Multicentric observational cohort study evaluating a composite mesh with incorporated oxidized regenerated cellulose in laparoscopic ventral hernia repair.

BACKGROUND: A variety of newly developed mesh products have recently become available to use inside the peritoneal cavity. This analysis reports the first clinical data evaluating the experience with the use of Proceed mesh in laparoscopic ventral hernia repair. PATIENTS AND METHODS: During a 6-month period, 114 adult patients underwent a laparoscopic ventral hernia repair using an intra-abdominal placement of a Proceed mesh. The operative procedure was stratified for all centers. Perioperatively, different parameters were evaluated considering the conversion rate to open procedure, complications such as seroma and hematoma, bowel lesions, urinary retention, acute, and chronic pain, mesh infection, and recurrences. RESULTS: The mean age of the patients was 45 years (range 19-84 years). There were no conversions to open repair and no mortality. Complications included 12 seromas/hematomas (four aspirated), chronic discomfort in two patients, and urinary retention in one patient. There have been four recurrences (3.5%), occurring 3, 4, 4, and 15 months after surgery, respectively. The mean follow-up period was 27 months (range 12-38 months). There have been no documented infections of the mesh. CONCLUSIONS: This multicentric study documents a favorable experience using large-pore mesh in laparoscopic ventral hernia repair. There were no major complications related to the mesh. Technical advantages considering mesh handling and long-term advantages considering chronic pain might be of interest with the use of this lightweight mesh for minimally invasive ventral hernia repair.

[Current trends in the surgical treatment of chronic pancreatitis]. / Nieuwe trend in de heelkundige behandeling van chronische pancreatitis.

Since May 1980, we started treating patients suffering from chronic pancreatitis with pancreatic duct obstruction. During surgery, prolamine, a alcoholic amino-acid solution, was injected into the pancreas through the papil of Vater or directly into the pancreatic duct following pancreatic tail resection. So far thirteen patients were treated this way. Operative mortality was nil and complications were minimal. There were no clinical recurrences of pancreatitis after nearly two years of follow-up.

[Surgery in the octogenarian (introduction). Results of a national survey]. / Chirurgie de l'octogénaire (introduction). Résultats d'une enquête nationale.

Presentation of the results of a national, multicentric and retrospective study regarding the surgery of the octogenarian. The series counts 7,407 patients accepted for surgery, and which can be divided into 4,581 women (61.8%) and 2,826 men (38.2%) of an average age of 84.4 years old (extremities 80-101 years old). The global mortality of this population of elderly (whether operated on or not) amounts to 16.7%. The postoperative mortality of the 4,177 operated patients is 18.2% with different rates according to the surgical disciplines: 34.7% for surgery of the colon, 23.2% for bone surgery, 22.4% for vascular surgery, 15.3% for biliary surgery, 8.7% for urologic surgery and 5.6% for cardiac surgery.

[Surgical therapy of uremic pericarditis (author's transl)]. / Heelkundige behandeling van uremische pericarditis.

During a five year period (January 1975 - September 1980) 33 patients, in a population of 262 chronic hemodialysis patients, were treated for uremic pericarditis. They all underwent a pericardiostomy either through a lateral (15 cases) or through a subxiphoid approach (18 cases). Immediate clinical relief occurred in all but one patient who showed a progressive cardiac failure even after drainage. Operative mortality was absent and complications were minimal. There were two recurrences of pericardial effusion after an initial lateral approach through thoracotomy. A subsequent partial pericardectomy was successful in both cases.

[Surgical therapy of pheochromocytoma (author's transl)]. / Heelkundige behandling van het feochromocytoom.

Between 1958-1978 a total of 19 patients, 11 men and 8 women, were treated for pheochromocytoma. Their age varied between 9 and 67 years (overage 39 years). In all cases with unilateral tumor located in the adrenal gland a lateral approach was preferred. When not certain of the tumor location or when presumed outside the adrenals a laparotomy was deemed necessary. Fourteen thoraco-abdominal lateral approaches and 5 laparotomies were performed. Due to minimal manipulation, especially with the lateral approach, peroperatory hypertensive crises could be reduced to a minimum. Sofar no recurrence has been seen. There was no operative mortality.

Transthoracic vagotomy for recurrent peptic ulcer after gastrectomy. An appraisal of fifteen years experience.

The case records of 38 patients operated for recurrent ulcer following partial gastrectomy were examined. They all underwent a transthoracic vagotomy. Two patients died during follow-up, one because of a gastro-intestinal bleeding 14 days after operation and one following a psychiatric disorder (vital depression) three months after his second intervention. According to Visick's grading overall results are very good in 89%, moderate in 5.5% and disappointing in 5.5%. These figures indicate that transthoracic vagotomy is the treatment of choice for recurrent ulceration after partial gastrectomy.