Abstract:
PURPOSE:The goal of this study was to evaluate the efficacy, morbidity and safety of local parastomal hernia repair using biological mesh. PATIENTS AND METHODS:A retrospective analysis of a prospectively maintained database was performed for parastomal hernia repairs. All patients who underwent local parastomal hernia repair with biological mesh between July 2006 and July 2015 were included in the study. Non-local (laparoscopic or midline incision) procedures were excluded. The type of repair, incision used, mesh placement and morbidity were analyzed. Time to recurrence was measured as an independent variable. RESULTS:58 procedures with a median follow up of 3.8 years were analyzed. The majority (91%) of repairs were performed on an elective basis. Underlay technique was used in 24 patients (39%), overlay in 4 (7%) and both overlay and underlay (sandwich technique) in 33 (54%) of the cases. Overall, 11 patients (18.1%) experienced recurrence. Recurrence occurred in 8 patients in the underlay group (33%), 1 in the overlay group (25%), with 2 recurrences identified in the sandwich technique group (6%; p = 0.02). There was one occurrence of 30-day morbidity in our study population (0.016%). No difference was observed for recurrence or morbidity according to the type of biologic mesh used (human, bovine, or porcine). CONCLUSION:Our results demonstrate that local parastomal hernia repairs are associated with moderate recurrence rates, very low morbidity and consistent with the current literature. The sandwich technique was found to have a significantly lower recurrence rate compared to underlay or overlay techniques. Keyhole incisions were associated with less recurrence than traditional circular incisions. Our findings further reveal biologic mesh type was not associated with any difference in outcomes. Local parastomal hernia repair with biologic mesh is a safe procedure with very low morbidity and acceptable recurrence rate, especially using the sandwich repair technique.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hufford T,Tremblay JF,Mustafa Sheikh MT,Marecik S,Park J,Zamfirova I,Kochar Kdoi
10.1016/j.amjsurg.2017.05.005subject
Has Abstractpub_date
2018-01-01 00:00:00pages
88-90issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(17)30690-6journal_volume
215pub_type
杂志文章abstract::Six patients with intestinal obstruction secondary to benign adhesions so dense and vascular that the operating surgeon could not free them, were placed on a home total parenteral nutrition program. Four patients had enterocutaneous fistulas, and two had their bowels divided and stomas created to divert intestinal con...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90331-8
更新日期:1983-12-01 00:00:00
abstract:BACKGROUND:Patients with diverticulitis have a 20% risk of requiring urgent/emergent treatment. Since morbidity and mortality rates differ between elective and urgent/emergent care, understanding associated disparities is critical. We compared factors associated with treatment setting for diverticulitis and evaluated d...
journal_title:American journal of surgery
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journal_title:American journal of surgery
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更新日期:1978-04-01 00:00:00
abstract::The results achieved by liver resection for metastatic cancer in more than 400 patients have been studied in a collected review. Certain conclusions seem justified: The liver is no longer the surgeon's "no-man's-land," and local excision of metastatic tumor can achieve clinical cure in some patients. The risk-benefit ...
journal_title:American journal of surgery
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abstract:BACKGROUND:The purpose of this study was to determine the utility of breast-imaging studies in identifying cancer and high-risk lesions among patients with spontaneous, single-duct, nipple discharge (SSND). METHODS:The medical records of 168 cases with SSND treated with duct excision between June 1998 and May 2004 wer...
journal_title:American journal of surgery
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abstract::During a fourteen year period, diagnostic peritoneal lavage was 98.5 per cent accurate in determining the presence or absence of blunt intraabdominal injuries among 2,586 patients. Of these, 69.4 per cent had a negative lavage and 29.2 per cent a positive lavage. Six patients (0.2 per cent) had a false-positive lavage...
journal_title:American journal of surgery
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更新日期:1978-12-01 00:00:00
abstract::All carotid arteriograms performed between January 1, 1986 and December 31, 1991 were reviewed for instances of midcervical carotid stenosis. Sixteen cases were identified. A stenosis related to the hypoglossal nerve was specifically identified in three operative reports in the retrospective review. Pathologic examina...
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更新日期:1994-08-01 00:00:00
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journal_title:American journal of surgery
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更新日期:2001-12-01 00:00:00
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journal_title:American journal of surgery
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journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1977-10-01 00:00:00
abstract::The results of surgical treatment for chronic pancreatitis at our clinic and in the eight leading institutions of Japan were reviewed in a total of 328 cases. Abdominal pain disappeared or was alleviated in about 90 percent of the patients who survived more than 6 months after operation. There was no significant diffe...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1981-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.025
更新日期:2010-03-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Despite the development of several prediction rules to guide head CT imaging, determining whom to screen for head trauma in the geriatric population after a ground level fall remains controversial. The purpose of this study was to assess the impact of head CT on the management of older adult patients who pre...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.07.003
更新日期:2017-10-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90200-3
更新日期:1983-03-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-9610(01)00717-6
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:It is widely accepted that mastectomy and breast-conserving surgery (BCS) with irradiation yield similar results, yet many women continue to receive mastectomy. This study evaluates factors contributing to surgical decision-making in breast cancer. Registry data were obtained on all patients treated at the S...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.05.031
更新日期:2009-12-01 00:00:00
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abstract:BACKGROUND:Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. METHODS:The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 1...
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2013-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:1982-05-01 00:00:00
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journal_title:American journal of surgery
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更新日期:2016-07-01 00:00:00
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journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1992-01-01 00:00:00
abstract::A total of ninety three patients with biliary tract disease were studied to determine the concentration of the pancreatic enzymes, amylase and lipase, in bile obtained from the gallbladder and/or common bile duct. Of seventy gallbladder bile samples, amylase levels were higher than actual or predicted serum levels in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90055-2
更新日期:1979-03-01 00:00:00
abstract::A phase I clinical trial of immunotherapy with "Immune" RNA was undertaken fifteen months ago. Twenty-six cancer patients were treated with RNA extracted from the lymphoid organs of sheep immunized with either autologous tumor cells or allogeneic tumor cells of the same histologic type. Eighteen patients had gross dis...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90360-3
更新日期:1976-11-01 00:00:00
abstract::A prospective clinical trial was designed to evaluate the efficacy of postoperative jejunostomy feedings using high (44 percent) and low (15 percent) branched-chain amino acid elemental diet formulations compared with no jejunostomy feedings in a homogeneous surgical population. Twenty-eight patients undergoing radica...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:Virtual reality simulators provide an effective learning environment and are widely used. This study evaluated the Endoscopic Sinus Surgery Simulator (ES3; Lockheed Martin) as a tool for anatomic education. METHODS:Two medical student groups (experimental, n = 8; control, n = 7) studied paranasal sinus anat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.06.026
更新日期:2008-07-01 00:00:00
abstract::The experience with gastrointestinal cancer at a single large hospital has been utilized as a "micro-model" of the experience for the country at large, and the reasons why such a comparison might be possible have been presented. The incidence of various lesions has been discussed in terms of sex, age, and race. The ch...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90002-8
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00647-x
更新日期:2001-07-01 00:00:00