Abstract:
:Hernia repair is one of the most common surgical procedures performed in the United States, with 700,000 operations performed each year. Improvements in surgical technique, together with the development of new prosthetic materials and a better understanding of how to use them, have significantly improved outcomes for many patients. These improvements have occurred most notably in centers specializing in hernia surgery, with some institutions reporting failure rates of less than 1%. In contrast, failure rates for general surgeons, who perform most hernia repairs, remain significantly higher. This has important socioeconomic implications, adding an estimated $28 billion or more to the cost of treating the condition, based on calculations utilizing conservative estimates of failure rates and the average cost of a hernia repair. Success of groin hernia repair is measured primarily by the permanence of the operation, fewest complications, minimal costs, and earliest return to normal activities. This success depends largely on the surgeon's understanding of the anatomy and physiology of the surgical area as well as a knowledge of how to use most effectively the currently available techniques and materials. The most important advance in hernia surgery has been the development of tension-free repairs. In 1958, Usher described a hernia repair using Marlex mesh. The benefit of that repair he described as being "tension-eliminating" or what we now call "tension-free". Usher opened the posterior wall and sutured a swatch of Marlex mesh to the undersurface of the medial margin of the defect and to the shelving edge of the inguinal ligament. He created tails from the mesh that encircled the spermatic cord and secured them to the inguinal ligament. Every type of tension-free repair requires a mesh, whether it is done through an open anterior, open posterior, or laparoscopic route. The most common prosthetic open repairs done today are the Lichtenstein onlay patch repair, the PerFix plug and patch repair, the Prolene Hernia System bilayer patch repair and Trabucco's sutureless preshaped herniography. General surgeons today have access to a wider and more sophisticated range of synthetic biomaterials for use in hernia repair than ever before. The advantages and disadvantages of each of these devices must be understood, however, before surgeons select any of these implants. Meanwhile, a 1997 study of various biomaterials used in abdominal wall hernia repair further reported that the risk of infection, seroma formation, biomaterial-related intestinal obstructions, and other complications can be minimized or eliminated by understanding the process underlying these problems and taking proper precautions. The surgeon's choice of the prosthesis used in hernia repair is based on a combination of factors, including patient characteristics; clinical experience, training, interest, and skill; understanding of the range of products available and the clinical studies that may have been performed on each; and the surgeon's familiarity with a particular product and/or surgical approach. Innovations in technique and product design will no doubt continue to spur advances in hernia repair, and it is hoped that they will continue to improve outcomes. The availability of these outcomes data, along with the ongoing accumulation of clinical experience with a broad range of materials and techniques, will help surgeons to better identify the most appropriate prosthesis for the clinician and the patient. It appears that herniology will remain in the realm of the surgeon, since it is doubtful that any medical measures will replace the operative treatment for abdominal wall hernias. Although operative procedures are not yet ideal, important advances have been made in herniorrhaphy resulting in improved outcomes: The use of local techniques has maximized the safety of anesthesia; time needed for care has been minimized, with most procedures now being done on an outpatient basis; and better instruments and prosthetic devices have dramatically improved patient outcomes. However, a greater appreciation for the vulnerability of the entire myopectineal orifice--and the secondary effects of localized mesh grafts--is necessary to avoid iatrogenically created recurrences. An increased awareness of these factors by both general surgeons and hernia specialists alike will improve results for all patients undergoing hernia surgery.
journal_name
Srp Arh Celok Lekjournal_title
Srpski arhiv za celokupno lekarstvoauthors
Milić DJ,Pejić MAdoi
10.2298/sarh0302082mkeywords:
subject
Has Abstractpub_date
2003-01-01 00:00:00pages
82-91issue
1-2eissn
0370-8179issn
2406-0895journal_volume
131pub_type
杂志文章,评审abstract::Nosocomial infections (NI) are infections acquired in hospitals. The aim of this paper is to describe the organization of NI control program in France. The organization of this program started in 1988 by the formation of the Infection Control Committees in hospitals. Their role has been to organize the surveillance of...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract:INTRODUCTION:Decrease of daily alertness is a common cause of accidents in the work place, especially traffic accidents. Therefore, an increasing interest exists to determine reliable indicators of a tendency to fall asleep involuntarily. OBJECTIVE:To determine an optimal electroencephalographic (EEG) indicator of an ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1004130s
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Currently, in our country (Republic of Serbia) tetanus is a rarely occurring disease, mainly affecting people older than 65 years of age. A small number of reported cases is mainly due to appropriate immunization. Therefore, each case of tetanus may be considered as failure of health care system to provide...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0908430a
更新日期:2009-07-01 00:00:00
abstract:INTRODUCTION:Psychiatric treatment in developed countries has significantly changed in the last few decades, with a significant shortening of the duration of hospitalization. Numerous West European countries are undertaking health system reforms to improve treatment efficiency. OBJECTIVE:The aim of the study was to pr...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:In Serbia, there have been no broad campaigns or educational programs focused on adolescents' sun protection. OBJECTIVE:The aim of the study was to assess whether an educational program would have impact on changes of attitudes and sun-protective behaviors of high school students. More specific aim was to...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,随机对照试验
doi:10.2298/sarh1406330m
更新日期:2014-05-01 00:00:00
abstract:INTRODUCTION:Diabetes mellitus as a complex metabolic disease influences functioning of numerous organs. Chronic periodontitis is one of frequent diabetic complications. OBJECTIVE:The aim of this study was to compare the clinical effects of non-surgical periodontal therapy between diabetes mellitus type 2 patients (DM...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1312738m
更新日期:2013-11-01 00:00:00
abstract::Pharmacotherapy of autoimmune thyroid disease (AITD) is complex. Apart from the replacement hormone therapy, antithyroid agents, beta adrenoceptor blockers and other drugs, in regard to the present symptoms, it also includes the administration of glucocorticoids and immunosuppressive agents. Physiological actions of g...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh05s1067g
更新日期:2005-10-01 00:00:00
abstract::Anatomic and physiological sphincters of the colon are localized narrowness of the colon with adequate name. These sphincters appear due to the thickening of longitudinal and circular muscle fibers in the wall of colon or due to the reflex irritation of the autonomous nervous system which innervates the colon. If they...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:INTRODUCTION:Antioxidant systems are important factors affecting the oxidation of lipoproteins and thereby the progression of atherosclerotic disease. It has been suggested that physical activity might maintain and promote the antioxidant defence capacity against the oxidative stress. Left ventricular dysfunction (LVDD...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0904146k
更新日期:2009-03-01 00:00:00
abstract::The authors present the epidemiological situation of venereal diseases (syphilis and gonorrhea) on the territory of Belgrade over the past twenty years with a detailed analysis of the past ten-year period. Constant decrease in morbidity rate was recorded in both diseases. The study showed that both diseases, expressed...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The management of idiopathic nephrotic syndrome (INS) in children includes immunosuppressive and symptomatic treatment. The response to corticosteroid therapy is the best prognostic marker of the disease. The majority of children with INS (about 85%) are steroid-sensitive as they normalize proteinuria within 4 weeks o...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh0410352p
更新日期:2004-09-01 00:00:00
abstract::Familial hypercholesterolaemia (FH) is an autosomal-dominant inherited disorder clinically characterized by high serum cholesterol (low-density lipoprotein--LDL-fraction) concentrations, xanthomas and premature atherosclerosis. Homozygous individuals suffer from vascular disease in childhood or young adolescence since...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:INTRODUCTION:In the last few years, an increasing number of patients suffering from terminal renal disease of various leading causes was treated with renal replacement therapy. Peritonaeal dialysis involves an exchange of water and solutes between blood in the peritonaeal capillaries and dialysate in the peritonaeal ca...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0512498j
更新日期:2005-11-01 00:00:00
abstract::Low-grade astrocytomas comprise a group of primary brain neoplasms with relatively low anaplastic potential, although through time they tend to behave more aggressively. They have a very heterogeneous natural course and clinical behavior. This report presents a natural history of a patient with low grade astrocytoma. ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0612537r
更新日期:2006-11-01 00:00:00
abstract::Our results of surgery of developmental disorder of the hip (DDH) in older children and adolescents by using the combination of Selter's innominate osteotomy and osteotomy of the superior pubis ramus were presented in this paper, enclosing the period from 1993 to 1995. The study included 11 hips, i.e. 9 patients, aged...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh04s1023b
更新日期:2004-10-01 00:00:00
abstract:INTRODUCTION:Treatment of carotid stenosis could be surgical: eversion endarterectomy, conventional endarterectomy and patch-plasty, resection with graft interposition and bypass procedure or, in the past few years, carotid artery angioplasty (PTA) with stent implantation. OBJECTIVE:The aim of this study is to present...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0810494c
更新日期:2008-09-01 00:00:00
abstract::Interest in measuring the quality of life (QL) in relation to health care has increased enormously in recent years. This is also true for end-stage renal failure where it is important not only to provide a better survival but also the quality of that survival. The aim of this study was to assess the relative influence...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::The celebration of the 80th anniversary of the foundation of the Serbian Medical Association as an important jubilee "for all cultural and social life of our country", "the importance of which" we many not be able to apprehend yet, "falls in times that show to us all the complexity of social and political situation in...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 历史文章,杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract:Introduction:Mucoepidermoid carcinoma, compared to other tumors of salivary glands, occurs in 5–10% of cases. Histopathologically, it is divided into a well differentiated tumor that is of low-grade of malignancy, and a medium and poorly differentiated tumor of high grade of malignancy. Central mucoepidermoid carcinoma...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2016-09-01 00:00:00
abstract:INTRODUCTION:The prevalence of obesity is rising to epidemic proportions at the alarming rate in both developed and underdeveloped countries around the world. Current prevalence data from individual national studies suggest that the obesity prevalence in the European countries ranges from 10% to 20% for men, and 10% to...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0702061g
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:Term breech presentation occurs in 3-4% of all deliveries. Most obstetricians are completely sure how to end delivery when the foetus is in breech presentation, by caesarean section as the only option. OBJECTIVE:The main goal of the paper was to present the method of delivery for term breech presentation ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1104155d
更新日期:2011-03-01 00:00:00
abstract:INTRODUCTION:Glucagonomas are rare, frequently malignant tumours, arising from the Langerhans' islets of the pancreas. They usually secrete large amounts of glucagon that can cause a characteristic "glucagonoma syndrome", which includes necrolytic migratory erythema, glucose intolerance or diabetes, weight loss and som...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1004244c
更新日期:2010-03-01 00:00:00
abstract::The bone disease in chronic renal failure patients with secondary hyperparathyroidism is usually termed renal osteodystrophy. Radiographic methods have been applied in renal bone disease mainly to discover lesions on long bones, hands and fee. During the evaluation of hormonal disturbances of hemodialysed chronic rena...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:INTRODUCTION:Alveolar adenoma belongs to the group of benign epithelial tumours. Histogenesis of alveolar adenoma is a combination of proliferation of alveolar pneumocytes and fibrous tissue originating from septal mesenchyma. CASE OUTLINE:A sixty-nine-year old female patient was hospitalizied for clinical examination...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0708461s
更新日期:2007-07-01 00:00:00
abstract:INTRODUCTION:An algorithm to study hand movements in patients with Parkinson's disease (PD) who experience temporary, involuntary inability to move a hand have been developed. In literature, this rather engimatic phenomenon has been described in gait, speech, handwriting and tapping, and noted as motor blocks (MB) or f...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0212376p
更新日期:2002-11-01 00:00:00
abstract::Search and disclosure of most adequate diagnostic criteria and prognostic indicators of disease represents one of the most difficult tasks in the understanding of any disease, which creates the way toward a more successful treatment and longer survival. The recent advances in research techniques that have helped refin...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh11s2095d
更新日期:2011-12-01 00:00:00
abstract::In 97 patients with different stages of chronic renal failure prolactin serum level was determined, and its diurnal rhythm and dependence on haemodialysis treatment were studied. Diurnal rhythm was investigated in 6 men and 6 women with advanced chronic renal failure on diet and other symptomatic treatment. A normal d...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract:INTRODUCTION:Predictable endodontic treatment depends on the dentist's knowledge about root canal morphology and its possible anatomic variations. The majority of mandibular canines have one root and root canal, but 15% may have two canals and a smaller number may have two distinct roots. The following clinical reports...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1410592s
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:Obstructive sleep apnoea (OSA) syndrome represents a significant medical problem due to numerous consequences that may follow it. OBJECTIVE:The aim of the study was to analyze morphology of the maxilla in children with mouth breathing, and to assess possible characteristics in persons with marked clinical...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1204159v
更新日期:2012-03-01 00:00:00
abstract:INTRODUCTION:Experience with lamivudine treatment for acute severe hepatitis B is limited. Fulminant hepatitis develops in 1% of immunocompetent patients with acute hepatitis B. OBJECTIVE:The aim of this study was to evaluate the efficacy of lamivudine in the treatment of severe acute hepatitis B (SAHB) in immunocompe...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1412703v
更新日期:2014-11-01 00:00:00