Complex abdominal wall hernia repair with biologic mesh in elderly: a propensity matched analysis
ConclusionElderly patients undergoing CAWR with biological mesh have comparable outcomes with non-elderly patients when using propensity matching score.
ConclusionThe survey results indicate that the majority of practicing DoD general surgeons still empirically prescribe surgical antibiotic prophylaxis in IHR despite more conflicting opinions that it has no meaningful effect or that current evidence does not supports its use.
AbstractIntroductionIn an Expert Consensus guided by systematic review, the panel agreed that for open elective incisional hernia repair, sublay mesh location is preferred, but open intraperitoneal onlay mesh (IPOM) may be useful in certain settings. This analysis of data from the Herniamed Registry aimed to compare the outcomes of open IPOM and sublay technique.MethodsPropensity score matching of 9091 patients with elective incisional hernia repair and with defect width ≥ 4 cm was performed. The following matching variables were selected: age, gender, risk factors, ASA score, preoperative pain, defe...
ConclusionLong-term re-recurrence rate and incidence of chronic pain was surprisingly high respectless of surgical approach and neither TAPP nor Lichtenstein ’s procedure was superior to improve surgical results.
ConclusionThis retrospective study shows that mesh fixation in laparoscopic IPOM using cyanoacrylate glue with the Liquiband Fix8 ™ device is feasible, safe, easy to learn, and is associated with a low risk of seroma, hernia recurrence and chronic pain with short-medium term follow-up.
ConclusionsThe utilization of SVF-coated mesh influences the level of angiogenesis during the early onset of tissue healing. Further long-term animal experiments are needed to confirm that this effect correlates with a more robust mesh integration compared to non-SVF-coated mesh.
ConclusionThe incidence of mesh infection was observed in 4.97% of total 181 cases. To the best of knowledge, this seems to be the first prospective observational carried out in this country. Of the numerous factors studied, the duration of surgery and mesh contamination were the factors found to have statistical significance on the incidence of mesh infection. Although a clear picture to differentiate surgical site infection from acute mesh infection is yet to be obtained, the study provided better understanding of the management as no mesh explantation was required in either of the cases.
AbstractPurposeTo examine the updated evidence on safety, effectiveness, and outcomes of mesh versus suture elective umbilical hernia (UH) repair and to explore the timely tendency variations favouring one treatment over another.MethodsMEDLINE and CENTRAL databases were consulted. A systematic review, pairwise meta-analysis, and trial sequential analysis (TSA) were conducted.ResultsSix RCTs were included for a total of 742 patients. Overall, 383 (51.6%) underwent mesh, while 359 (48.4%) underwent suture repair. The estimated pooled postoperative recurrence RR was 0.27 (95% CI 0.13 –0.53;p
ConclusionsLaparoscopic exploration is an effective and minimally invasive method for managing the late-onset infection which can identify whether internal organ was involved and consult for the further treatment. The approach of mesh removal should be tailored according to the exploration results.
Minimally invasive repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) and congenital diaphragmatic hernia (CDH) is feasible and confers benefits compared to thoracotomy or laparotomy. However, carbon dioxide (CO2) insufflation can lead to hypercapnia and acidosis. We sought to determine the effect of lower insufflation pressures on patients' surrogate markers for CO2 absorption — arterial partial pressure of CO2 (PaCO2), end tidal CO2 (EtCO2) and pH.
CONCLUSION This simulation study provides important new insight into the concept of EGS regionalization, suggesting that 1 in 10 risk-adjusted deaths could be prevented by a structured system of EGS care. Future work should expand upon these findings using more complex discrete-event simulation models. LEVEL OF EVIDENCE Therapeutic/Care Management, level IV.