RESUMEN
BACKGROUND: This study assessed clinical outcomes, including safety and recurrence, from the two-year follow-up of patients who underwent open ventral primary hernia repair with the use of the Parietex™ Composite Ventral Patch (PCO-VP). METHODS: A prospective single-arm, multicenter study of 126 patients undergoing open ventral hernia repair for umbilical and epigastric hernias with the PCO-VP was performed. RESULTS: One hundred twenty-six subjects (110 with umbilical hernia and 16 with epigastric hernia) with a mean hernia diameter of 1.8 cm (0.4-4.0) were treated with PCO-VP. One hundred subjects completed the two-year study. Cumulative hernia recurrence was 3.0% (3/101; 95%CI: 0.0-6.3%) within 24 months. Median Numeric Rating Scale pain scores improved from 2 [0-10] at baseline to 0 [0-3] at 1 month (P < 0.001) and remained low at 24 months 0 [0-6] (P < 0.001). 99% (102/103) of the patients were satisfied with their repair at 24 months postoperative. CONCLUSIONS: The use of PCO-VP to repair primary umbilical and epigastric defects yielded a low recurrence rate, low postoperative and chronic pain, and high satisfaction ratings, confirming that PCO-VP is effective for small ventral hernia repair in the two-year term after implantation. TRIAL REGISTRATION: The study was registered publically at clinicaltrials.gov ( NCT01848184 registered May 7, 2013).
Asunto(s)
Hernia Ventral/cirugía , Herniorrafia/instrumentación , Complicaciones Posoperatorias/epidemiología , Mallas Quirúrgicas , Adulto , Anciano , Femenino , Estudios de Seguimiento , Herniorrafia/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos , RecurrenciaRESUMEN
A simple method of combined atraumatic vascular control and apposition of vein and artery which facilitates performance of a Cimino-Brescia arteriovenous fistula for angioaccess is described herein.
Asunto(s)
Derivación Arteriovenosa Quirúrgica/métodos , Mano/irrigación sanguínea , Diálisis Renal/métodos , Derivación Arteriovenosa Quirúrgica/instrumentación , Humanos , SuturasRESUMEN
A simple method of aortic graft plication with a retrocolic omental pedicle is described; plication should protect against both graft infection and graft enteric fistulas.
Asunto(s)
Aorta Abdominal/cirugía , Epiplón/cirugía , Colgajos Quirúrgicos , Colon , Duodeno , Humanos , MétodosRESUMEN
The literature contains more than 250 cases of graft enteric fistula. The classic symptom complex involves antecedent bleeding followed by exsanguinating hemorrhage within hours to days. In patients with gastrointestinal hemorrhage and a history of aortic graft implantation, the role of endoscopy is crucial, first to delineate any coexistent disease and secondarily to view the fistula itself. Although only 20 cases have been so diagnosed, aggressive intubation of the distal duodenum in a patient fully prepared for surgical intervention may yield a definitive diagnosis of aortoduodenal fistula, thus facilitating appropriate aggressive surgical management.
Asunto(s)
Enfermedades de la Aorta/diagnóstico , Prótesis Vascular/efectos adversos , Enfermedades Duodenales/diagnóstico , Duodenoscopía , Fístula/diagnóstico , Fístula Intestinal/diagnóstico , Anciano , Humanos , Masculino , Tereftalatos PolietilenosRESUMEN
Two cases of villous adenoma of the duodenum are reviewed. Surgical resection is complicated by the local anatomy but in 80 per cent of the patients may be limited to submucous resection via lateral duodenotomy. The two cases are compared to the 50 published case reports.
Asunto(s)
Adenoma/diagnóstico , Neoplasias Duodenales/diagnóstico , Adenoma/cirugía , Neoplasias Duodenales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The first spontaneous Salmonella aortic graft infection is reported, being due to graft contamination via a graft enteric erosion. The high mortality of Salmonella aortic infection and gram-negative graft infections is noted.
