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- Ali, Fathalla, 1963-, et al.
(författare)
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Effect of the SARS-CoV-2 pandemic on planned and emergency hernia repair in Sweden : a register-based study
- 2023
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Ingår i: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; 27:5, s. 1103-1108
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The COVID-19 has had a profound impact on the health care delivery in Sweden, including deprioritization of benign surgeries during the COVID-19 pandemic. The aim of this study was to assess the effect of COVID-19 pandemic on emergency and planned hernia repair in Sweden.METHODS: Data on hernia repairs from January 2016 to December 2021 were retrieved from the Swedish Patient Register using procedural codes. Two groups were formed: COVID-19 group (January 2020-December 2021) and control group (January 2016-December 2019). Demographic data on mean age, gender, and type of hernia were collected.RESULTS: This study showed a weak negative correlation between the number of elective hernia repairs performed each month during the pandemic and the number of emergency repairs carried out during the following 3 months for inguinal hernia repair (p = 0.114) and incisional hernia repair (p = 0.193), whereas there was no correlation for femoral or umbilical hernia repairs.CONCLUSION: The COVID-19 pandemic had a great impact on planned hernia surgeries in Sweden, but our hypothesis that postponing planned repairs would increase the risk of emergency events was not supported.
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| 2. |
- Ali, Fathalla, 1963-, et al.
(författare)
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Laparoscopic ventral and incisional hernia repair using intraperitoneal onlay mesh with peritoneal bridging
- 2022
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Ingår i: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; 26:2, s. 635-646
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to assess the feasibility and safety of a novel IPOM procedure with peritoneal bridging (IPOM-pb) for laparoscopic ventral hernia repair, and to compare the outcomes of this procedure with IPOM with- (IPOM-plus) and IPOM without (sIPOM) defect closure.Method: A single-centre retrospective study comparing a novel IPOM technique with peritoneal bridging (IPOM-pb) with the two commonly used IPOM techniques, IPOM with defect closure (IPOM-plus) and without defect closure (sIPOM). The intraoperative and postoperative data of patients who underwent laparoscopic IPOM ventral hernia repair were reviewed. Preoperative data, recurrence, and postoperative seroma, surgical site infection, and pain, were compared.Results: From January 2017 to June 2020, a total of 213 patients underwent laparoscopic ventral and incisional hernia repair with IPOM technique. The mean length and width of the ventral hernia was 4.4 +/- 1.8 cm and 3.6 +/- 1.4 cm, respectively, and the mean BMI was 30.1 +/- 5.2 kg/m(2). The mean operating time was 67 +/- 28 min and was longer for IPOM-pb (71 +/- 27 min), less for IPOM-plus (63 +/- 28 min), and least for sIPOM (61 +/- 26 min). The incidence of early postoperative seroma was least in IPOM-pb (1/98, 1%), and similar in the IPOM-plus (4/94, 4%) and sIPOM (1/21, 5%) group. Late postoperative seroma was found only in IPOM-plus (2, 2%). The incidence of early and late postoperative pain was relatively higher in sIPOM (3, 14%; 1, 5%, respectively) compared to IPOM-pb and IPOM-plus in the early (5, 5% and 6, 6%) and late (2, 2% and 1, 1%) postoperative period, respectively. Surgical site infection was higher in sIPOM group (3, 14%), compared to IPOM-pb (1, 1%), and IPOM-plus (3, 3%). Recurrence rates were similar in IPOM-pb group (3/98, 3%) and IPOM-plus (3/94, 3%), and none in sIPOM (0/21).Conclusion: IPOM with peritoneal bridging is as feasible and safe as conventional IPOM with defect closure and simple non-defect closure. However, a large randomised controlled trial is required to confirm this finding.
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| 5. |
- Bringman, S, et al.
(författare)
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Hernia repair: the search for ideal meshes
- 2010
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Ingår i: Hernia : the journal of hernias and abdominal wall surgery. - : Springer Science and Business Media LLC. - 1248-9204. ; 14:1, s. 81-87
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Tidskriftsartikel (refereegranskat)
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| 6. |
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| 7. |
- Bringman, S., et al.
(författare)
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Location of recurrent groin hernias at TEP after Lichtenstein repair : a study based on the Swedish Hernia Register
- 2016
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Ingår i: Hernia. - : Springer Science and Business Media LLC. - 1265-4906 .- 1248-9204. ; 20:3, s. 387-391
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Tidskriftsartikel (refereegranskat)abstract
- To investigate which type of hernia that has the highest risk of a recurrence after a primary Lichtenstein repair. Male patients operated on with a Lichtenstein repair for a primary direct or indirect inguinal hernia and with a TEP for a later recurrence, with both operations recorded in the Swedish Hernia Register (SHR), were included in the study. The study period was 1994-2014. Under the study period, 130,037 male patients with a primary indirect or direct inguinal hernia were operated on with a Lichtenstein repair. A second operation in the SHR was registered in 2236 of these patients (reoperation rate 1.7 %). TEP was the chosen operation in 737 in this latter cohort. The most likely location for a recurrence was the same as the primary location. If the recurrences change location from the primary place, we recognized that direct hernias had a RR of 1.51 to having a recurrent indirect hernia compared to having a direct recurrence after an indirect primary hernia repair. Recurrent hernias after Lichtenstein are more common on the same location as the primary one, compared to changing the location.
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| 9. |
- Clay, Leonard, et al.
(författare)
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Full-thickness skin graft vs. synthetic mesh in the repair of giant incisional hernia : a randomized controlled multicenter study
- 2018
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Ingår i: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; :2, s. 325-332
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Repair of large incisional hernias includes the implantation of a synthetic mesh, but this may lead to pain, stiffness, infection and enterocutaneous fistulae. Autologous full-thickness skin graft as on-lay reinforcement has been tested in eight high-risk patients in a proof-of-concept study, with satisfactory results. In this multicenter randomized study, the use of skin graft was compared to synthetic mesh in giant ventral hernia repair.METHODS: Non-smoking patients with a ventral hernia > 10 cm wide were randomized to repair using an on-lay autologous full-thickness skin graft or a synthetic mesh. The primary endpoint was surgical site complications during the first 3 months. A secondary endpoint was patient comfort. Fifty-three patients were included. Clinical evaluation was performed at a 3-month follow-up appointment.RESULTS: There were fewer patients in the skin graft group reporting discomfort: 3 (13%) vs. 12 (43%) (p = 0.016). Skin graft patients had less pain and a better general improvement. No difference was seen regarding seroma; 13 (54%) vs. 13 (46%), or subcutaneous wound infection; 5 (20%) vs. 7 (25%). One recurrence appeared in each group. Three patients in the skin graft group and two in the synthetic mesh group were admitted to the intensive care unit.CONCLUSION: No difference was seen for the primary endpoint short-term surgical complication. Full-thickness skin graft appears to be a reliable material for ventral hernia repair producing no more complications than when using synthetic mesh. Patients repaired with a skin graft have less subjective abdominal wall symptoms.
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| 10. |
- Dalenbäck, Jan, 1957, et al.
(författare)
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Long-term follow-up after elective adult umbilical hernia repair: low recurrence rates also after non-mesh repairs.
- 2013
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Ingår i: Hernia : the journal of hernias and abdominal wall surgery. - : Springer Science and Business Media LLC. - 1248-9204. ; 17:4, s. 493-497
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to establish long-term outcome after elective adult umbilical hernia (AUH) repair. METHODS: Peri- and postoperative data considering all consecutive procedures at our institution during the time span from 1999 to 2009 were retrospectively gathered and followed by a questionnaire and, if needed, a clinical investigation in early 2011. RESULTS: A total of 162 patients (female/male 35%/65%) were operated, and 144/162 (89%) answers were gathered, mean follow-up time 70months; 77% were sutured, non-mesh repairs; 94% of all AUHs were smaller than 3cm; and 49% of the operations were performed under local anaesthesia. No perioperative complications were encountered. Five postoperative complications were encountered, two serious, both after mesh-based repairs. Wound infection rate (SSI) was low, 2/144 (1.4%). 7/144 (4.9%) recurrences were registered, none if mesh-based techniques were used, giving a recurrence rate of 6.3% in suture-based repairs, the difference, however, not statistically significant (p=0.141); 2% reported persistent pain at follow-up, 89% were overall satisfied with the outcome. CONCLUSIONS: AUH repair could be performed with low early and long-term complication rates, with low recurrence rates also after non-mesh repairs. A substantial cohort of patients will unnecessary be implanted with meshes if mesh-reinforced repairs should be used on a routine basis, that is, 16 surplus meshes to prevent one recurrence in the present study. We recommend a tailored approach to AUH repair: suture-based methods with defects smaller than 2cm and mesh-based repairs considered if larger than that.
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