RESUMO
We report our initial experience using Minimally-Invasive Surgery (MIS) technique for Posterior Fossa Decompression (PFD) in Adult Chiari 1 Malformation (C1M) patients. Five subjects who were treated with MIS PFD at our center and followed up over a 5-year period. Another nine subjects who were treated with Open PFD and follow up over the same period were used for comparison. This study suggests that there are little differences in efficacy and safety between MIS and Open PFD. Larger series and prospective randomized trials comparing the two methods would provide higher-quality evidence and clarify the role of either technique in the treatment of C1M.
Assuntos
Malformação de Arnold-Chiari/diagnóstico por imagem , Malformação de Arnold-Chiari/cirurgia , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/cirurgia , Descompressão Cirúrgica/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Adulto JovemRESUMO
Lumbar hernias are rare, resulting from protrusion through the posterior abdominal wall that may be congenital, acquired or spontaneous. They very rarely present with acute bowel obstruction. We present a case of incarcerated small bowel within a spontaneous inferior (Petit's) lumbar hernia, treated by early open repair with mesh insertion. This case highlights the importance of thorough clinical examination and a high index of suspicion, even in the absence of previous surgery around the anatomical site of the suspected hernia, in order to effect an early repair before the onset of ischaemia in incarcerated contents.