Donor-Site Morbidity After DIEAP Flap Breast Reconstruction—A 2-Year Postoperative Computed Tomography Comparison
Conclusions: Symmetry of the 2 hemiabdomens is well preserved after DIEAP flap harvest; however, significant changes to the rectus muscles and DRA were observed. Hernia formation does not seem to be a postoperative complication of importance. The study indicates that DIEAP flaps result in limited donor-site morbidity, which for most patients does not outweigh the benefits of free perforator flap breast reconstruction.
ConclusionSurgeons performing laparoscopic excisional biopsy of the diaphragmatic peritoneum should consider the potential risk for iatrogenic diaphragmatic hernias.
This study is registered with ClinicalTrials.gov, NCT02238964.FindingsBetween Nov 28, 2012, and Nov 11, 2015, of 1286 screened patients, 790 were randomly assigned. 394 (50%) patients were randomly assigned to mesh closure and 396 (50%) to standard closure. In the mesh group, 373 (95%) of 394 patients successfully received mesh and in the control group, three patients received mesh. The clinically detectable hernia rate, the primary outcome, at 2 years was 12% (39 of 323) in the mesh group and 20% (64 of 327) in the control group (adjusted relative risk [RR] 0·62, 95% CI 0·43–0·90; p=0·012...
ConclusionRobot-assisted colostomy takedown and anastomosis of the descending colon to rectum were successfully performed. Although there is a paucity of literature examining this technique within gynecologic surgery, the literature on general surgery has supported laparoscopic Hartmann's reversal and has demonstrated improved rates of postoperative complications and incisional hernia and reduced duration of hospitalization . Minimally invasive technique is a feasible alternative to laparotomy for gynecologic oncology patients who undergo colostomy, as long as the patients are recurrence free.
Conclusions This study illustrates specific MDCT findings of IHs, and these observations may help guide early clinical management of the condition.
We report a patient with signs of recurrent small-bowel obstruction who was found to have a dual transmesocolic, TOH. Computed tomography imaging and subsequent laparoscopic exploration identified small-bowel loops passing through a defect in the transverse mesocolon behind the stomach to emerge through the gastrohepatic omentum. This was treated successfully by laparoscopy. To the best of our knowledge, this is the first reported case of a combined transmesocolic, TOH undergoing successful laparoscopic repair.
ConclusionRobotic-assisted colostomy take-down and anastomosis of descending colon to rectum were successfully performed. While there is a paucity of literature examining this technique within gynecologic surgery, general surgery literature has supported laparoscopic Hartmann's reversal and have demonstrated improved rates of postoperative complications and incisional hernia, while lowering the length of hospitalization (1). Minimally invasive technique is a feasible alternative to laparotomy for gynecologic oncology patients with colostomy, as long as they are recurrence-free.
ConclusionWe believe that mesenteric defects should be closed after laparoscopic resection of the left side of transverse colon, regardless of their size.
Conclusion: It is important to consider mesh graft migration to viscus as a cause of persistent abdominal pain and bleeding per rectum irrespective of the time of presentation post hernia repair. PMID: 31788028 [PubMed]
We report a case of small bowel herniation caused by the ureter in a woman who underwent radical hysterectomy for cervical cancer. Patient concerns: A 53-year-old woman presented with acute abdominal pain and vomiting and reported a history of radical hysterectomy for cervical cancer 6 years prior to presentation. Diagnoses: Computed tomography revealed segmental luminal dilatation of pelvic ileal loops, 2 transition zones with the beak sign in the left-sided pelvic cavity, and reduced enhancement of bowel loops. Hydronephrosis with abrupt luminal narrowing of the left distal ureter was also observed. Interventions:...
DiscussionThe Chimney Trial aims to provide level-I evidence on PSH prevention.Trial registrationClinicalTrials.gov, ID:NCT03799939. Registered on 10 January 2019