Hernias at the Extraction Incision After Laparoscopic Colon and Rectal Resection: Influence of Incision Location and Use of Prophylactic Mesh

ConclusionsThe location of the incision is relevant to avoid incisional hernias. Transverse incisions should be used as the first option. When a midline incision is needed, a prophylactic mesh could be considered in high risk patients because it is safe and associated with low morbidity.ResumenObjetivosDeterminar la incidencia de hernia incisional (HI) en la incisión de asistencia (IA) de la pieza en cirugía por neoplasia de colon y recto. Análisis de la relación de la localización de la incisión y uso de una malla en la prevención de la HI en pacientes de alto riesgo.MétodosRevisión retrospectiva de la base de datos de cirugía de colon entre enero de 2015 y diciembre de 2016. Se establecieron 2 grupos: incisión transversa (IT) e incisión media (IM), a su vez este con 2 subgrupos (malla [IMM] y sutura [IMS]). Se categorizaron los pacientes mediante el sistema HERNIAscore. Las hernias se diagnosticaron clínicamente y por TAC.ResultadosSe intervino a 210 pacientes, de los que fueron incluidos 182. Tras un seguimiento de 13,0 meses, se detectaron un total de 39 HI (21,9%), de las que 23 (13,4%) fueron en las IA. Estas fueron mucho menos frecuentes en el grupo de IT (3,4%) y en el de IMM (5,9%) que en el de IMS (29,5%; p=0,007). La probabilidad de aparición en el grupo IMS de una HI presentó una OR=11,7 (IC 95%: 3,3-42,0) frente a las IT y de 4,3 (IC 95%: 1,1-16,3) frente al g...
Source: Cirugia Espanola - Category: Surgery Source Type: research

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This study aimed to analyze the clinical features and risk factors for internal hernia after gastrectomy for gastric cancer.MethodsWe retrospectively analyzed internal hernia after gastrectomy for gastric cancer in 6474 patients between January 2003 and December 2016 at Seoul National University Bundang Hospital. Multivariable logistic regression was performed to evaluate risk factors.ResultsInternal hernias identified by computed tomography or surgical exploration were 111/6474 (1.7%) and the median interval time was 450 days after gastrectomy. Fourteen (0.9%) of the 1510 patients who underwent open gastrectomy and 97 (2....
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
CONCLUSIONS: The location of the incision is relevant to avoid incisional hernias. Transverse incisions should be used as the first option. When a midline incision is needed, a prophylactic mesh could be considered in high risk patients because it is safe and associated with low morbidity. PMID: 30348508 [PubMed - as supplied by publisher]
Source: Cirugia eEspanola - Category: Surgery Authors: Tags: Cir Esp Source Type: research
Rina Takahashi, Kazuhiro Sakamoto, Hisashi Ro, Kazumasa Kure, Masaya Kawai, Shun Ishiyama, Kiichi Sugimoto, Yutaka Kojima, Atsushi Okuzawa, Yuichi TomikiJournal of Minimal Access Surgery 2018 14(1):71-73A 76-year-old male underwent endoscopic mucosal resection for a stage T1 tumour of the sigmoid colon. We performed laparoscopic sigmoidectomy through 5 ports using needlescopic instruments. The resected specimen was extracted from the abdominal cavity transanally. After attaching an anvil to the sigmoidal stump, the rectal stump was reclosed using an endoscopic linear stapler, and then, colorectal anastomosis was conducted ...
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
CONCLUSIONS: Laparoscopy was documented safe, with similar morbidity rates and long-term results comparing with open surgery. Laparoscopy provided better functional short-term results comparing with the midline approach, but only small differences with respect to the transverse incision approach. PMID: 27282341 [PubMed - as supplied by publisher]
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Conclusion PODH is a common complication following hybrid esophagectomy and MIO. Given the high mortality from emergency repair, careful thought is needed to identify surgical techniques to prevent PODH forming when minimal access esophagectomy are performed. Upper GI surgeons need to have a low index of suspicion to investigate and treat patients for this complication.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Ciuro FP, Ruiz JP Abstract This review focuses on the laparoscopic approach to gastrointestinal emergencies and its more recent indications. Laparoscopic surgery has a specific place in elective procedures, but that does not apply in emergency situations. In specific emergencies, there is a huge range of indications and different techniques to apply, and not all of them are equally settle. We consider that the most controversial points in minimally invasive procedures are indications in emergency situations due to technical difficulties. Some pathologies, such as oesophageal emergencies, obstruction due to colon c...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected wi...
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research
CONCLUSIONS: Prophylactic laparoscopic placement of intraperitoneal onlay mesh does not significantly reduce the overall risk of radiologically detected parastomal hernia after laparoscopic abdominoperineal resection. However, prophylactic mesh repair was associated with significantly lower risk of clinically detected parastomal hernia.
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Benign Source Type: research
We report a rare case of peritoneal metastasis from colon cancer being found in the bilateral sites of inguinal hernia repair. The patient was an 85-year-old man who underwent colonoscopy for a positive fecal occult blood test, with a subsequent diagnosis of ascending colon cancer. He had undergone mesh plug repair for bilateral inguinal hernias at another hospital 6 years previously. We performed laparoscopy-assisted right hemi-colectomy and found nodes in the bilateral scars from the inguinal hernioplasty. Biopsy confirmed that both of the nodes were peritoneal metastasis, leading to the assumption that cancer cells...
Source: Surgery Today - Category: Surgery Source Type: research
CONCLUSIONS: Visceral obesity, history of inguinal hernia, and location of specimen extraction site are significantly associated with the development of an incisional hernia, whereas BMI is poorly associated with hernia development. These findings suggest that a lateral transverse location is the incision site of choice and that new strategies, such as prophylactic mesh placement, should be considered in viscerally obese patients.
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions Source Type: research
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