bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of increasing proportion mixed vegetable wastes in combination with corn stover as a basal diet on intake, digestion, liveweight gain and income over feed cost of Bali bulls supplemented with rice bran
Authors: Sulendre I W , Marsetyo
Published: May 2024

A 12 weeks feeding trial was conducted to evaluate the effect of increasing proportion of mixed vegetable wastes (MVW) in combination with corn stover (CS) as basal diet on dry matter feed intake (DMI), dry matter digestibility (DMD), average daily gain (ADG) and income feed cost (IOFC) of Bali bulls supplemented with rice bran. Twenty four Bali bulls (159.29 kg) were allocated to 4 dietary treatments, in a completely randomized block design. Each dietary treatment was repeated 6 times. The dietary treatment include CS:MVW (100:0), (80:20), (60:40), (40:60), that was offered ad libitum. Rice bran was added to all treatment at the level of 0.5% of bull weight per day. Increasing proportion of MVW in combination with CS ad libitum resulted in a significant increase (P<0.05) in DMI, DMD, ADG and IOFC of Bali bull supplemented with RB. Bali bulls received CS:MVW (100:0) ad libitum had the lowest total DMI,DMD, ADG and IOFC value, while at the similar parameters, Bali bulls treated with CS:MVW (40:60) ad libitum, showed the highest: It was concluded that MVW can be included as a basal diet up to 60% with high profitability for Bali cattle.
Effects of probiotic on growth and production of brown midrib sorghum mutant line (Sorghum bicolor L. Moench) in ultisol
Authors: Sriagtula R , Aini Q , Mardhiyetti  , Yanti G
Published: May 2024

This study aims to observe the efficiency of probiotic inoculants on growth, soil fertility, and production of brown midrib (BMR) sorghum mutant lines. The experimental using a Randomized Block Design of four treatments and four blocks, P0: manure + (N, K, 0% P) + probiotic; P1: manure + (N, K, 50% P) + probiotic; P2: manure + (N, K, 75% P) + probiotic; P3: manure + (N, K, 100% P) without a probiotic (control). The dose of cow manure fertilizer is 10 tons/ha, and the doses of N, P, and K fertilizers are 120 kg/ha, 90 kg/ha, and 60 kg/ha, respectively, from urea, triple superphosphate (TSP), and potassium chloride (KCl). Parameters observed were plant morphology, biomass production, nutrient and fiber fraction content, and soil fertility. The treatment had no significant effect (P>0.05) on stem diameter, leaf length, and width, soil pH, fresh and DM production, the number of leaves, plant height, stem:leaf: panicle ratio, colony PSB, soil P-available, fiber and nutrient fractions of sorghum whole plant. The conclusion is that applying probiotics with lower phosphate fertilizer in sorghum cultivation produces growth, forage production, nutrition and fiber fraction content, and P-available and colony PSB, like 100% P fertilizer application. Probiotic bacteria could be applied as phosphate-solubilizing bacteria and reduce the application of P fertilizer on BMR sorghum in ultisol.
The utilization of High-Quality Feed Supplement (HQFS) in the complete feed on blood metabolites, hormone profiles, and reproductive performances of thin-tailed ewes
Authors: Rahmawati  , Bintara S , Yusiati LM , Agus A
Published: May 2024

High-Quality Feed Supplement (HQFS) is a feed supplement containing high energy, protein, minerals, and vitamins important for sheep reproduction. This study aimed to evaluate the utilization of HQFS in the complete of adult ewes using dried ipomea aquatica straw (DIAS). Fifteen Thin-Tailed Ewes aged two to three years with an average body weight of 32 ± 3.2 kg were divided into three treatment groups, with five ewes per treatment. All ewes received DIAS and concentrate. The concentrate comprised soybean meal, corn meal, pollard, and copra meal, having TDN 70% and crude protein 17%. Treatment (T1) as the control group, ewes received 0% HQFS + 60% concentrate + 40% DIAS, T2: ewes received 10% HQFS + 50% concentrate + 40% DIAS, while T3: ewes received 20% HQFS + 40% concentrate + 40% DIAS. Ewe was kept in individual pens of 1 x 2 meters. Feed was given 4% of body weight/day and drinking water was given ad libitum. The treatment feed was for three months, following which blood samples, synchronization, and mating. The parameters of blood metabolites (glucose, urea, protein, cholesterol), profiles of estrogen and progesterone, oestrus characteristics (onset, intensity, duration), pregnancy rate, and service/conception (S/C) were studied. Both treatment groups (T2, T3) have significantly lower S/C (1.25 vs. 1,00) and pregnancy rates (80 vs. 100%) compared to the control. Glucose and protein blood did not differ among the treatments, but cholesterol was highest in T2, while urea was lowest in T3. Substituting 10% HQFS significantly (P<0.05) increased estrogen (20.21 vs. 22.93 pg/ml) and progesterone (4.49 vs. 7.98 ng/ml) levels during the oestrus phase compared to the control. Utilization of HQFS significantly (P<0.05) accelerated the onset of oestrus compared to the control (22 vs.28 hours and 23 vs. 28 hours), but it might not yet improve the reproductive performances of Thin-Tail Ewes.
Productivity of two species of tree legume as sources forage on post-tin mining in Bangka island
Authors: Sajimin  , Harmini  , Fanindi A , Sutedi E , Herdiawan I
Published: May 2024

Legume tree One of the crops that may function as a viable source of animal feed and be utilized for land reclamation on former mining sites. Ex-tin mining land, which is widely spread in Indonesia, has the potential to transform to productive agricultural land, as long as the land is given sufficient inputs through land rehabilitation. The legume tree has drought resistance, hence limiting its potential for development on many types of land, including post-tin mining areas in the Bangka Tengah District of Bangka Island. The objective of this research is to assess the adaptation of two legume tree species in post-tin mining environments. The research was completed throughout the period from 2017 to 2020. Experiments using Randomized block design (RBD) with two different species of treatments, were repeated a total of five times. Two species tested were (1)Leucaena leucocephalacv Taramba, and (2)Indigofera zollingeriana. Data growth and yield components are harvested every three months and yield is subjected to analysis using the Duncan test at a significance level of 5 %. The research result indicated that all of the tested two species of legume tree were well-adapted to post-tin mining in Bangka Tengah District, Bangka Island. The fresh yield ofL.leucocephalacv Taramba was higher (9.1 %) thanI.zollingerianabut the quality was similar, so the two species can be developed on post-tin mining areas as forage material for an animal in Central Bangka District, Bangka Island.
Response of Digestive Tract Size In Indonesian Native Chickens Fed Indigofera sp.
Authors: Dharmawan R , Parwati IA , Reza ZF , Suyasa IN , Atmoko BA
Published: May 2024

The development of Balitbangtan native chicken through tractic feed is continually being advocated by the Indonesian government to enhance poultry protein consumption. Indigofera sp. is known for its flavonoid, tannin, and saponin content, which act as antimicrobial and anti-inflammatory agents for chicken digestive tract. The study aimed to investigate the response of Balitbangtan chicken’s digestive tract size substituted with Indigofera sp. A total of 40 chickens were used in four treatments with five replications. The four treatments were T0 (25% concentrate + 35% rice bran + 40% maize); T1 (T0 with substitution of concentrate with 10% Indigofera sp. meal); T2 (T1 + 2cc/l Bio-B); and T3 (22% concentrate + 31.5% rice bran + 10% Indigofera sp. meal + 36.5% maize). The collection of digestive tracts was measured by unit/100g. Data were analyzed using ANOVA by SPSS 26. Overall, the treatments did not differ significouldtly in digestive tract size (p>0.05). Treatment T1 showed great size of crop, proventriculus, duodenum, jejunum, cecum, colon, and pancreas sizes compared to T0, T2, and T3. In conclusion, the substitution of 10% Indigofera sp. meal in T1 resulted the best response in Balitbangtan chicken’s digestive tract size.
Effect oral administration of saviotan feed on body temperature, HDL, LDL and total protein in Ulu chicks
Authors: Erwan E , Fitra D , Irawati E , Loh T C
Published: May 2024

Currently, the using of tannins as secondary metabolites and active compounds is rising in animal production. The functions of tannins especially extracted from chestnut wood, namely Saviotan Feed (SF) in poultry, especially in Ulu chickens, have not yet been fully determined. The aim of this study was to determine the effect of orally administered SF on some plasma metabolites, including body temperature, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total protein (TP) concentration. In the study, 40 unsexed Ulu chicks aged 7 days were divided into four groups with different doses orally administered of SF (0%, 0.1%, 0.2%, and 0.3%). The body temperature of the chick was measured at 30, 60, and 120 min. At 120 min after oral administration, the blood samples were collected through the jugular vein, then centrifuges, and then plasma metabolites were analyzed. The results showed that no significant effect of SF on body temperature, LDL, and TP. However, it has a significant effect in increasing HDL concentration, especially SF at low levels. In conclusion, oral administration of SF increased HDL concentration, which is good for supporting health.
Marketing analysis and price transmission elasticity of beef cattle at Batang Kapas District, Pesisir Selatan Regency
Authors: Suresti A , Wati R , Sari T G
Published: May 2024

This study aims to determine the marketing channels and institutions, marketing functions, marketing margins, elasticity of price transmission and marketing efficiency of Pesisir cattle in Batang Kapas District. This research was conducted using the survey method. The data collected were primary and secondary data. Respondents were 60 farmers and 8 cattle traders. Data analysis used was descriptive qualitative and quantitative analysis. The results showed that there were three types of marketing channels in Batang Kapas Sub-district, South Pesisir Regency, consisting of: (1) farmers – collectors – wholesalers – consumers, (2) farmers – wholesalers – consumers, (3) farmers – collectors – consumers. The marketing functions carried out by collectors and wholesalers are almost the same, namely the exchange function includes buying and selling, the physical function includes transportation and storage, the facility function includes risk management, financing and market information, but wholesalers do not carry out the risk management sub-function. The marketing channel with the highest marketing margin is channel I at IDR 2,375,000/cattle. The price transmission elasticity of Pesisir cattle is 0.97. The smallest efficiency value is channel II at 2.54% and marketing channel I at 3.67% and channel III at 2.94%. Based on these results, it can be stated that the most efficient marketing channel is channel II.
Causes of panic selling in broiler farms in Malang raya
Authors: Sutanto A , Sahara H , Prihartini I , Widodo W , Rahayu I D , Sutawi
Published: May 2024

Broiler farmers in Malang Raya are not only faced with chicken performance targets that must be achieved. However, farmers are more faced with the powerlessness to determine prices and unpredictable market conditions. It was found that many intermediary traders were speculating to reduce the price of chicken at the farmer level, especially during a pandemic. Farmers experience panic selling by choosing to sell chickens below the Cost of Production (HPP) rather than delaying the harvest schedule. The imbalance between the production price and the sales price causes the farmers to suffer losses. An analysis of the factors causing panic selling was carried out to find out the root of the problem in order to create a solution for chicken price stability at the farmer level. This study used a descriptive research design through filling out questionnaires by 30 respondents. Data analysis used quantitative descriptive and Partial Least Square (PLS-SEM). The results showed that the factors causing panic selling in broiler farms in Malang Raya were internal factors (38.9%), demography (29.9%), the Covid-19 pandemic (15.3%) and external factors (0.6%). External factors were confirmed to significantly strengthen the influence of the Covid-19 pandemic on panic selling with a p-value of 0.035 and a path coefficient of 29.6%. In addition, internal factors were confirmed to significantly strengthen the influence of demography on panic selling with a p-value of 0.083 and a path coefficient of 23.2%. The biggest cause of panic selling is internal factor so that the selection of sapronak used and maintenance management determines the mortality rate of the chickens and the performance of the chickens produced. Because both of them determine the income earned by farmers as a motivation to remain wise in raising livestock.
In vivo study: The effects of Carica pubescens seed extract on the anthelmintic activity, feed digestibility, performance, and clinical parameters of thin-tailed sheep
Authors: Baihaqi Z A , Sofyan A , Suwignyo B , Angeles A A , Widiyono I , Nurcahyo W , Ibrahim A , Putri E M , Wulandari
Published: May 2024

This research serves to follow up on the results of an in vivo study of the administration of aqueous seed extract (ASE) of Carica pubescens waste on the performance and health parameters of thin-tailed sheep. This research was conducted at Al Baihaqi farm in Kediri, East Java. Thirty-two thin-tailed sheep aged 12 months were randomly given four treatments with P0 = negative control, P1 = 2.5% ASE, P2 = 5% ASE, and P4 = positive control (Albendazole). This study used sheep that were naturally exposed to Haemonchus contortus (from the farmer’s field) with the epg qualification being above 1000. The in vivo study was carried out for 9 weeks with the administration of Carica seed extract on the initial 7 days in a row, and the positive control was given Albendazole once on the seventh day. The number of ASE grants was based on the average fluid in the abomasum per kg of body weight. The feed design used in this study was wheat bran and Pennisetum purpureum cv. Mott according to the livestock’s needs. The data taken in this study were the feed consumption, digestibility, average daily gain, percent fecal egg count reduction, body condition score, and clinical parameters. The results showed that the FECR, ADG, and clinical parameters (AST and ALT) (P>0.05) underwent significant changes to support good performance while the BUN, creatinine, feed consumption, and digestibility were normal. This study indicates that ASE of up to 5% can be used as an anthelmintic alternative and support the recovery of sheep performance.
Agro-technology for climate-smart agriculture and resilience to climate extremes in sub-Saharan Africa
Authors: Arenas-Calle Laura , Jennings Stewart , Challinor Andrew
Published: May 2024

Agro-technologies such as irrigation and new crop varieties can reduce climate risk for agricultural production in sub-Sahara Africa (SSA). SSA has the highest maize yield gaps globally, despite its importance as a staple crop in the region. Reducing maize yield gaps is key to tackling food insecurity; however, closing yield gaps might imply an increased greenhouse gas (GHG) emission cost. Climate smart agriculture (CSA) seeks to minimise this cost whilst maximising productivity and resilience. One key element of CSA is resilience to extreme events, although this is rarely examined. Accordingly, we assess the climate smartness of contrasting agro-technology and climate scenarios to assess both resilience to extremes and the overall climate smartness of the scenarios. We use simulations from an existing integrated modelling framework for Malawi, Tanzania, and Zambia, centred on 2050. Four scenarios were examined, defined by combinations of high vs. low agro-technology adoption and high vs. low climate risk (RCP2.6 and RCP8.5). We calculated a climate smartness index (CSI) to the model outputs that quantify the trade-offs between greenhouse gas emissions and agricultural productivity. CSI scores showed that the increase in GHG emissions from improved agro-technology is compensated for the yield benefits. Agro-technology in SSA can therefore benefit the pillars of climate-smart agriculture, namely increased mitigation, adaptation, and productivity. Further, we show that improved maize varieties and irrigation can substantially reduce future yield shocks and enhance resilience to climate change extremes in SSA, pointing to best-bets for agro-technology adoption. Irrigation reduces mid-century yield shocks by 64% (RCP2.6) or 42% (RCP8.5). When combined with improved maize varieties, irrigation removes the majority of yield shocks (90%) in RCP8.5. We therefore conclude that: (i) irrigation has significant potential to increase resilience in SSA; and (ii) investment in strategies to improve crop varieties is critical if the benefits or irrigation are to be fully realized under an RCP8.5 future.
Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia
Authors: Santos Lauren G , Kenney Lauren E , Ray Alyssa , Paredes Alfredo , Ratajska Adrianna M , Eversole Kara , Patel Bhavana , Rawls Ashley E , Okun Michael S , Bowers Dawn
Published: May 2024

Objective

Cognitive changes are heterogeneous in Parkinson’s disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.

Method

A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants’ medications were scored (0–3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS’ relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.

Results

Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.

Conclusions

Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia.
AMBULATORY TAPP VERSUS TEP FOR GROIN HERNIA IN WOMEN: A RANDOMIZED CLINICAL TRIAL
Authors: Martínez-Núñez S , Tinoco-González J , Moreno-Suero F , Sánchez-Arteaga A , Suárez-Grau J , Bustos M , Padillo-Ruiz J , Tallón-Aguilar L
Published: May 2024

Groin hernia in women is understudied. Minimal invasive techniques may be preferred because of the female higher rate of femoral hernia, often overlooked with open techniques. To date, there are no studies comparing laparoendoscopic techniques in women.

A randomized controlled trial is conducted between 2019 and 2023. Women over 18 with primary groin hernia are randomly assigned to ambulatory TAPP or TEP approach. The main objective is to compare hospital postoperative length of stay. The secondary objective is to evaluate discharge pain, and chronic postoperative inguinal pain (CPIP) during the first postoperative year. Recurrence and adverse events are calculated.

78 patients are recruited, 39 for each group. 2 patients are excluded. Median postoperative stay is 360 minutes for TAPP group and 300 minutes for TEP group (p < 0.001). Globally, median pain at discharge is 3.5 without differences between techniques. Postoperative length of stay is related to pain at discharge (ρ = 0.268, p = 0.021), increasing intensity with bilateral repair (ρ = 1.223, p = 0.002) or usage of tacks (ρ = 1.833, p = 0.034). Incidence of CPIP is 14,8% one year after surgery (n = 61; TAPP 12,5%, TEP 17,2%, p = 0,724). CPIP limits daily life at the third month (p = 0,040), but not at the one-year follow-up. Radiological recurrence rate is 7,9% at the one-year follow-up (TAPP 11,4%, TEP 3,6%, p = 0,371). No relevant adverse events are registered.

Ambulatory laparoendoscopic surgery is feasible and safe for female groin hernia. The TEP approach implies less median hospital stay, although not clinically relevant. CPIP affects daily-life activities in the early postoperative, but wanes at the one-year follow-up.
GLOBAL ACCESS TO TECHNOLOGIES TO SUPPORT SAFE AND EFFECTIVE INGUINAL HERNIA SURGERY: A PROSPECTIVE, INTERNATIONAL COHORT STUDY
Authors: Picciochi M , Eseenam Agbeko A
Published: May 2024

Acknowledgments

This study was supported by NIHR Global Health Research Unit Grant (NIHR16.136.79) and a project research grant from Portuguese Hernia and Abdominal Wall Society (Sociedade Portuguesa de Hernia e Parede Abdominal). The funders had no role in study design or writing of this report. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the UK Department of Health and Social Care.

Background

Technologies such as mesh and minimally invasive surgery (MIS) are recommended for inguinal hernia repair, but access and expertise varies significantly across different contexts. This study aimed to assess variability in the use of these two technologies, and evaluate their safety.

Methods

This was a pre-planned analysis of adults undergoing elective inguinal hernia repair in a prospective, international, cohort study between 30 January and 21 May 2023. Recurrent hernias and open midline approach were excluded. The primary outcome was the placement of mesh during open repair. The secondary outcome was adoption of MIS. A mixed-effects logistic regression model was used to identify factors associated with the adoption of these two technologies.

Results

This analysis included 14,768 patients from 612 hospitals in 81 countries: 8,916 (60.4%) from high-, 2,575 (17.4%) from upper-middle-, 2,642 (17.9%) from lower-middle and 635 (4.3%) from low-income countries. Mesh use in open surgery decreased from high- to low-income countries (98.9%, 94.4%, 82.3%, 72.1% respectively). MIS was adopted in less than a quarter of patients (3,661/14,768, 24.7%), and also decreased across income groups (29.3%, 27.6%, 12.5%, 1.1%). Surgery in a low-middle income country was associated with both lower mesh use (adjusted odds ratio 0.02, 0.01–0.06, p < 0.001) and lower MIS (0.11, 0.07–0.18, p < 0.001).

Conclusion

Global priority is to increase access and training programmes for mesh inguinal hernia repair in low-middle income countries. Expanding the role of MIS in well-resourced settings will require expansion of dedicated training programmes and a focus on patients who will have the most clinical benefit.
SECURITY ANALYSIS OF A NO-ADMISSION CIRCUIT IN HIGH-INTERMEDIATE-RISK PATIENTS WITH INGUINAL HERNIA
Authors: Álvarez-Aguilera M , Martínez-Núñez S , Moreno Suero F , De Jesús Gil A , Sánchez-Arteaga A , Tinoco-González J , Padillo Ruiz J , Tallón-Aguilar L
Published: May 2024

Background

The aim of the study is to assess the impact of different preoperative risk classification criteria on postoperative outcomes and hospital stay in patients undergoing inguinal hernia surgery in a no-admission circuit (NOADS) compared to a conventional admission circuit (ADS). The goal is to provide information to assist in decision-making and choice of surgical circuit.

Methods

Single-center retrospective comparative analysis of a continuous prospective database of moderate-to-high-risk inguinal hernia interventions in a no-admission circuit (NOADS) compared to a conventional admission circuit (ADS) from 2018–2021. A predictive model of multiple regression was designed, followed by a retrospective retest to assess the impact of each risk criterion on postoperative stay.

Results

No significant differences were found in the complication or hospital readmission rate (p = 0.343 and p = 0.563), however, a shorter total hospital stay was observed in NOADS circuit patients (p = 0.000). The analysis of the hierarchical predictive model of multiple regression proposed two opposite scenarios. The best scenario, patients who probably do not require admission, were women operated laparoscopically for a primary unilateral hernia (Estimated postoperative stay: 0.049 days). In contrast, the worst scenario or one in which patients probably need admission consisted of male patients operated openly for bilateral and recurrent inguinal hernia (Estimated postoperative stay: 1.505 days).

Conclusion

Patients with high-intermediate-risk inguinal hernia could safely benefit from a no-admission circuit. Our predictive model could be useful in the decision-making process for surgical circuits.
AN EVALUATION OF RANDOMIZED CONTROLLED TRIALS UTILIZING MESH IN ABDOMINAL WALL RECONSTRUCTION
Authors: Ayuso S A , Holland A M , Lorenz W R , Scarola G T , Fischer J P , Smart N J , Todd Heniford B
Published: May 2024

Background

The fragility index (FI) was developed in order to assess the robustness of clinical trials. FI calculates the number of individual outcomes that would need to change in order to make a significant result insignificant. The aim of this study is to evaluate the fragility of mesh RCTs in AWR.

Methods

Google Scholar® and PubMed were used to query for mesh RCTs in AWR from 2000–2023. FI and Reverse Fragility Index (RFI) I were calculated. Fragility quotient (FQ) and reverse fragility quotient (RFQ) were determined by dividing FI and RFI by sample size. The impact factor (IF) of each journal and conflicts of interest (COI) were reported.

Results

There were 37 RCTs identified. The median FI for positive RCTs was 2 (range: 0–37), and the median RFI nor negative RCTs was 3.5 (range:1–8). For all studies, 11 of 17 (64.7%) had an FI or RFI ≤3. Four studies had an FI/RFI of one, and one study that had an FI of zero, which indicated that if a different statistical test was used for the same data (e.g., Fisher’s exact), then the study outcomes would not be significant. Mean FQ was 0.04 ± 0.06 and mean RFQ was 0.04 ± 0.04. IF of journal did not correlate with FI/RFI (p = 0.67). There was COI reported in 5/17 (29.4%) of studies; 4/5 of these studies had an FI/RFI ≤3.

Conclusions

The majority of mesh RCTs in AWR were fragile and lacked robustness. For fragile studies, a change in very few patient outcomes would have altered their conclusions.
THE DANGER OF OPERATING BY NUMBERS IN INCISIONAL HERNIA SURGERY
Authors: de Beaux A , East B
Published: May 2024

Background

Fascial closure is held as a key step in abdominal wall repair. How ‘tight’ the abdomen can be closed to effect this, or when other intra-operative techniques are required to gain closure is not clear, and are likely surgeon dependent.

Methods

Popular pre-operative measurements: hernia width; hernia area; rectus hernia ratio; and component separation index were considered. Theoretical modelling of a variety of incisional hernias was undertaken.

Results

Following modelling of incisional hernias, all of these measurements are adversely affected by the state of play once abdominal contents are restored to the abdominal cavity. Fascial closure is also influenced by the actual elasticity of the abdominal wall, the effect of pre-operative muscle relaxation, and weight loss by the patient if they can lose weight or indeed have weight to lose. Pre-operative planning that no additional intra-operative techniques are necessary to facilitate abdominal wall closure (techniques which can have a significant learning curve) is difficult except in very small hernias.

Conclusion

Surgery by numbers in predicting fascial closure during incisional hernia repair (with a plan to leave easy cases in the hands of generalists) is a dangerous strategy. Intra-operative plans may need to change in light of the intra-operative findings, and AWR surgeons need to be competent to move to plan B or C, minimising the risk to patients.
TRENDS AND PREVALENCE OF UMBILICAL HERNIA REPAIRS IN SWEDEN; A NATIONWIDE POPULATION-BASED REGISTER-STUDY
Authors: Bergström M , Widhe B , Bringman S , Melkemichel M
Published: May 2024

Aim

Umbilical hernia repairs (UHRs) are widely performed worldwide, yet knowledge about their repairs remains underexplored. Guidelines suggest that UHR larger than 1 cm should preferably be repaired using mesh. The aim was to assess trends and prevalence over time for the use of suture versus mesh following UHR in Sweden.

Material and Methods

This observational population-based register study included prospectively collected data from the nationwide Swedish Perioperative Register (SPOR). Patients >18 years old with a UHR between 2017–2022 in SPOR were eligible. Surgical units were categorized into six healthcare regions. Primary outcome was change in method of repair over time. Secondary outcome was regional variations in method of repairs.

Results

Out of 10,356 elective primary UHRs; mesh was used in 47.9%, whereas 14.1% of these were repaired laparoscopically. Women were less frequently repaired with mesh (38.8%) compared to men (52.1%). Suture repairs had a lower median age (49 years) and BMI (27.2 kg/m2) compared to mesh repairs (55 years, BMI 29.7 kg/m2). Lower ASA class (1–2) were predominant in suture repairs (53.8%), while higher ASA class (3–4) were predominant in mesh repairs (59.1%). Mesh repairs increased marginally, 46.1% to 49.3% during the study period (p < 0.001). Only the Southest healthcare regions had a significant increase from 25.9% to 56.4% for mesh repairs (p < 0.001).

Conclusion

Mesh repairs, despite guidelines, have still not significantly influenced UHR practices in Sweden. Mesh was more commonly used for men, obese patients, those of older age and with a greater co-morbidity.
BILATERAL INGUINAL HERNIOPLASTY IN EMERGENCY SURGERY IS FEASIBLE. COMPARATIVE RETROSPECTIVE STUDY USING PROPENSITY SCORE MATCHING
Authors: Bravo-Salva A , Ochoa-Segarra F , Pérez-Guitart M , Riba L , Juvany-Gómez M , Pereira-Rodriguez J A
Published: May 2024

Aim

The aim of this study is to determine if bilateral emergency hernioplasty practice is safe.

Material and Methods

We have performed a retrospective, observational, single-center study comparing by propensity score matching analysis two similar characteristics groups: patients who underwent emergency inguinal hernioplasty for complicated unilateral groin hernia (UH group) and patients who underwent emergency bilateral inguinal hernioplasty for complicated unilateral hernia, with non-complicated contralateral hernia (BH group).

Results

A total of 341 patients were included in analysis. Bilateral inguinal hernioplasty was performed in 38 of them (11.1%). Complication in study sample rate was high, with 143 complicated patients (41.9%), and a 90-day mortality of 20 patients (5.9%). In long-term analysis, recurrence was observed in 6.5% (22 patients). When comparing both groups short-term results, there were no statistically significant differences between the two groups. 4 recurrences were diagnosticated in BH group.

Discussion

In conclusion, emergency inguinal hernioplasty has high morbidity and mortality in our serie. Performing bilateral inguinal hernioplasty in this urgent situation does not seem to add morbidity or lengthen hospital stay, thus avoiding the need for a new intervention with inherent risks and costs.
MINIMIZING SEROMA INCIDENCE BY QUILTING IN ENDOSCOPIC REPAIR OF CONCOMITANT VENTRAL HERNIAS AND DIASTASIS RECTI
Authors: Cossa J P , Ngo P , Gillion J F , Pelissier E
Published: May 2024

Aim

To assess efficacy of the quilting technique to reduce the incidence and severity of seromas after endoscopic-assisted subcutaneous repair of concomitant ventral hernia (VH) and diastasis recti (DR).

Methods

176 consecutive patients operated for concomitant VH and DR by double layer suturing technique were divided in two groups: Group 1 comprised 102 patients operated without quilting, and Group 2 comprised 74 patients operated with quilting.

Seromas were ranked in two types: Type A included spontaneously resorbable seromas and seromas drained by a single puncture; Type B included seromas requiring two or more punctures, and complicated cases requiring reoperation.

Results

The global percentage of seromas was 24.4%. In Group 1 there were more seromas (27.5%) and more Type B seromas (19.6%) than in Group 2 (20.3% and 5.4% respectively). Conversely, the percentage of Type A seromas was higher in Group 2 (14.9%) than in Group 1 (7.9%). The differences were significant (p < 1.4%). The mean operation duration was significantly longer in Group 2 (84 mn) than in Group 1 (70 mn). Four complicated cases requiring reoperation (included in Type B) were observed in Group 1: three cases of persistent seroma that required surgical drainage in general anesthesia and one case of encapsulation that was reoperated.

Conclusion

The quilting technique adapted to the endoscopic-assisted bilayer suturing technique of repair of concomitant VH and DR, can significantly reduce the incidence and severity of postoperative seromas.
THE IMPORTANCE OF EVIDENCE-BASED SURGERY – THE CASE OF FEMALE GROIN HERNIA
Authors: Dahlstrand U , Melkemichel M , Österberg J , de la Croix H
Published: May 2024

Background

In 2005 the first study regarding outcome after groin hernia repair in women, based on data from the Swedish Hernia Register (SHR), was published. Women had a substantially higher risk of reoperation due to recurrence than men, and poorer results after open anterior mesh repair. Recommendations and guidelines were issued. The aim of this study was to investigate how implementation of guidelines regarding treatment of groin hernia in females have affected the outcomes.

Material and Methods

Epidemiological study on prospective data in the SHR. The studied outcome was reoperation due to recurrence, by Cox proportional hazards regression analyses.

Results

A total of 35,179 groin hernia repairs in women have been registered. The proportion of endo-laparoscopic repairs have increased from 4.9% in 2005 to 84.2% in 2023. The 5-year rate of reoperation due to recurrence for procedures before 2012 was 4.2%, with a hazard ratio of 1.25 (95%CI 1.16–1.35) compared to males. For groin hernia repairs in women 2012–2022 the 5-year reoperation rate was 2.1% with a hazard ratio of 0.67 (95% CI 0.58–0.76) compared to men. There was a significantly reduced risk for women who had endo-laparoscopic repair (HR 0.30, 95% CI 0.23-0.40).

Conclusions

Following implementation of the evidence-based guidelines for treatment of groin hernia in women the results in terms of reoperation for recurrence have improved significantly.
NEUROSENSORY ALTERATIONS FOLLOWING ANTERIOR OPEN INGUINAL HERNIOPLASTY: AN INCONVENIENT TRUTH
Authors: Gómez-Torres I , Menor-Duran P D , Gamón-Giner R L , Jara-Benedetti G , Queralt Escrig M , Alcobilla-Ferrara E
Published: May 2024

Aim

Neurosensory dysfunction represents a prevalent complication after open inguinal hernia repair. Nevertheless, the prevalence study of hypoesthesia and chronic neuropathic postoperative inguinal pain (CPIP) remains deficient. The principal objective of this prospective observational investigation is to ascertain the incidence of neurosensory aberrations within the first post-surgery year, employing the dermatome mapping test as the primary assessment modality, while concurrently assessing the trajectory of these manifestations and their enduring presence.

Material and Methods

A total of 129 patients, who underwent inguinal hernia mesh repair (Lichtenstein tension-free mesh repair) between January 2020 and January 2022, were included in this prospective observational study.

All patients were assessed at 30 days, 6 months, and 1 year postoperatively using the dermatome mapping test.

Results

At 30 days, the rate of sensory alteration for the ilioinguinal (II), Iliohypogastric (IH), and genitofemoral (GF) nerves was 57.3%, 11.6%, and 45%, respectively, with a rate of chronic neuropathic pain (CPIP) of 10%, 3.1%, and 7%. At 6 months, it was 35.6%, 2.3%, and 32%, with a CPIP rate of 4.6% for the II nerve. Finally, at one year, it was 20.9%, 1.5%, and 10.8%, with a persistent CPIP rate of 4.6% for the II nerve.

Conclusions

Sensory alteration (hypoesthesia or CPIP) is the most common long-term complication following open anterior inguinal hernia surgery, with significant rates affecting up to 1 in 5 patients for the ilioinguinal territory, and 1 in 10 for the genitofemoral territory one year after surgery.

These results raise questions about whether other surgical techniques, such as the open posterior approach (Nyhus) or laparoscopic or endoscopic surgery (TAPP and TEP), can reduce or prevent these long-term alterations.

The dermatome mapping test is a tool that helps us detect these alterations in an easy and effective manner, and it should be systematically performed in postoperative evaluations of all inguinal hernia surgeries.
ADDRESSING THE BURDEN OF HERNIAS IN AFRICA: A COMPREHENSIVE ANALYSIS OF CHARITY-DRIVEN SURGICAL INTERVENTIONS" – 14 YEARS OF EXPERIENCE WITH CHARITY SURGERY MISSIONS
Authors: Gorjanc J
Published: May 2024

This abstract outlines a research endeavor focused on the charitable provision of hernia surgeries in Africa, seeking to shed light on the challenges, successes, and potential avenues for improvement in addressing this prevalent health issue. Starting with the organisation “Operation Hernia” and continuing with “Hernia International”, we today know that hernias pose a substantial burden in resource-limited settings in Africa, and charitable surgical interventions play a pivotal role in alleviating this burden. There is an alarming prevalence of 6,3 million untreated hernias in Sub-Saharan Africa. This study aims to evaluate the effectiveness of current charity-driven hernia surgery programs and explore strategies for enhancing their impact.

Our research employs a mixed-methods approach, combining quantitative data analysis of surgical outcomes with qualitative insights gathered through interviews with healthcare professionals, patients, and organizations involved in charity hernia surgery initiatives. Preliminary findings underscore the positive impact of these programs, showcasing improved patient outcomes and increased accessibility to surgical care. However, challenges such as surgical capacity constraints, logistical hurdles, and long-term follow-up care disparities are identified as critical areas requiring attention.

This abstract contributes to the broader discourse on healthcare accessibility in Africa by presenting evidence-based recommendations for optimizing charity hernia surgery programs. The findings presented in this abstract serve as a foundation for a comprehensive congress presentation, fostering dialogue and collaboration among researchers, practitioners, and policymakers committed to advancing charity hernia surgery and healthcare accessibility in Africa.
COMPARATIVE ANALYSIS OF PERITONEAL FLAPS (PF) AND ENDOSCOPIC TRANSVERSUS ABDOMINIS RELEASE (eTAR) FOR MIDLINE RESTORATION IN eTEP INCISIONAL HERNIA REPAIR
Authors: Guevara Martínez J , Gutiérrez E , Zapata C , Abad R , del Mar Olmedo M , Reinoso F , Fondevila C , Salido S
Published: May 2024

Aim

This study aims to compare the utilization of peritoneal flaps (PF) with endoscopic transversus abdominis release (eTAR) for midline restoration in incisional hernia repair via the enhanced-view totally extraperitoneal (eTEP) approach.

Patients and Methods

A total of 115 eTEP incisional hernia repairs were initially considered, with exclusion criteria applied to patients requiring combined PF and eTAR procedures or those not requiring either. The final analysis included 14 patients treated exclusively with eTAR and 36 with PF. Parameters compared included hernia defect size, operative time, length of stay, and postoperative complications.

Results

The mean hernia defect size for the eTAR group was 70 mm, and for the PF group 79 mm, although this disparity lacked statistical significance. The length of stay was marginally higher for the PF group, averaging 3 days, compared to 2 days in the eTAR cohort. Notably, a statistically significant difference in operative time was observed (p: 0.022), with eTAR requiring a mean of 180 minutes and PF 148 minutes. Postoperative complications, including seromas and surgical site infections, occurred in 22.2% and 7.1% of patients for eTAR and PF, respectively (p: 0.207). No hernia recurrences were observed.

Conclusion

Both PF and eTAR procedures demonstrated comparable hernia defect sizes, complication rates, and lengths of stay, with eTAR exhibiting a longer operative time. This study suggests that PF can be considered as a valid alternative in the armamentarium of techniques for midline restoration during eTEP incisional hernia repair, with similar outcomes to eTAR.
LONG TERM INGUINAL PAIN COMPARING TEP TO LICHTENSTEIN REPAIR – THE TEPLICH RCT 8 YEARS FOLLOW-UP
Authors: Gutlic A , Petersson U , Rogmark P , Montgomery A
Published: May 2024

Aim

To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein.

Material and Methods

A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The primary end-point was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed.

Results

A total of 322 of 366 patients (88%) completed the follow-up of mean 7,94 years (5–10,75 years). Non-ignorable pain last week was reported by 7,6 % in TEP and 6,7% in Lichtenstein (p < 0,73). New non-ignorable pain was reported by 4 patients. No difference in non-ignorable pain over time (1 to 8 years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3,8% in TEP and 5,5 % in Lichtenstein (p < 0,48). QoL remained above the Swedish norm. No recurrences occurred after 3 years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain.

Conclusions

RCTs, comparing TEP to Lichtenstein repair with follow-up ≥5 years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3 years seem to persist at 8 years. Recurrences occured within the first 3 years. Patients need to be informed of the risk of long-term CPIP.
LAPAROSCOPIC INGUINAL HERNIA SURGERY CAN BE SAFELY PERFORMED IN A DAY SURGERY CENTRE
Authors: Hayward R , Smith J J , O’Brien P , Teare J , Warren O J
Published: May 2024

Background

Laparoscopic inguinal hernia repair is among the most frequently performed day-case operations. Ambulatory surgery centres alleviate pressures on acute provider hospitals and reduce patient anxiety and nosocomial infection risk. However, concerns remain regarding the safety of these facilities and occurrence of complications that may require inpatient stay.

Method

In 2020, a dedicated day surgical unit was established in London with no inpatient beds, requiring patients to return home on the day of their operation. A prospective database was established for patients undergoing laparoscopic totally extraperitoneal inguinal hernia repair by one experienced consultant surgeon, with routine follow-up occurring at 3–6 weeks post-operatively.

Results

70 patients were operated on between August 2020 and January 2024, 87%male, median age 47 years. ASA grade was 1 or 2 in all patients.

There were no major complications, conversions to open, blood transfusions, admissions for overnight stay, emergency admission to hospital within 30 days, or recurrences, with a median length of follow-up of 1.4 years.

68 patients (97%) made a complication-free recovery. Superficial wound infection at the umbilical port, requiring oral outpatient antibiotics, occurred in 2 patients.

Conclusion

This dataset demonstrates the ability to safely perform laparoscopic inguinal hernia repair in an entirely ambulatory facility with no major complications, no conversions to open and a 0% admission rate in well-selected patients. Ambulatory units place constraints on the surgeons and anaesthetists involved and therefore must occur under strict patient selection and clinical governance. The collection and reporting of prospective safety data helps this process.
THE IMPACT OF PREOPERATIVE BOTULINUM TOXIN A (BTA) INJECTION ON SUBXIPHOID (M1) HERNIA REPAIRS
Authors: Holland A , Lorenz W , Ayuso S , Ku D , Scarola G , Augenstein V , Heniford B T , Polcz M
Published: May 2024

Background

Preoperative relaxation of the abdominal wall with Botulinum Toxin A (BTA) injection can assist with fascial closure and decrease the need for component separation (CST). Its efficacy in subxiphoid (M1) hernias is unclear with high rates of CST reported despite BTA. For M1 hernias requiring CST, we assessed whether use of preoperative BTA offered any additional benefit toward fascial closure or recurrence rates.

Methods

A tertiary hernia center’s prospectively maintained database was reviewed for M1 hernias, as defined on CT imaging. Patients who underwent subsequent CST were grouped based on whether preoperative BTA injections were performed.

Results

Of 67 M1 hernia patients, 30 (44.8%) received BTA and 37 (55.2%) did not. BTA versus non-BTA groups had similar age (56.0 ± 14.1 vs. 61.5 ± 11.8 years; P = 0.087), ASA score, diabetes history, and defect size (499.2 ± 185.5 vs. 416.1 ± 238.6 cm2; P = 0.144). BTA group had lower BMI (28.9 ± 5.1 vs. 32.7 ± 7.2 kg/m2; P = 0.018), fewer current and former smokers (0% vs. 10.8%, 40.0% vs. 62.2%; P = 0.006), more contaminated and dirty cases (20.0% vs. 5.4%, 33.3% vs. 13.5%; P = 0.008), and more biologic mesh used (62.1% vs. 35.1%; P = 0.046). Neither panniculectomy rates nor CST techniques differed (external oblique release: 80.0% vs. 62.2%; P = 0.179, posterior rectus sheath release: 70.0% vs. 67.6%; P > 0.999, transversus abdominus release: 26.7% vs. 35.1%; P = 0.598). Rates of unilateral versus bilateral CST were not statistically different. There were no differences in fascial closure (90.0% vs. 94.6%; P = 0.650), recurrence (6.7% vs. 2.7%; P = 0.583), or in-total wound complication rates (33.3% vs. 43.2%; P = 0.458) between BTA and non-BTA groups with follow-up of 12.7 ± 18.8 versus 24.1 ± 28.2 months (P = 0.062).

Conclusions

M1 hernia repair often requires CST despite BTA injections. BTA as a preoperative adjunct in this population does not benefit fascial closure rates, risk of recurrence, or frequency of bilateral CST.