Elective and Emergent Laparotomy Closure: The Importance of Protocolizing the Technique

ConclusionThe abdominal wall closure was deficient in nearly one-quarter of the laparotomies performed at a third-level medical center. A protocol improved the quality of the laparotomy closure.ResumenIntroducciónLa hernia incisional es una patología altamente prevalente cuya prevención incluye medidas como el correcto cierre de la pared abdominal.MétodosSe llevó a cabo un estudio prospectivo en un centro de tercer nivel que incluyó a pacientes intervenidos de modo electivo y de urgencias tras la implementación de un protocolo de cierre de la laparotomía media. Se realizó una medida objetiva de la relación entre la sutura usada y la longitud de la laparotomía y se analizaron los resultados postoperatorios.ResultadosDe los 127 pacientes incluidos, 34 (26,8%) recibieron un cierre técnicamente deficiente. La incidencia de hernia incisional fue del 20,5%. Se demostró una mejoría progresiva en la calidad del cierre.ConclusionesEl cierre de la pared abdominal es deficiente en cerca de una cuarta parte de las laparotomías realizadas en un centro de tercer nivel. La implementación de un protocolo de cierre mejora la calidad del mismo.
Source: Cirugia Espanola - Category: Surgery Source Type: research

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CONCLUSIONS: Considering the severity of this condition, accurate diagnosis and timely surgical treatment is mandatory to reducing morbidity and mortality. KEY WORDS: Bochdalek hernia, Gastric volvulus. PMID: 31702578 [PubMed - in process]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
AbstractBackgroundIncisional hernias are a common complication of emergency laparotomy and are associated with significant morbidity. Recent studies have found a reduction in incisional hernias when mesh is placed prophylactically during abdominal closure in elective laparotomies. This systematic review will assess the safety and efficacy of prophylactic mesh placement in emergency laparotomy.MethodsA systematic review was performed according to the PROSPERO registered protocol (CRD42018109283). Papers were dual screened for eligibility, and included when a comparison was made between closure with prophylactic mesh and clo...
Source: Hernia - Category: Sports Medicine Source Type: research
​BY FAHAD SHAH &AHMED RAZIUDDIN, MDA 68-year-old woman presented with acute abdominal pain that had started three hours earlier. She said she had constant upper abdominal pain that was sharp and stabbing, and she rated her pain as 8/10.The patient said the pain did not radiate, and she was clearly in acute distress. She reported that her last meal had been four hours before and that she was nauseated and had had three to four episodes of dry heaves.She had no other concerning symptoms, and her pain was unaffected by eating, drinking, or position. She had a paraesophageal rolling hiatal hernia and was aware of her chr...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
We investigated the incidence of complications following Roux-En-Y gastric bypass (RNY-GBP), and factors that may better-predict the risk for abdominal exploration following bariatric surgery.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Publication date: Available online 9 September 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Amanda Muñoz, Victoria Pepper, Faraz A. Khan, Andrei RadulescuAbstractAnterior diaphragmatic hernias through the foramen of Morgagni are rare accounting for about 3% of surgically treated diaphragmatic hernias. Current management of Morgagni type diaphragmatic hernias involves surgical intervention, which is traditionally done by open laparotomy, laparoscopy or thoracoscopic approach. Here we present the case of a two year old female with a Morgagni type congenital diaphragmatic hernia (CDH) found during wo...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
ConclusionAcute appendicitis should be suspected as a cause of mechanical intestinal obstruction in an elderly patient with no obvious diagnostic cause, and can be managed with simple appendectomy when an early intervention is made.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
ConclusionsAbsent patency of the abdominal wall vasculature is a novel risk factor for incisional hernia development in the setting of aortic disease. Preoperative assessment of perfusion may convey the risk of hernia development and may be a tool to guide measures such as prophylactic mesh placement to reduce the future risk of incisional hernia.
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionIntestinal obstruction due to internal hernia after laparoscopic rectosigmoidectomy is a rare postoperative complication that can be avoided by the adequate closure of the mesocolon defect.ResumoIntroduçãoO desenvolvimento de hérnias internas pelo defeito mesocólico após a realização de colectomia laparoscópica é uma complicação rara com apenas 39 casos descritos. Existem controvérsias se fechamento do defeito após a ressecção do cólon preveniria o desenvolvimento desta complicação.Objetiv...
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
ConclusionThe clinicians should consider this rare condition in the differential diagnosis of patients presenting with large paraumbilical hernias associated with classical symptoms of acute pancreatitis, particularly in the absence of typical risk factors for pancreatitis. An intravenous contrast-enhanced abdominal CT scan should be performed immediately in these patients. We recommend the patients and the surgeons to consider prompt surgical repair for paraumbilical hernias to avoid further complications and the higher incidence of morbidity and mortality associated with emergency surgeries.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
ConclusionHigh index of clinical suspicion and early intervention saves the patient from extensive bowel resection and other serious complications.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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