 1 year was comparable 1.9% after TREPP vs 1.4% after TIPP, p = 0.535). The overall recurrence rate was higher in the TREPP group, 8.9% vs 4.6%, p = 0.022). Corrected for a learning curve for TREPP, no significant difference could be assessed (TREPP 5.7% and TIPP 4.8%, p = 0.591). Conclusions both the TREPP and TIPP technique resulted in a low incidence of CPIP after 1 year follow-up. The TREPP method can be considered a solid method for inguinal hernia repair if expertise is present. The learning curve of the TREPP techniques needs further evaluation.

Importance of Treatment Institution in Head and Neck Cancer Radiotherapy

2009 ◽  
Vol 141 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Gregory J. Kubicek ◽  
Fen Wang ◽  
Eashwar Reddy ◽  
Yelizaveta Shnayder ◽  
Cristina E. Cabrera ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Treatment Outcome ◽  
Head And Neck ◽  
Neck Cancer ◽  
Time Course ◽  
Medical Center ◽  
Recurrence Rates ◽  
Historical Cohort ◽  
Initial Surgery ◽  
Significant Difference

OBJECTIVE: The treatment for head and neck cancer (HNC) often involves radiotherapy. Many HNC patients are treated at the academic center (AC) where the initial surgery or diagnosis was made. Because of the lengthy time course for radiotherapy, some patients are treated at community radiation facilities (non-AC) rather than the AC despite potential AC advantages in terms of experience and technology. Our goal is to determine if these potential AC advantages correspond to a difference in treatment outcome. STUDY DESIGN: Historical cohort study. SETTING: University of Kansas Medical Center, Kansas City, Kansas. SUBJECTS AND METHODS: Review of records of patients with HNC cancers evaluated at the otolaryngology (ENT) department of an AC. Each patient's information and treatment characteristics were recorded, including radiotherapy treatment venue and treatment outcome. RESULTS: Three hundred seventy-four patients were analyzed, 263 were treated at an AC and 101 at a non-AC. Patients treated at a non-AC were more likely to present with earlier stage tumors, be treated with radiation alone rather than chemoradiotherapy, and be treated with adjuvant rather than primary radiotherapy. There was no difference in overall survival or recurrence rates between AC and non-AC. CONCLUSION: Patients treated at an AC are more likely to have advanced stage tumors and receive chemoradiotherapy as their primary treatment. In analyses of matching patient subsets, there was no significant difference in patient outcomes. Patients can be treated at a non-AC without affecting outcome compared with treatment at an AC.

Infertile bulls versus steers: III. Carcass characteristics

1971 ◽  
Vol 77 (2) ◽  
pp. 317-323 ◽  
Author(s):  
M. A. Price
Keyword(s):  
Muscle Growth ◽  
Weight Ratio ◽  
Carcass Characteristics ◽  
Carcass Composition ◽  
Lower Percentage ◽  
Nutritional Conditions ◽  
Significant Difference ◽  
Kidney Fat ◽  
The Difference ◽  
The One

SummaryThe carcass characteristics of a total of 43 infertile bulls were oompared with those of 42 steers from five independent trials. In most cases there was no significant difference between the bulls and the steers for dressing percentage, or fleshing index. Bulls were generally found to have greater hide percentages than steers, the difference being very highly significant (P < 0·001) in one of the trials and significant (P < 0·05) in another. Eye musole area expressed relative to caroass weight was greater in the bulls, the difference being significant (P < 0·05) in three of the trials. The depth of fat over the eye musole and the hind to fore-quarter weight ratio were greater in the steer carcasses. Head weights were found to be significantly greater (P < 0·05) and caul and kidney fat weights less (P < 0·05) in bulls than in steers in the one trial where these parameters could be measured.Carcass composition was estimated by the three-rib sample joint teohnique in four of the trials, and in these the bulls had a greater percentage of bone and muscle, but a lower peroentage of fat than the steers, the differences being significant in most oases. In the fifth trial composition was estimated by half carcass dissection. This, too, showed bulls to have a greater percentage of bone and muscle and a lower percentage of fat, the differences being highly significant (P < 0·01) and very highly significant (P < 0·001) respectively. On a fat-corrected basis the estimated retail value of the carcasses favoured the bulls by about $20.00 each.The studies, conducted over a range of nutritional conditions, showed that non-castration favoured muscle growth while suppressing fat deposition, and that this advantage was more pronounced when growth rates were high.

Laparoscopic-assisted Ventral Hernia Repair: Primary Fascial Repair with Polyester Mesh versus Polyester Mesh Alone

2016 ◽  
Vol 82 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Farah Karipineni ◽  
Priya Joshi ◽  
Afshin Parsikia ◽  
Teena Dhir ◽  
Amit R.T. Joshi
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Fascial Closure ◽  
Recurrence Rates ◽  
Polyester Mesh ◽  
Significant Difference ◽  
Laparoscopic Assisted ◽  
Closure Group ◽  
Primary Fascial Closure

Laparoscopic-assisted ventral hernia repair (LAVHR) with mesh is well established as the preferred technique for hernia repair. We sought to determine whether primary fascial closure and/or overlap of the mesh reduced recurrence and/or complications. We conducted a retrospective review on 57 LAVHR patients using polyester composite mesh between August 2010 and July 2013. They were divided into mesh-only (nonclosure) and primary fascial closure with mesh (closure) groups. Patient demographics, prior surgical history, mesh overlap, complications, and recurrence rates were compared. Thirty-nine (68%) of 57 patients were in the closure group and 18 (32%) in the nonclosure group. Mean defect sizes were 15.5 and 22.5 cm2, respectively. Participants were followed for a mean of 1.3 years [standard deviation (SD) = 0.7]. Recurrence rates were 2/39 (5.1%) in the closure group and 1/18 (5.6%) in the nonclosure group ( P = 0.947). There were no major postoperative complications in the nonclosure group. The closure group experienced four (10.3%) complications. This was not a statistically significant difference ( P = 0.159). The median mesh-to-hernia ratio for all repairs was 15.2 (surface area) and 3.9 (diameter). Median length of stay was 14.5 hours (1.7–99.3) for patients with nonclosure and 11.9 hours (6.9–90.3 hours) for patients with closure ( P = 0.625). In conclusion, this is one of the largest series of LAVHR exclusively using polyester dual-sided mesh. Our recurrence rate was about 5 per cent. Significant mesh overlap is needed to achieve such low recurrence rates. Primary closure of hernias seems less important than adequate mesh overlap in preventing recurrence after LAVHR.

A comparative study on treatment outcomes of bandage and casting in non-displaced extra-articular fracture of distal radius: A clinical trial study

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Hamid Reza Arti ◽  
Reza farahnak
Keyword(s):  
Clinical Trial ◽  
Distal Radius ◽  
Dash Score ◽  
Articular Fracture ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Vas Scores ◽  
The Difference ◽  
Fracture Of Distal Radius

Background: There are some therapeutic choices in non-displaced extra-articular fracture of distal radius that confront with some controversy in their selection. We tried to study these two methods in this article. Methods: This was a prospective randomized clinical trial conducted on the patients (n=62) with NDEA fracture of distal radius, during 2015. The patients were randomly assigned to casting (n-32) or bandage (n=30) group to receive the respective fracture healing procedure. The patients were followed-up at the first, second, third, and sixth weeks after the treatment. The Disabilities of the DASH and the VAS questionnaire were completed. All patients underwent an X-ray radiographic assessment to evaluate any potential complication. Results: At the end of the study, in the bandage and casting group 30 and 32 patients finished the study. The statistical analyses showed that the bandage group showed significantly higher mean DASH score than the casting group at the first week, but for the second week the difference decreased so that for the third week, the casting group showed significantly higher value than the bandage group. Finally, at the sixth week the two groups showed no significant difference in the DASH value. The two groups showed no significant differences in the VAS scores for all follow up assessments. The returning time to work was shorter in the bandage group and the treatment cost was also lower in this group. Conclusion: Bandage is more appropriate treatment option for the NDEA fractures of distal radius.

Revalidation of the Flipi Score in the Era of Immunotherapy.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4437-4437
Author(s):  
German Stemmelin ◽  
Carlos Doti ◽  
Claudia Shanley ◽  
Jose Ceresetto ◽  
Oscar Rabinovich ◽  
...  
Keyword(s):  
Bone Marrow ◽  
High Risk ◽  
Univariate Analysis ◽  
Risk Groups ◽  
Marrow Transplant ◽  
Intermediate Risk ◽  
Significant Difference ◽  
The Difference ◽  
The One ◽  
The Impact

Abstract The FLIPI prognosis score for follicular lymphoma (FL) was developed based on cases diagnosed between 1985 and 1992, and treated with different schemes that did not include rituximab (R). In the present study, we report the evolution of all FL treated in a single institution through the last decade and analize whether FLIPI mantains its effectiveness to identify different risk groups within patients treated with the new therapeutic alternatives available. Material and Methods: We identified sixty two patients with diagnosis of grade I-II-IIIa FL. Patients characteristics: median age 57.5 yr (r, 30–80); 36 males; 63% stages III–IV, and 37% with bone marrow infiltration at the time of diagnosis. Thirty eight percent had a low risk by FLIPI, 34% had an intermediate risk and 27.4% had a high risk. In 19 pts (30.6%) the initial decision was “watch and wait” but 82% received a form of treatment at some point. R was used in 36 pts (58%) with some of the following regimes: chemotherapy (chemo) + R and/or R as consolidation therapy and/or R as monotherapy and/or R as maintenance therapy. Of all prescribed treatments (excluding R as monotherapy and/or maintenance treatment), 52.8% were chemo alone, 20.2% chemo + R, 21.3% radiotherapy and 5.6% received a bone marrow transplant. Results: we considered the analysis of overall survival (OS) the most appropiate approach, since most treatments were seeking the control of the FL, and not the complete remission or cure. The follow up median time was 53.2 months ± 34.8 1SD. The 5-yr OS for the 62 pts was 81.8% ± 11.3 CI 95%. The 5-yr OS for those with a low, intermediate and high risk FLIPI was 100% −5, 84.2% ± 21 and 52% ±26.2, respectively. The difference in 5-yr OS was statistically significant between low and high risk, intermediate and high risk, but failed to prove a significant difference between low and intermediate risk. Among the different risk factors tested in a univariate analysis only age ≥ < 60 yr old demonstrated a significant difference, 60.7% vs 90%, respectively. Conclusions: The 5-yr OS in our series is higher than the one described in the original FLIPI study (Blood2004; 104:1258–65) which was 81.8% vs 71% for the whole group; 90% vs 78.1% for pts <60 yr old; 60.7% vs 57.7% for ≥ 60 yr old; 100% vs 90.6% for low FLIPI and 84.2% vs 77.6% for intermediate FLIPI. The only group that failed to prove an improvement was the high risk FLIPI with 52% vs 52.5%. The impact of novel therapies was more evident in patients with a low or intermediate FLIPI and was even more evident in patients younger than 60 yr old. According to our results, FLIPI maintains its effectiveness in differentiating two risk groups, i.e., low-intermediate vs high. We believe that the OS curves will probably continue to improve as the treatments that are considered today as the most effective ones, were just included in our series in the last three years.

Sign in / Sign up

Export Citation Format

Share Document