scholarly journals Comparative Study on the Efficiency of 2 Different Types of Meshes (Polypropylene and ProGripTM ) in the Surgical Treatment of Incisional Hernias

2018 ◽  
Vol 55 (2) ◽  
pp. 152-155
Author(s):  
Bogdan Andrei Suciu ◽  
Ioana Halmaciu ◽  
Decebal Fodor ◽  
Cristian Trambitas ◽  
Adrian Ivanescu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Polypropylene Mesh ◽  
Incisional Hernias ◽  
Hospitalization Period ◽  
Duration Of Surgery ◽  
Different Types ◽  
Group A ◽  
Group B ◽  
Clinical Records

Postoperative eventration is a quite common condition in patients with clinical records of abdominal surgery. The purpose of this study was to investigate the efficacy of use of 2 different types of meshes (Polypropylene mesh and ProGripTM mesh-self-gripping mesh) in the surgical treatment of incisional hernias. In this respect, we conducted a study in which we introduced 128 patients operated for incisional hernias. Patients were divided into 2 lots: group A (102 patients with polypropylene mesh) and group B (26 patients with ProGripTM mesh). From the analysis of the data studied, we noticed that the average duration of surgery and hospitalization for patients with ProGripTM mesh is lower compared to patients with polypropylene mesh. Also, the rate of local postoperative complications was lower when using the ProGripTM mesh (15.38%) than in the case of polypropylene mesh. In conclusion, we can state that the use of the ProGripTM heterologous mesh is beneficial in the surgical treatment of patients with incisional hernias. The major advantage of using this type of mesh is given by a shorter hospitalization period for these patients, as well as by a lower rate of local postoperative complications in these patients.

scholarly journals Study on the Need for Postoperative Analgesic Medication in Patients where Polypropylene Mesh was Used in the Surgical Treatment of Incisional Hernias

2018 ◽  
Vol 55 (4) ◽  
pp. 648-651
Author(s):  
Ioana Halmaciu ◽  
Bogdan Andrei Suciu ◽  
Cristian Trambitas ◽  
Vlad Vunvulea ◽  
Alexandra Martin Stoica ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Polypropylene Mesh ◽  
Incisional Hernias ◽  
Surgical Meshes ◽  
Analgesic Medication ◽  
Group A ◽  
Group B ◽  
Surgical Clinic

One of the most common postoperative complications that may occur in patients treated for incisional hernias is pain. The occurrence of postoperative pain refractory to drug treatment may worsen the prognosis of these patients. We have carried out a retrospective observational study in which we have introduced 122 patients operated for incisional hernia at the Surgical Clinic No. 1 in the Tirgu Mures Emergency County Clinical Hospital. The patients included in the study were divided into two groups: group A consisting of 80 patients where the polypropylene mesh was used over the aponeurosis in the surgical treatment of the incisional hernias, and the group B consisting of 42 patients where no prosthetic materials were used in the surgical treatment of the incisional hernias. All patients were administrated 1 g of sodium metamizole monohydrate for the treatment of pain. The statistical analysis of the data revealed that, on the day of surgery, on the first, second and third postoperative day there were statistically significant differences in the need for analgesic medication between the two groups, the need for the analgesic medication being lower for group A. In contrast, on the 4th postoperative day there were no statistically significant differences in the need for analgesic medication between the two groups. In conclusion, our study showed that, when using the polypropylene mesh in the surgical treatment of incisional hernias, the need for analgesic medication is lower in the immediate postoperative period compared to cases where surgical meshes are not used in the surgical treatment of these patients.

scholarly journals Comparative Study on the Use of Polypropylene Mesh in the Surgical Treatment of Patients with Strangulated or Uncomplicated Incisional Hernias

2018 ◽  
Vol 55 (2) ◽  
pp. 207-210
Author(s):  
Ioana Halmaciu ◽  
Bogdan Andrei Suciu ◽  
Decebal Fodor ◽  
Dumitru Godja ◽  
Cristian Trambitas ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Polypropylene Mesh ◽  
Incisional Hernias ◽  
Tissue Integration ◽  
Number Of Patients ◽  
History Of ◽  
Group B

Incisional hernias affects approximately 10-20% of patients with history of abdominal surgery. The purpose of this study was to examine the tissue integration of the polypropylene mesh in patients operated for strangulated incisional hernias to those operated for uncomplicated incisional hernias. For this purpose, we introduced 218 patients with surgical treatment of the incisional hernia with polypropylene mesh. The total number of patients studied was divided into 2 lots: group A consisting of 189 patients with uncomplicated incisional hernia and group B of 29 patients with strangulated incisional hernia. We studied separately the local postoperative complications in the two groups (hematomas, seromas, abdominal wall infections). Although the number of local postoperative complications was higher for group B, the differences were statistically significant only for the incidence of abdominal wall infections. Although the use of the polypropylene mesh in the surgical treatment of strangulated incisional hernias predisposes to a higher risk of local postoperative complications compared to its use in the surgical treatment of the uncomplicated incisional hernias, its use in the surgical treatment of the strangulated incisional hernias is beneficial.

Surgical management of synchronous colorectal liver metastases: Simultaneous versus staged resections.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 616-616
Author(s):  
Igor Shchepotin ◽  
Andrii Lukashenko ◽  
Olena Kolesnik ◽  
Anton Burlaka
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Liver Metastases ◽  
Metastatic Cancer ◽  
Economic Effect ◽  
Hepatic Metastases ◽  
Group A ◽  
Bed Days ◽  
Group B

616 Background: Surgical treatment of metastatic colorectal cancer remains the only method that improves overall 5-year survival. This study aimed to compare the surgical outcome and survival benefit between synchronous and staged resection of liver metastases from colorectal cancer. Methods: Clinicopathologic data, treatments, and postoperative outcomes from 110 patients who underwent simultaneous (48 patients, group A) or staged (62 patients, group B) colorectal and hepatic resections at clinic of National cancer institute in period of 2008-2013 were reviewed. Results: Postoperative complications in patients with simultaneous resections (group A) were observed in 13 cases (27.1%), including 5, 1, 4, 2, 0, and 1 of grades I, II, IIIa, IIIb, IV, and V, respectively. Similar results have been reported in group B after staged resections, where overall postoperative complications registered in 16 patients (25.8 %), including 4, 3, 6, 3, 0 of grades I, II, IIIa, IIIb, and IV respectively. Overall level of post-operative complications in the groups A and B after surgical stages finishing did not differ statistically (p=0.96). Shorter operative intervention duration was registered in the group A – (311±10.1) min, whereas in the group B it was (496.6±16.2) min (р<0.001). Patients after staged resection stayed in clinic for a longer time – 23.9±0.8 bed-days, when simultaneous resections provided with shorter recovery terms in post-operative period – 9.8±0.5 bed-days (p<0.001). Overall 3-year survival in the group of patients with simultaneous resections (group А) was 42 % and in the group B 55 % (р=0.22). Conclusions: Analysis of our research indicated necessity of the development of differentiated approach in management of synchronous colorectal liver metastatic cancer. Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected patients. Subsequent research should be directed towards study of prognosis factors and criteria for patients’ selection for surgical treatment groups, assessment of economic effect, and patients life quality.

scholarly journals INCREASING SAFETY OF SURGICAL INTERVENTIONS IN PATIENTS WITH VENTRAL AND INCISIONAL HERNIA UNDER COMORBIDITY CONDITIONS WHEN PERFORMING DIFFERENT TYPES OF OPEN HERNIOPLASTY

2020 ◽  
pp. 135-139
Author(s):  
V. I. Piatnochka ◽  
I. Ya. Dziubanovskyi ◽  
A. M. Prodan
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Polypropylene Mesh ◽  
Immunosuppressive Agents ◽  
Technical Improvement ◽  
Surgical Interventions ◽  
Duration Of Surgery ◽  
Ventral Hernias

Abstract. In the period from 2001 to 2017, 1419 patients with ventral and postoperative ventral hernia were operated on. The unsatisfactory results of the surgical treatment of this pathology were due to a number of disadvantages: the choice of an inadequate method of hernioplasty in a specific clinical situation, an incomplete revision of the muscle-aponeurotic layer of the anterior abdominal wall, especially in patients with postoperative veterinary hernias, concomitant syndrome of undifferentiated connective tissue dysplasia and obesity, and weak points, the wrong choice of the type of mesh implant (“light” or “heavy” polypropylene mesh) and its size, the choice of an inappropriate type of suture material, as well as the high invasiveness of surgical intervention. Based on the given causes of complications in the operated patients with a high risk of their development, we have made a technical improvement of the existing methods of hernioplasty and development of new ones, which significantly reduced the number of postoperative complications and increased the safety of performing surgical interventions in patients with ventral and postoperative ventral hernia. Purpose. Based on the results of the analysis of surgical treatment of patients with comorbid conditions for primary and incisional ventral hernias to develop technical prerequisites for improving the safety of surgical interventions in this category of patients. Methods. Іn the period from 2001 to 2017, an in-depth comprehensive clinical-instrumental and laboratory examination of 1419 patients with primary ventral hernia (PVH) and postoperative ventral hernia (PVH) was conducted. The patients were divided into groups according to the periods of surgical treatment of patients. For this purpose, two periods were formed: from 2001 to 2009 and from 2010 to 2017. At the first period, 597 (42.07%) patients were examined and operated on. These patients formed a comparison group. The main group corresponding to patients who were treated in the period from 2010 to 2017 was 822 (57.93%) people. Results. Developed techniques for performing retromuscular allogernioplasty, which were based on controlled visualization of suturing when fixing polypropylene mesh to the posterior leaf of the vagina of the rectus muscle, allowed us to reliably and safely place and secure the implant in the retromuscular space, significantly reduce the trauma and duration of surgery. Kind of treatment using the mesh allograft with a liposomal complex with included antibacterial and immunosuppressive agents during the operation on the "onlay" method significantly reduced the number of local infectious complications. The location of the PRF membrane over the polypropylene mesh during retromuscular allogernioplasty improved neoangiogenesis at the mesh implantation site, increased fibroblast activity and the formation of collagen fibers around the mesh material, which provided maximum integration of the "light" abdominal wall with polypropylene tissue. Conclusion. These features of the dynamics of the used methods of surgical interventions and types of polypropylene nets with an individualized approach to each patient were reflected in a significant reduction in the number of both early local and general late postoperative complications, which improved the effectiveness of surgical treatment of patients with primary postoperative ventral hernias.

scholarly journals Use of Caudal Analgesia Supplemented with Low Dose of Morphine in Children Who Undergo Renal Surgery

2015 ◽  
Vol 9 (3) ◽  
pp. 132-137 ◽  
Author(s):  
Boris Chertin ◽  
Alexander Zeldin ◽  
Stanislav Kocherov ◽  
Alexander Ioscovich ◽  
Israel A. Ostrovsky ◽  
...  
Keyword(s):  
Pain Score ◽  
Low Dose ◽  
Statistical Significance ◽  
Morphine Group ◽  
Renal Surgery ◽  
Hospitalization Period ◽  
Caudal Analgesia ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Introduction: To test the efficacy and safety of caudal anesthesia (CA) supplemented by low dose morphine in children who undergo renal surgery. Materials and Methods: Forty patients aged 2 months-14 years were enrolled and randomly divided into two groups of 20 patients each: Group A (bupivacaine 0.2% with fentanyl); Group B (bupivacaine with morphine). The duration of surgery and hospitalization time were recorded. Postoperative pain score was measured by Face Legs Activity Cry Consolability scale and Wong-Baker Faces scale for those who are older. Overall use of rescue analgesics was calculated. Results: There was no statistical difference in the length of surgery, incidence of pruritus, postoperative nausea, vomiting and urinary retention between the two groups. However the postoperative opioid requirements were significantly higher in Group A 1.03 ± 0.9 mg/kg compared to Group B, in which only one patient required opioid therapy (p < 0.0001). Moreover the need for non-opioid rescue analgesic was higher in Group A, (36 ± 5.7 mg/kg of paracetamol) compared to morphine CA group there only 26 ± 3.6 mg/kg required during first 24 h of the postoperative period (p = 0.0312). The Face Legs Activity Cry Consolability pain score (1, 4, and 24 h after surgery) and Wong-Baker Faces scale were significantly higher in Group A. The hospitalization period was shorter in the CA morphine group, but the difference did not reach statistical significance. None developed hemodynamic instability or respiratory depression. Conclusions: Our data show that CA supplemented with low dose morphine provides a longer duration of analgesia without significant side-effects in children undergoing renal surgery.

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.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

scholarly journals Prophylactic temporary abdominal aortic balloon occlusion for patients with pernicious placenta previa: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Huo ◽  
Hansheng Liang ◽  
Yi Feng
Keyword(s):  
Placenta Previa ◽  
Balloon Occlusion ◽  
Artery Embolism ◽  
Abdominal Aortic ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Clinical Records ◽  
Group D ◽  
Central Placenta Previa

Abstract Background Pernicious placenta previa (PPP) can increase the risk of perioperative complications. During caesarean section in patients with adherent placenta, intraoperative blood loss, hysterectomy rate and transfusion could be reduced by interventional methods. Our study aimed to investigate the influence of maternal hemodynamics control and neonatal outcomes of prophylactic temporary abdominal aortic balloon (PTAAB) occlusion for patients with pernicious placenta previa. Methods This was a retrospective study using data from the Peking University People’s Hospital from January 2014 through January 2020. Clinical records of pregnant women undergoing cesarean section were collected. Patients were divided into two groups: treatment with PTAAB placement (group A) and no balloon placement (group B). Group A was further broken down into two groups: prophylactic placement (Group C) and balloon occlusion (group D). Results Clinical records of 33 cases from 5205 pregnant women underwent cesarean section were collected. The number of groups A, B, C, and D were 17, 16, 5 and 12.We found that a significant difference in the post-operative uterine artery embolism rates between group A and group B (0% vs.31.3%, p = 0.018). There was a significant difference in the Apgar scores at first minute between group A and group B (8.94 ± 1.43 vs 9.81 ± 0.75,p = 0.037),and the same significant difference between two groups in the pre-operative central placenta previa (29.4% vs. 0%,p = 0.044), complete placenta previa (58.8% vs 18.8%, p = 0.032),placenta implantation (76.5% vs 31.3%, p = 0.015). We could also observe the significant difference in the amount of blood cell (2.80 ± 2.68vs.10.66 ± 11.97, p = 0.038) and blood plasma transfusion (280.00 ± 268.32 vs. 1033.33 ± 1098.20, p = 0.044) between group C and group D. The significant differences in the preoperative vaginal bleeding conditions (0% vs 75%, p = 0.009), the intraoperative application rates of vasopressors (0% vs. 58.3%, p = 0.044) and the postoperative ICU (intensive care unit) admission rates (0% vs. 58.3%, p = 0.044) were also kept. Conclusions PTAAB occlusion could be useful in reducing the rate of post-operative uterine artery embolism and the amount of transfusion, and be useful in coping with patients with preoperative vaginal bleeding conditions, so as to reduce the rate of intraoperative applications of vasopressors and the postoperative ICU (intensive care unit) admission. In PPP patients with placenta implantation, central placenta previa and complete placenta previa, we advocate the utilization of prophylactic temporary abdominal aortic balloon placement.

scholarly journals Re-operation rate after surgical treatment of osteochondral lesions of the talus in paediatric and adolescent patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniel Körner ◽  
Christoph E. Gonser ◽  
Stefan Döbele ◽  
Christian Konrads ◽  
Fabian Springer ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bone Grafting ◽  
Cartilage Damage ◽  
Osteochondral Lesions ◽  
Retrograde Drilling ◽  
Autologous Bone Grafting ◽  
Operation Rate ◽  
Group A ◽  
Autologous Bone ◽  
Group B

Abstract Background The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents. Methods Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus. ‘Re-operation’ as the outcome measure was evaluated after a median follow-up of 42 months (range 6–117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables. Results Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13–61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001). Conclusions We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.

Comprehensive Nursing can Relieve the Negative Emotions of Patients undergoing Breast Cancer Resection and Reduce Postoperative

2021 ◽  
Vol 7 (5) ◽  
pp. 4234-4243
Author(s):  
Xiaoxia Lv ◽  
Lihua Wang ◽  
Yan Zhai
Keyword(s):  
Breast Cancer ◽  
Postoperative Complications ◽  
Quality Score ◽  
Cancer Resection ◽  
Upper Limb Function ◽  
Sf 36 ◽  
Group A ◽  
Group B ◽  
Nursing Quality

To explore the effect of comprehensive nursing on adverse emotions and postoperative complications of breast cancer patients undergoing mastectomy. Altogether 180 patients who received treatment in our hospital from May 2017 to May 2019 were selected as the research participants and divided into group A and group B. Among them, 100 cases in group A received comprehensive nursing, 80 cases in group B received routine nursing. The surgical indications, upper limb function, serum NGF, TK1 and CA15-3 expression level, VAS score, SAS, SDS score, quality of life SF-36 score were detected, and the incidence rate of postoperative complications and nursing quality score were compared. Compared with group B, group A had less postoperative bed time, intraoperative blood loss, length of hospital stay, better recovery of upper limb function, lower expression levels of serum NGF, TK1 and CA15-3, lower VAS score, SAS and SDS score, higher quality of life SF-36 score, lower incidence of postoperative complications and higher nursing quality score. Comprehensive nursing can relieve the negative emotions of patients undergoing breast cancer resection and reduce the incidence of postoperative complications.

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