bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ecological and evolutionary drivers of phenotypic and genetic variation in the European crabapple [Malus sylvestris(L.) Mill.], a wild relative of the cultivated apple
Authors: Chen X , Avia K , Forler A , Remoué C , Venon A , Rousselet A , Lucas G , Kwarteng A O , Rover R , Le Guilloux M , Belcram H , Combes V , Corti H , Olverà-Vazquez S , Falque M , Alins G , Kirisits T , Ursu T M , Roman A , Volk G M , Bazot S , Cornille A 
Published: May 2023

AbstractBackground and AimsStudying the relationship between phenotypic and genetic variation in populations distributed across environmental gradients can help us to understand the ecological and evolutionary processes involved in population divergence. We investigated the patterns of genetic and phenotypic diversity in the European crabapple, Malus sylvestris, a wild relative of the cultivated apple (Malus domestica) that occurs naturally across Europe in areas subjected to different climatic conditions, to test for divergence among populations.MethodsGrowth rates and traits related to carbon uptake in seedlings collected across Europe were measured in controlled conditions and associated with the genetic status of the seedlings, which was assessed using 13 microsatellite loci and the Bayesian clustering method. Isolation-by-distance, isolation-by-climate and isolation-by-adaptation patterns, which can explain genetic and phenotypic differentiation among M. sylvestris populations, were also tested.Key ResultsA total of 11.6 % of seedlings were introgressed by M. domestica, indicating that crop–wild gene flow is ongoing in Europe. The remaining seedlings (88.4 %) belonged to seven M. sylvestris populations. Significant phenotypic trait variation among M. sylvestris populations was observed. We did not observe significant isolation by adaptation; however, the significant association between genetic variation and the climate during the Last Glacial Maximum suggests that there has been local adaptation of M. sylvestris to past climates.ConclusionsThis study provides insight into the phenotypic and genetic differentiation among populations of a wild relative of the cultivated apple. This might help us to make better use of its diversity and provide options for mitigating the impact of climate change on the cultivated apple through breeding.
BJS-03 DEVELOPMENT AND IMPLANTATION OF 3D ANATOMICALLY TAILORED POLYPROPYLENE MESH FOR LAPAROSCOPIC INGUINAL HERNIA REPAIR DESIGNED ON THE BASIS OF CT IMAGES (THE ILAM STUDY)
Authors: Śmietański M , Zamkowski M , Karbowski K 
Published: May 2023

Abstract

Aim
The aim of the ILAM (Individualized Laparoscopic Anatomical Mesh) study was to create and implant a fully individualized mesh based on CT scans, taking into account the published body of knowledge about the material and mechanical behavior of the implant for laparoscopic inguinal hernia repair.

Material and Methods
The team creating and conducting this study consisted of surgeons and engineers. A specific project was made and divided into four phases. The process of development and implantation was divided into four milestones: CT scans and modeling based on predefined subgroups, mesh manufacture, certification and clinical evaluation.

Results
The result of study was first individually designed hernia mesh to have been implanted in a human subject. After 12-months of follow-up no recurrences or other complications were reported.

Conclusions
New mesh that provides a better anatomic fit to the patients’ inguinal region geometry. Mechanical stability is ensured by the multiple contact points between the implant and the tissues, which generate friction forces. Together with possibility of shape design (proper overlap) the authors believe that there is no need of mesh fixation. If so, the use of such design meshes can change the guidelines in laparo/endoscopic hernia repair in the future.
OC-002 CREATING THE INFRASTRUCTURE TO MAKE HERNIA RESEARCH A REALITY
Authors: Scarola G , Wilson H , Ku D , Brown K , Tawkaliyar R , Colavita P , Augenstein V , Heniford T 
Published: May 2023

Abstract

Background
Research at hernia surgery centers is growing around the United States but what does it takes to make this research possible? The aim of this study is to shed light on the process of creating and maintaining a hernia research program and addressing quality improvement initiatives.

Methods
To create a hernia research program certain pieces are required within an institution, an administration that supports research and phyisicians with research expertise and sufficient patient volume, research staff including: managers, fellows, research residents, advanced practice providers (APPs), nurses, statisticians, data abstractors, Instituitional Review Board (IRB), legal and contracting, and finance staff. Following IRB approval, data was collected in a prospective institutional outcomes database. The prospective database was designed longinatudally to track patient demographic, diagnosis, comorbidities, operative and patient outcomes from index procedure through 20+ years of follow-up. Data from the database can then be queried and analyzed to answer meaningful research and quality improvement questions.

Results
The results of of the aforementioned infrasctructure are more than 400 peer-reviewed publications accepted to more than 150 journals and over 900 abstract submissions accepted to more than 100 national and international conferences over a 22-year period from 2000–2022. The byproduct of data collection and manuscript writing results in constant quality improvement, academic advancement, teaching for residents and attendings, and driving national and international standards of care.

Conclusion
With thoughtful planning and correct implementation a hernia research program can be developed and produce decades of quality improvement and research to advance patient care.
OC-005 COMPARISON OF POSTOPERATIVE PAIN: BIOLOGICAL VERSUS SYNTHETIC MESH SIX MONTHS AFTER LAPAROENDOSCOPIC HERNIA REPAIR – RESULTS OF THE RANDOMIZED, MULTICENTER, SELF-CONTROLLED BIOLAP TRIAL
Authors: Seefeldt C S , Knievel J , Meyer-Zillekens J , Lange J , Lefering R , Heiss M 
Published: May 2023

Abstract

Aim
A remaining problem after hernia surgery is the occurrence of chronic pain. Up to now, the use of synthetic meshes is the standard procedure, but there is raising evidence that biological meshes could be advantageous concerning occurrence of chronic pain without the disadvantages of a life-long implant.
The BIOLAP trial compares synthetic and biological meshes in laparoendoscopic inguinal hernia repair. To test the hypothesis that the use of biological meshes results in significantly less pain postoperatively than the use of synthetic meshes, without an increased recurrence rate, patients with bilateral primary inguinal hernias were included. Patients received biological mesh on one side and synthetic mesh on the other.

Materials and Methods
In 21 German hernia centres, 982 hernias were treated using TEP or TAPP techniques. In addition to the study endpoints (recurrence rate within 2 years, pain intensity after 6 months), demographic and perioperative data as well as intraoperative and postoperative complications were recorded.

Results
Recruitment was successfully completed in February 2021. Six month after laparoendoscopic hernia repair there is no significant difference in pain occurrence comparing biological to synthetic mesh implants. Furthermore general demographics of the patients with bilateral primary inguinal hernias are evaluated.

Conclusion
The study provides data from 982 hernia operations dependent of the mesh material used. According to the study protocol, at the current time pain intensity after 6 months comparing both mesh materials has been evaluated as the first endpoint. Further study endpoints will be evaluated after completion of the two-year follow-up phase.
OC-010 5-YEAR ASSESSMENT OF RESORBABLE BIOSYNTHETIC MESH WITH TRANSVERSE ABDOMINIS RELEASE FOR LARGE VENTRAL HERNIA REPAIR: A LONG-TERM EVALUATION OF CLINICAL OUTCOMES AND QUALITY OF LIFE
Authors: Amro C , Messa Iv C A , Niu E F , Habarth-Morales T E , Talwar A A , Thrippleton S , Broach R B , Fischer J P 
Published: May 2023

Abstract

Aim
This study assesses long-term clinical and quality-of-life (QoL) outcomes following large ventral hernia repair (VHR) with transverse abdominis release (TAR) using resorbable biosynthetic mesh.

Methods
Retrospective review of clinical outcomes with prospective assessment of QoL was performed for patients undergoing VHR with Poly-4-hydroxybutyrate[P4HB]/Phasix mesh (C.R. Bard, Warwick, RI) and TAR from 2016–2021. Patients with less than 24 months of follow-up, defects smaller than 150cm2, and parastomal hernias were excluded.

Results
Sixty-nine patients were initially identified. Twenty-nine patients met inclusion criteria. Median age and BMI were 61 years (IQR 53.2–68.1 years) and 31.4 kg/m2(IQR 26.1–35.3kg/m2). Average hernia defect was 390cm2±152.4cm2. All patients underwent previous abdominal surgery and were primarily VHWG 2 (55.2%). Two hernia recurrences (6.9%) occurred over the median follow-up period of 63.1 months (IQR 43.7–71.3 months). Delayed healing and seroma occurred in 27% and 10.3% of patients, respectively. There were no cases of mesh infection or explantation. Cost analysis revealed no significant average margin loss(p&gt;0.05) and risk-adjusted analysis demonstrated higher costs associated with ASA class and length of stay(p&lt;0.05). Throughout the study period, patients demonstrated a significant improvement in long-term postoperative QoL(p&lt;0.005). This was seen continuously throughout the 5-year follow up period (p&gt;0.05), with an 80% response rate and overall average improvement of 41% compared to preoperative QoL.

Conclusion
Large VHR with resorbable biosynthetic mesh and TAR can be performed safely and effectively leading to an optimal ratio of recurrence and mesh infection at acceptable costs and with significant and sustained improvement in disease-specific QoL at long-term follow-up.
OC-031 TROCAR SITE INCISIONAL HERNIA PREVENTION BY ONLAY MESH PLACEMENT, NOT WHAT WAS EXPECTED
Authors: Ferreres Serafini J , Olona Casas C , Memba Ikuga R , Vives Abelló J P , Julià Verdaguer E , Casanova Marquès R , Varona Mancilla A , Rodrigo Rodrigo M , Jorba Martín R 
Published: May 2023

Abstract

Aim
The prevalence of Trocar site incisional hernia (TSIH) might be as high as 30%, due to this reason is paramount to find a better closure technique. Our aim is to test the TSIH preventive effect of the placement of an onlay mesh versus the standard fascial closure at the umbilical trocar site closure.

Material&Methods
We designed a Two-Center Randomized Controlled Trial where adult participants presenting for elective laparoscopic cholecystectomy, were allocated into 2 groups (Prosthesis and Control). The Hasson technique was the pneumoperitoneum creation technique. The procedure in the Prosthesis group consisted in the complete closure of the umbilical vertical section of the aponeurosis by single 0 Polydioxanone stitches, a 2cm onlay plane dissection, the placement of a lightweight, large-pore synthetic mesh and its fixation applying cyanoacrylate glue, subcutaneous stitches, and skin staplers. The Control group aponeurosis was closed by single stitches of Polydioxanone followed by skin staplers.
An ultrasound scan was performed at 12 postoperative months.

Results
At 12-month control, a 41.7% incidence of TSIH was recorded in the Prosthesis group while 28.5% in the control group. 6 patients developed a superficial wound infection at the umbilical port site in the Prosthesis group, and none in the Control group. 5 of the patients had to be operated for mesh removal as they developed 4 chronic infections and 1 seroma with bad wound pain control.

Conclusions
The preliminary results of the study show no benefit in the Prosthesis group for the prevention of TSIH and presented with a greater number of complications.
OC-044 MODIFIED CHEVREL TEHCNIQUE. A LIMITED OPTION FOR ABDOMINAL CLOSURE IN PATIENTS WITH ABDOMINAL HYPERTENSION
Authors: Vega V , Navarro D , Chitty M , Chacón F , Jiménez C , Loinaz C , Justo I 
Published: May 2023

Abstract

Abdominal compartment syndrome is a potentially life-threatening condition seen in critically ill patients. Several techniques have been described for abdominal wall closure after a damage control laparotomy to achieve static and dynamic support without leading to abdominal hypertension.

Aim
To describe short termn results after a modified Chevrel technique for midline incisional hernia repair in patients with abdominal hypertension.

Materials and Methods
We perfomed a modified Chevrel as an abdominal wall closure technique in 9 patients between January 2016 and January 2022. The inclusion criteria were patients surgical intervened from gastrointestinal diseases and postoperative complications who suffered from varying degrees of abdominal hypertension. We consider this surgical approach in symptomatic patients with intrabdominal pressures exceeding 20mmHg who were stable enough to undergo surgery.

Results
Nine patients were treated with this technique (6 male and 3 female). Their BMI ranged from morbidly obese to severe underweight. The main reasons why only one side of the fascia could be used were: The presence of a stoma, intrabdominal drains and inverted T-scars from previous surgeries. The use of mesh was dismissed in 6 of the patients (66.7%) because they required subsequent abdominal surgeries. None of the patients developed hernia recurrence, although we did have one case of bulging, one hematoma and one case of seroma. Our results are limited by a 33% mortality within the first two years.

Conclusions
The modified Chevrel technique can be used as an urgent surgical tool for closing midline defect in patients undergoing compartimental syndrome and abdominal hypertension.
OC-046 THE INGUINAL HERNIA OPERATION NOTES (GROIN) QUALITY IMPROVEMENT PROJECT
Authors: Kapsampelis P , Prce D , Saunders J , Bezzaa S , Gerogiannis I 
Published: May 2023

Abstract

Aim
Accurate and comprehensive operation notes are crucial for patient safety, quality assurance and medico-legal purposes. Inguinal hernia repair is one of the most common surgical procedures. Thus, operative documentation should be precise and standardised. The GROIN project aims to improve the quality of inguinal hernia operation notes using an evidence-based proforma and an operation note composition software.

Methods
We retrospectively reviewed operation notes of inguinal hernia repair performed at our institution between August and November 2022. Operation notes were assessed against the Royal College of Surgeons’ Good Surgical Practice standard, consisting of 18 items.

Results
The operation notes from 89 cases were reviewed. High-scoring items included: operation name (100%), operative findings (99%), surgeon's name (99%), closure technique (98%), operation date (90%) and signature (90%). Postoperative instructions were sufficiently detailed in 79% of cases. Regarding mesh placement, 63% of notes described mesh size and type, whereas 30% documented only the mesh type. The lowest-scoring items were: venous thromboembolism prophylaxis (31%), designation as elective or emergency (22%), operative diagnosis (6%), and estimated blood loss (2%).

Conclusions
We identified several areas for improvement in inguinal hernia operation notes based on our results. The next step of the GROIN project is to standardise operation note creation by implementing an evidence-based template, which will be delivered through a novel operation note composition software. This will allow accurate record-keeping and efficient operative data extraction analysis. Efforts to standardise operative notes and enhance their quality on a national and international level are imperative for patient safety.
OC-052 Study of incisional hernia as a result of patients with open abdomen management in a tertiary hospital
Authors: García Alonso L , Rodicio Miravalles J L , Cifrian Canales I , Lopez-Negrete Cueto E , Ramos Montes C , Amoza Pais S , Sanz Navarro S , Sanz Alvarez L 
Published: May 2023

Abstract

Aim
Open abdomen (OA) is a useful resource in critical situations, such as damage control surgery, abdominal sepsis, or compartment syndrome. However, it is not an innocuous technique with repercussions on the abdominal wall, for this reason, we have reviewed the results in our center.

Material and Methods
Retrospective descriptive study was carried out in a tertiary hospital between 2015–2022, all patients who required OA therapy were included.

Results
92 patients (68 men, 24 women) were operated, with a mean age of 65 years, 65.3% were ASA 3–4. The most frequently system used was negative pressure therapy (NPT) (81 patients). 45 patients were closed without need replacement and 14 died before being performed. In the rest, the first TPN change was performed in 48–72 h, requiring a mean of 3.5 changes.
Of the 78 patients underwent closure, 30 received primary fascial closure, 43 associated prophylactic mesh and other 5 only skin closure due to poor short-term prognosis. 24 patients died before discharge.
5 of the 30 patients with primary fascial closure had an incisional hernia. There were no hernias in the patients treated with prophylactic mesh but there was one case of chronic rejection.

Conclusions
OA is a useful resource; however, it is not exempt from short and long-term complications. At the time of definitive closure, it must be taken into account that these patients present multiple risk factors for the development of incisional hernias. For this reason, the use of prophylactic meshes in a protocolized manner is justified.
OC-063 REPAIR OF UMBILICAL HERNIAS ASSOCIATED TO DIASTASIS USING LAPAROSCOPIC ENDOSCOPIC EXTRAPERITONEAL STAPLE BASED SUBLAY MESH TECHNIQUE (LEESS)
Authors: Hashim D , Haso A , Meyer F , García-Ureña M A , Albyarak N 
Published: May 2023

Abstract

Aim
Patients with symptomatic umbilical hernia with associated rectus diastasis represent an increasing clinical problem. The objective was to analyze feasibility and safety using a novel surgical approach: laparoscopic extraperitoneal endoscopic staple-based sublay operation (LEESS).

Methods
Observational study with all patients for patients who underwent LEESS and a minimum follow-up of 1 year. Data was obtained from a prospective mantained database at Herniamed Registry

Results
81 patients were operated from January 1, 2016, to June 30, 2020. Mean operative time was 100 (range, 15–200) min and mean length of hospital stay was 5 (range, 1–9) days. The overall 30 days postoperative morbidity was 12.34%: 2 (2.4%) developed a symptomatic subfascial seroma (minor complication); 2 (2.4%), a postoperative bleeding; 2 (2.4%), mild wound infection without mesh infection; and 1 (1.23%) of internal herniation through a defect in the posterior rectus sheath suture line. There were no surgery-related deaths (in-hospital mortality, 0). After a total follow-up of 12 months, 54 patients out of 81 (rate, 69.3%) recorded their information in the registry; 9 (16.7%) reported pain. The ratio of “Pain at rest” (5.6%) was significantly less than preoperatively (58.8%; p&lt;0.001). “Pain during exercise” (11.1%) is significantly less than preoperatively (58.8%; p&lt;0.001).

Conclusion
The LEESS technique with mesh augmentation appears to be an innovative, minimally invasive, feasible and safe surgical procedure for treatment of patients with symptomatic ventral midline hernia
OC-064 CHOICE FOR ANTERIOR VERSUS POSTERIOR COMPONENT SEPARATION IN INCISIONAL HERNIA REPAIR IS IMPORTANT REGARDING POSTOPERATIVE COMPLICATIONS
Authors: Dries P , Mathias A , Eker H , Berrevoet F 
Published: May 2023

Abstract

Aim
Both anterior component separation technique (aCST) and posterior Transversus Abdominis Release (TAR) are valuable techniques, but the limits for using these techniques are unclear. The aim is to compare outcomes regarding postoperative wound morbidity and recurrence for both techniques.

Methods
A retrospective analysis of prospectively collected data was carried out. Patients with any form of component separation technique, aCST or TAR, between 3/2013 and 8/2022 were included. Data was analyzed for patient demographics, risk factors, surgical site occurrences(SSO), general complications and hernia recurrence. Follow up was performed at 1 month, 1 year and 2 years.

Results
A total of 258 patients underwent CST: 68 (26.4%) aCST and 190 patients (73.6%) TAR. Patients showed no significant difference for gender, risk factors and comorbidities. The aCST group showed larger defects (EHS-W3 in 64.7% vs. 45.3%, p=0.006). Intrahospital complications were lower in the TAR group (12.1% vs 29.4%, p=0.001). SSO rate at one month was significantly lower in the TAR group (12.7% vs 43.9%, p&lt;0.001) with SSO- procedural interventions 6.3% vs 30.3%, p&lt;0.001). Recurrence was low in both groups (aCST 3.0% vs TAR 1.6%). Follow up was complete in 93.8% of patients.

Conclusion
Although aCST and TAR are both valid options in large incisional hernia repair, postoperative wound morbidity as well as overall complication rates are significantly increased after aCST. It seems indicated to choose TAR over aCST in laterally located hernia defects and in large midline defects and only consider aCST in case of doubt about complete anterior fascial closure.
OC-071 Biomechanical Causes for Failure of The Physiomesh/Securestrap System. Experimental study
Authors: Zamkowski M , Śmietański M , Tomaszewska A , Lubowiecka I 
Published: May 2023

Abstract

Introduction
Physiomesh/Securestrap system entered market in 2013 and despite its producer assurence it become a spectacular disaster, eliminating Ethicon from market and resulting in multi-milion dollar lawsuits. The biological reasons for faileure of the Physiomesh implant were partly explained in animal models. However conlusions suggested that apart from biological components failure of Physiomesh/Securestrap was mainly due to biomechanical factors.

Aim
Based on above assumptions we assembled a multidisciplinary team to examine the biomechanical reasons of failure of Physiomesh/Securestrap system.

Material and Methods
Three kinds of experiments were performed with the use of porcine model to conclude on the reasons of system failure in the natural conditions: uni-axial test of mesh samples, determination of the mesh-tissue junction force limit and mesh-staples-tissue model behaviour under high “intra-abdominal” pressure load.

Results
Main reason for failure of Physiomesh/Securestrap is its primary concept. Building a mathematical model describing the forces acting on the implant anchored to anterior abdominal wall demonstrated that mesh lacked proper distribution of elasticity. Despite promising preclinical studies on the rabbit and porcine model, our experiment showed that it cannot me directly translated into humans.

Conclusions
The results of research on the cause and mechanism of failure of the Physiomesh/Securestrap system allow to draw conclusions to avoid similar errors in the future. The findings not only to expose the cause for the failure of Physiomesh/Securestrap, but also allow to better understand the forces acting within the abdominal cavity. Optimally, this will prevent similar situations from arising in the future.