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1.
BMC Vet Res ; 20(1): 115, 2024 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-38521902

RESUMO

BACKGROUND: Swelling of the perineal region in male dogs is most commonly caused by a perineal hernia. Clinical signs associated with perineal hernia are constipation, tenesmus or stranguria. This case report documents a rare cause of perineal swelling created by the growth of a malignant tumour leading to urethral obstruction and subsequent stranguria. CASE PRESENTATION: An 11-year-old neutered male German Shepherd was presented for swelling in the perineal region and stranguria for three days. Complete blood count and serum biochemistry were unremarkable. Ultrasound revealed a heterogeneous mass in the perineal region. Retrograde urethrography showed a severe narrowing of the urethra caudal to the pelvis. A fine-needle aspirate of the mass was highly suspicious for liposarcoma. Staging was performed by computed tomography (CT) of the thorax and abdomen. Total penile amputation in combination with pubic-ischial pelvic osteotomy, transposition of the remaining urethra through the inguinal canal, V-Y-plasty cranial to the prepuce and preputial urethrostomy were performed to remove the tumour. Histopathology confirmed a well-differentiated liposarcoma with complete histological margins. Six months after the surgery the dog was doing well and there were no signs indicating local tumour recurrence. CONCLUSIONS: Wide surgical excision is generally recommended for soft tissue sarcomas, however this is sometimes not feasible for large tumours. In the case reported here, tumour resection was achieved by a combination of several surgical techniques with a good clinical outcome.


Assuntos
Doenças do Cão , Lipossarcoma , Obstrução Uretral , Cães , Masculino , Animais , Obstrução Uretral/etiologia , Obstrução Uretral/cirurgia , Obstrução Uretral/veterinária , Uretra/patologia , Pênis/patologia , Lipossarcoma/complicações , Lipossarcoma/cirurgia , Lipossarcoma/veterinária , Hérnia/patologia , Hérnia/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/etiologia , Doenças do Cão/cirurgia
2.
Ulus Travma Acil Cerrahi Derg ; 30(3): 226-228, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38506380

RESUMO

Internal herniation is an extremely rare cause of intestinal obstruction. Paraduodenal hernias result from abnormal rotation of the bowel. Symptoms that may range from recurrent abdominal pain to acute obstruction may occur. If it is not diagnosed and treated in time, the disease may result in intestinal ischemia. This article aimed to present the diagnosis and treatment process of a 47-year-old male presenting with acute abdomen symptoms by evaluating retrospectively with the accompaniment of literature. During the abdominal exploration of the patient, nearly all of the intestines were observed to be herniated from the right paraduodenal region to the posterior area. The opening of the hernial sac was repaired primarily by reducing the intestinal bowel loops into the intraperitoneal region. The patient undergoing anastomosis by performing resection of the ischemic part after reduction of herniated bowel loops was discharged uneventfully on the post-operative 10th day. Paraduodenal hernia is a condition that should be considered in patients with abdominal pain and intestinal obstruction symptoms. Early diagnosis is of vital importance to prevent the complications which can develop.


Assuntos
Duodenopatias , Obstrução Intestinal , Masculino , Humanos , Pessoa de Meia-Idade , Hérnia Paraduodenal/complicações , Estudos Retrospectivos , Duodenopatias/diagnóstico , Duodenopatias/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Hérnia/diagnóstico , Hérnia/diagnóstico por imagem , Dor Abdominal/etiologia
5.
Med Sci Monit ; 30: e943259, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38419323

RESUMO

Pulmonary hypoplasia is one of main causes of neonatal mortality and morbidity in patients with congenital diaphragmatic hernia. With most cases diagnosed prenatally, the emphasis is put on prediction of the severity of this defect. Several attempts are made to reduce the mortality and provide optimal prenatal and postnatal care. Appropriate estimation of risk of pulmonary hypoplasia also provides an important inclusion criterion for prenatal intervention. The main tool used for the detection and prediction of pulmonary hypoplasia is ultrasound, with an increasing number of available formulas to estimate the risk of occurrence of this phenomenon and complication associated with it. For most of the formulas used in this measurement method, the main limitations are either gestational-age dependency or limited research. Other imaging methods used to assess the risk of pulmonary hypoplasia involve magnetic resonance imaging and vascular assessment of affected lungs. The limitation in these remains the limited accessibility. Currently, the most widely used indexes are observed-to-expected lungs-to-head ratio and presence of liver herniation. These are the 2 most commonly used measurement methods, as they are the basis for patient qualification for fetoscopic endoluminal tracheal occlusion. This article aims to review the evaluation of pulmonary hypoplasia or hypoplastic lung disease as an important determinant of clinical outcomes in infants with congenital diaphragmatic hernia. In this review, we emphasize the importance of early prenatal diagnosis of congenital diaphragmatic hernia and present a summary of different methods of prenatal risk assessment of lung hypoplasia in congenital diaphragmatic hernia.


Assuntos
Hérnias Diafragmáticas Congênitas , Gravidez , Feminino , Recém-Nascido , Humanos , Hérnias Diafragmáticas Congênitas/diagnóstico por imagem , Hérnias Diafragmáticas Congênitas/patologia , Diagnóstico Pré-Natal/métodos , Pulmão/patologia , Fetoscopia/métodos , Hérnia , Ultrassonografia Pré-Natal
6.
Vet Radiol Ultrasound ; 65(2): 157-169, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38318920

RESUMO

Caudal protrusion of pelvic organs and dilatation and deviation of the rectum with perineal hernia (PH) have not previously been studied using CT, and it is not known how completely the changes normalize after PH repair. Objectives of this prospective experimental case series were to evaluate the dimensions and shape of the rectum and the volume, location, and other features (enhancement pattern, presence of cysts, and mineralizations) of the prostate of 66 dogs on CT before and 3 months after PH repair. The rectal cross-sectional areas were measured at intrapelvic and caudal locations, and the shape was categorized as straight, deviated, flexure, or caudal fold on dorsal images. According to paired samples t-tests, the caudal rectal dimensions were significantly larger (P < .001) than the intrapelvic dimensions both before and 3 months after PH repair, and according to linear mixed models, the intrapelvic dimensions increased significantly (P < .001) after repair. Before PH repair, the most common rectal shape was flexure (69.2%); after repair, the number of dogs having a straight rectum increased significantly (P < .001) according to the McNemar paired-samples proportion test. We were also able to show that rectal dimensions increased after PH repair despite straightening in most dogs. According to the linear mixed model, prostate ratio volume, and according to Wilcoxon signed ranks test, the number of prostates with intraprostatic cysts decreased significantly (both P < .001) after PH repair, but the proportion of prostates located in the caudal or perineal area did not. Small mineralizations remained in some dogs.


Assuntos
Cistos , Doenças do Cão , Masculino , Cães , Animais , Reto/diagnóstico por imagem , Reto/cirurgia , Próstata , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Cistos/veterinária , Hérnia/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia
7.
Biomacromolecules ; 25(2): 1214-1227, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38295271

RESUMO

Hernia surgery is a widely performed procedure, and the use of a polypropylene mesh is considered the standard approach. However, the mesh often leads to complications, including the development of scar tissue that wraps around the mesh and causes it to shrink. Consequently, there is a need to investigate the relationship between the mesh and scar formation as well as to develop a hernia mesh that can prevent fibrosis. In this study, three different commercial polypropylene hernia meshes were examined to explore the connection between the fabric structure and mechanical properties. In vitro dynamic culture was used to investigate the mechanism by which the mechanical properties of the mesh in a dynamic environment affect cell differentiation. Additionally, electrospinning was employed to create polycaprolactone spider-silk-like fiber mats to achieve mechanical energy dissipation in dynamic conditions. These fiber mats were then combined with the preferred hernia mesh. The results demonstrated that the composite mesh could reduce the activation of fibroblast mechanical signaling pathways and inhibit its differentiation into myofibroblasts in dynamic environments.


Assuntos
Polipropilenos , Aranhas , Animais , Polipropilenos/química , Cicatriz , Seda , Hérnia/prevenção & controle , Telas Cirúrgicas , Herniorrafia/métodos
8.
Biomacromolecules ; 25(2): 1180-1190, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38240673

RESUMO

In recent years, the utilization of medical devices has gradually increased and implantation procedures have become common treatments. However, patients are susceptible to the risk of implant infections. This study utilized chemical grafting to immobilize polyethylenimine (QPEI) and hyaluronic acid (HA) on the surface of the mesh to improve biocompatibility while being able to achieve antifouling antimicrobial effects. From the in vitro testing, PP-PDA-Q-HA exhibited a high antibacterial ratio of 93% against S. aureus, 93% against E. coli, and 85% against C. albicans. In addition, after five rounds of antimicrobial testing, the coating continued to exhibit excellent antimicrobial properties; PP-PDA-Q-HA also inhibits the formation of bacterial biofilms. In addition, PP-PDA-Q-HA has good hemocompatibility and cytocompatibility. In vivo studies in animal implantation infection models also demonstrated the excellent antimicrobial properties of PP-PDA-Q-HA. Our study provides a promising strategy for the development of antimicrobial surface medical materials with excellent biocompatibility.


Assuntos
Anti-Infecciosos , Incrustação Biológica , Animais , Humanos , Staphylococcus aureus , Escherichia coli , Antibacterianos/farmacologia , Antibacterianos/química , Biofilmes , Anti-Infecciosos/farmacologia , Hérnia , Materiais Revestidos Biocompatíveis/farmacologia , Materiais Revestidos Biocompatíveis/química , Propriedades de Superfície
9.
Biomater Adv ; 158: 213769, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38266333

RESUMO

The effectiveness of polypropylene (PP) mesh is often compromised by severe inflammation. Engineering anti-inflammatory coatings has significant implications for PP mesh to repair unwanted hernias. Here, we presented a facile strategy to develop an anti-fouling coating consisting of zwitterionic poly(carboxybetaine methacrylate) (PCBMA), which could prohibit protein adsorption to endow PP mesh with anti-inflammatory efficacy. The incorporation of PCBMA coating had little impact on the raw features of PP mesh. While the modified mesh PCBMA-PP possessed noticeable hydrophilicity increase and surface charge reduction. The excellent lubricity and surface stability enabled PCBMA-PP to exhibit superior anti-fouling capacity, thus efficiently inhibiting the adsorption of proteins. In vivo experiments showed that incorporating the PCBMA layer could provide PP meshes with outstanding anti-inflammatory effects and tissue compatibility for repairing hernias.


Assuntos
Herniorrafia , Polipropilenos , Humanos , Adsorção , Telas Cirúrgicas , Hérnia , Inflamação , Anti-Inflamatórios
10.
Am J Sports Med ; 52(3): 653-659, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38284216

RESUMO

BACKGROUND: In the event that nonoperative treatment for sports hernia fails, surgical repair may be warranted. Bilateral repair can occur in up to 45% of surgically treated patients. PURPOSE: To investigate the clinical outcomes of athletes who underwent unilateral sports hernia repair and determine the proportion of patients who required contralateral sports hernia repair. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We identified patients at our institution who underwent primary unilateral sports hernia repair (rectus abdominis-adductor longus aponeurotic plate repair and adductor lengthening) with a single surgeon between 2015 and 2020. We assessed patient-reported outcomes using the Hip Outcome Score-Sport (HOS-Sport), the Numeric Pain Rating Scale, and an internally developed return-to-play questionnaire. We further collected data regarding subsequent sports hernia procedures on the ipsilateral or contralateral side. We calculated summary statistics for outcomes and examined the association between preinjury patient characteristics and the HOS-Sport score at follow-up or successful return to preinjury sport using linear and logistic regression, respectively. RESULTS: A total of 104 of 128 (81.3%) eligible patients (mean age at surgery, 23.0 ± 6.2 years; 94.2% male; 51.9% American football athletes) completed follow-up at a mean time of 4.4 ± 1.5 years. Overall, 79.8% of athletes (n = 83) were able to return to their preinjury sport/activity, but 90.2% (83/92) who attempted to return were able to do so. When examining reasons for not returning to preinjury sport, only 9 patients reported not returning to preinjury sport because of limitations or persistent symptoms from their original injury. Only 4 patients underwent subsequent sports hernia procedures (3 contralateral, 1 ipsilateral revision) after their index unilateral sports hernia repair. At follow-up, the mean HOS-Sport score was high (94.0 ± 10.8), and the mean Numeric Pain Rating Scale score was low (0.31 ± 1.26). There were no preinjury patient characteristics associated with either the HOS-Sport score at follow-up or the successful return to preinjury sport. CONCLUSION: Patients with unilateral sports hernia symptoms can undergo repair and return to sport at the preinjury level with little concern for injuries to the contralateral groin. In our cohort, patient-reported hip function and pain outcomes at follow-up were excellent.


Assuntos
Futebol Americano , Herniorrafia , Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Feminino , Atletas , Hérnia , Dor
11.
Nihon Shokakibyo Gakkai Zasshi ; 121(1): 42-48, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-38220179

RESUMO

A 72-year-old woman was admitted to our department in March 2020 for an evaluation of nausea, vomiting, diarrhea, liver dysfunction, and hypokalemia, which had persisted intermittently since 2013. Thickening of the descending duodenal wall and a sac-like appearance the intestinal tract in the vicinity of the duodenal papilla were observed in abdominal computed tomography. No duodenojejunal curvature, with two intestinal loops identified in the descending region, was detected in contrast-enhanced upper gastrointestinal imaging. Based on these imaging findings, the patient was diagnosed with intestinal malrotation (incomplete rotation and fixation) accompanied by a right paraduodenal hernia based on the Nishijima classification. Thus, surgery was performed at our hospital. Gastrointestinal symptoms did not recur, and liver dysfunction and hypokalemia improved postoperatively.


Assuntos
Anormalidades do Sistema Digestório , Duodenopatias , Hipopotassemia , Volvo Intestinal , Hepatopatias , Idoso , Feminino , Humanos , Duodenopatias/complicações , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Duodeno , Hérnia/complicações , Hipopotassemia/complicações , Hepatopatias/complicações , Hérnia Paraduodenal/complicações
12.
J Trauma Acute Care Surg ; 96(1): 129-136, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37335920

RESUMO

BACKGROUND: Acute incisional hernia incarceration is associated with high morbidity and mortality yet there is little evidence to guide which patients will benefit most from prophylactic repair. We explored baseline computed tomography (CT) characteristics associated with incarceration. METHODS: A case-control study design was utilized to explore adults (≥18 years) diagnosed with an incisional hernia between 2010 and 2017 at a single institution with a 1-year minimum follow-up. Computed tomography imaging at the time of initial hernia diagnosis was examined. Following propensity score matching for baseline characteristics, multivariable logistic regression was performed to identify independent predictors associated with acute incarceration. RESULTS: A total of 532 patients (27.26% male, mean 61.55 years) were examined, of whom 238 experienced an acute incarceration. Between two well-matched cohorts with and without incarceration, the presence of small bowel in the hernia sac (odds ratio [OR], 7.50; 95% confidence interval [CI], 3.35-16.38), increasing sac height (OR, 1.34; 95% CI, 1.10-1.64), more acute hernia angle (OR, 0.98 per degree; 95% CI, 0.97-0.99), decreased fascial defect width (OR, 0.68; 95% CI, 0.58-0.81), and greater outer abdominal fat (OR, 1.28; 95% CI, 1.02-1.60) were associated with acute incarceration. Using threshold analysis, a hernia angle of <91 degrees and a sac height of >3.25 cm were associated with increased incarceration risk. CONCLUSION: Computed tomography features present at the time of hernia diagnosis provide insight into later acute incarceration risk. Improved understanding of acute incisional hernia incarceration can guide selection for prophylactic repair and thereby may mitigate the excess morbidity associated with incarceration. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level III.


Assuntos
Hérnia Ventral , Hérnia Incisional , Adulto , Humanos , Masculino , Feminino , Hérnia Incisional/diagnóstico por imagem , Hérnia Incisional/cirurgia , Estudos de Casos e Controles , Hérnia , Tomografia Computadorizada por Raios X/métodos , Hérnia Ventral/cirurgia , Herniorrafia
13.
Cranio ; 42(1): 90-93, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37325909

RESUMO

BACKGROUND: Herniation of the temporomandibular joint (TMJ) into the external auditory canal (EAC) due to a bony defect in the EAC is rare. Such bony defects can be secondary to inflammation, neoplasm, trauma. In rare instances, TMJ herniation can occur when the Huschke foramen is constantly exposed. TMJ herniation can induce clicking tinnitus, otalgia, conductive hearing loss, and otorrhea, but can also present with no symptoms. This study reports a case of TMJ herniation. CLINICAL PRESENTATION: A male patient presented with clicking tinnitus that had developed 3 years ago. Dome-shaped soft tissue was found on the anterior EAC wall, which protruded and depressed with mouth movement. The patient underwent surgical reconstruction of the bony defect with titanium mesh, and the symptoms resolved after surgery. CONCLUSION: This case highlights the importance of surgical reconstruction of a bony defect in the EAC using appropriate materials.


Assuntos
Transtornos da Articulação Temporomandibular , Zumbido , Humanos , Masculino , Meato Acústico Externo/cirurgia , Zumbido/etiologia , Zumbido/cirurgia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Tomografia Computadorizada por Raios X , Articulação Temporomandibular , Hérnia/complicações , Hérnia/diagnóstico por imagem
15.
Pediatr Transplant ; 28(1): e14656, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37984827

RESUMO

BACKGROUND: Lung herniation is a rare complication of heart-lung transplantation that can be fatal owing to vascular compromise and airway obstruction. To date, only five cases of lung herniation related to heart-lung transplantation have been reported in the literature; however, to the best of our knowledge, this is the first worldwide report of heart-lung transplantation-related lung herniation in an infant. METHODS: We describe the case of lung herniation as a rare heart-lung transplantation-related complication in an infant. A 12-month-old female baby developed severe bronchopulmonary dysplasia with severe pulmonary hypertension, and she underwent extracorporeal membrane oxygenation for cardiac collapse and lung support. Then, we performed heart-lung transplantation to manage the irreversible deterioration of her lung function. After the heart-lung transplantation, we found the radiological abnormalities persisted on follow-up chest radiographs until the 13th postoperative day diagnosed as lung herniation of the right lower lobe on chest computed tomography. RESULTS: After the relocation of the herniated lung, the clinical condition of the patient improved, and the patient is currently growing without any respiratory symptoms. CONCLUSIONS: In this case report, we emphasize that clinical awareness and high suspicion of this rare complication are needed for early diagnosis and proper treatment to prevent post-transplantation morbidity and mortality related to potential ischemic injury.


Assuntos
Transplante de Coração-Pulmão , Hipertensão Pulmonar , Transplante de Pulmão , Lactente , Recém-Nascido , Humanos , Feminino , Pulmão/diagnóstico por imagem , Hérnia/diagnóstico , Hérnia/etiologia , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/etiologia , Transplante de Pulmão/efeitos adversos
16.
Abdom Radiol (NY) ; 49(1): 249-257, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37979005

RESUMO

PURPOSE: Sigmoidocele, which is a type of obstructed defecation syndrome (ODS), is a peritoneal hernia of the pelvic floor that has been seldom studied individually. This study investigated the anatomic characteristics of sigmoidocele based on imaging features. METHODS: This retrospective cohort population comprised adult patients with ODS who underwent defecography between December 2017 and July 2020. Sigmoidocele was classified based on existing criteria. Novel radiological parameters including the vertical distance descended by the sigmoid colon from rest to maximum straining (RMS) and from the inferior border of the sigmoid colon to the superior border of the rectum at maximum straining (MSR) were measured. RESULTS: Among 275 patients with sigmoidocele, 251 (91.6%) were female. The mean age was 51.53±12.99 years. We classified 26, 205, and 44 cases as grades I, II, and III, respectively. Patients with more severe sigmoidocele had greater sigmoid colon mobility (RMS: 19.13±8.54 mm, 34.45±14.51 mm, and 48.70±20.05 mm for grades I, II, and III, respectively; p < 0.001) and more pronounced compression of the rectum by the sigmoid colon at maximum straining (MSR: 35.23±8.44 mm, 26.33±13.29 mm, and 15.18±18.00 mm, respectively; p < 0.001). We regrouped the patients based on sigmoid colon alignment. Type L patients had the most severe constipation. CONCLUSION: Our study presents a novel sigmoidocele classification. The anatomic appearance and location of the herniated sigmoid colon observed using fluoroscopy during defecation may help improve the clinical awareness of ODS caused by sigmoidocele.


Assuntos
Defecação , Defecografia , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Defecografia/métodos , Constipação Intestinal/complicações , Constipação Intestinal/diagnóstico por imagem , Hérnia/complicações , Hérnia/diagnóstico por imagem , Síndrome
17.
Surg Endosc ; 38(1): 443-448, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38010410

RESUMO

INTRODUCTION: Paraduodenal hernias (PDH) are rare congenital internal hernias with non- specific symptoms. Left-sided paraduodenal hernia is three times more common than right-sided paraduodenal hernia with similar clinical presentation but different embryological origins. MATERIALS AND METHODS: We report a series of eight cases of paraduodenal hernia who presented with varied clinical presentation ranging from vague abdominal pain to complete intestinal obstruction. Six cases had left-sided paraduodenal hernia, while two cases had right-sided paraduodenal hernia. RESULTS: Seven cases based on their presentation underwent surgery either electively or on emergent basis. Three cases underwent laparoscopic repair. One case had a recurrence and was re-operated four months later. There was no mortality among any of the cases. CONCLUSION: A pre-operative diagnosis of paraduodenal hernia is essential. Laparoscopic surgery is safe in select cases and is found to be beneficial.


Assuntos
Duodenopatias , Obstrução Intestinal , Humanos , Herniorrafia , Hérnia Paraduodenal/cirurgia , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Duodenopatias/congênito , Hérnia/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia
18.
Hernia ; 28(1): 3-7, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37597106

RESUMO

PURPOSE: Utilisation of remote clinics is increasing in healthcare settings worldwide. During the height of the COVID pandemic, our UK-based teaching hospital has trialled telephone assessment for new patients presenting with primary hernias. Selected cases are listed for elective repair of primary hernia direct from telephone clinic assessment. In March 2021, after this process had been in place for 13 months, departmental triage criteria were introduced, allocating patients to initial assessment in Face to Face or Telephone Clinics. Here, we evaluate the effectiveness of telephone assessment, with specific attention to 'Day of Surgery' cancellation. We also assess the effect of our triage criteria on rate of 'Day of Surgery' cancellation. METHODS: Departmental diaries were studied retrospectively to identify patients listed for hernia repair between February 2020 and February 2022. Data were obtained from clinic letters, discharge paperwork and operating lists, as well as from management teams. Fishers Exact test was used to compare groups seen either face to face or remotely as well and pre- and post-intervention. RESULTS: 325 patients were listed for hernia repair, 56 after telephone assessment. 6 (11%) of those listed from telephone clinic were cancelled on the day of surgery, compared with 34 (13%) of those seen face to face. With triage criteria in place, listing from telephone clinic increased significantly from 14 to 27%. Overall day of surgery cancellations reduced from 13 to 9%. Rate of day of surgery cancellation in those assessed in telephone clinic reduced from 12 to 9%. CONCLUSIONS: There is no significant difference between day of surgery cancellations after face to face or telephone clinic assessment. Triage criteria for telephone assessment appear to increase the numbers being listed after remote clinics. This did not significantly impact the number of day of surgery cancellations.


Assuntos
Procedimentos Cirúrgicos Eletivos , Herniorrafia , Humanos , Estudos Retrospectivos , Encaminhamento e Consulta , Telefone , Hérnia
19.
Int Urol Nephrol ; 56(2): 759-765, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37566322

RESUMO

BACKGROUND: Intraperitoneal pressure (IPP) in peritoneal dialysis (PD) is an individual characteristic that can be modified by posture and intraperitoneal volume (IPV). It is considered one of the predisposing factors for complications in the abdominal wall, such as the appearance of hernias. No studies to date have confirmed this. The main aim of this study was to assess the relationship between the development of hernia in incident PD patients and IPP measured at PD onset. METHODS: A prospective observational study of incident patients in a PD programme between 2010 and 2020. IPP was measured using the Durand's method. RESULTS: One hundred and twenty-four incident patients on PD, 68% male, mean age 62.1 ± 15.23 years, body mass index (BMI) 27.7 ± 4.82 kg/m2, 44% were diabetic. IPP in supine was 16.6 ± 4.60 cm H2O for a mean IPV of 2047.1 ± 359.19 mL. Hernias were reported in 18.5% of patients during PD follow-up: 57% were inguinal hernias, 33% umbilical, and a further 10% presented in a combined form. PD hernias correlated positively with IPP in supine position (p = 0.037), patient age (p = 0.008), BMI (p = 0.043), a history of prior hernia (0.016), laparoscopic catheter placement (p = 0.026), and technique failure (p = 0.012). In the multivariate analysis, a higher IPP was independently related to the development of hernias (p = 0.028). CONCLUSIONS: The development of hernias in PD was related to a higher IPP at PD onset, older age, higher BMI, history of prior hernia, catheter placement by laparoscopy, and technique failure.


Assuntos
Falência Renal Crônica , Laparoscopia , Diálise Peritoneal , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Massa Corporal , Hérnia , Falência Renal Crônica/terapia , Diálise Peritoneal/efeitos adversos , Diálise Peritoneal/métodos , Estudos Prospectivos
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