bluuebunny/crossref_metadata_2025_split huggingface dataset:
OC-057 PREVENTION OF INCISIONAL HERNIAS BY PROPHYLACTIC MESH-AUGMENTED REINFORCEMENT OF MIDLINE LAPAROTOMIES FOR ABDOMINAL AORTIC ANEURYSM TREATMENT. 5-YEAR FOLLOW-UP OF A RANDOMIZED CONTROLLED TRIAL
Authors: Dewulf M , Muysoms F , Vierendeels T , Huyghe M , Miserez M , Ruppert M , Van Bergen L , Berrevoet F , Detry O 
Published: October 2022

Abstract

Introduction
The incidence of incisional hernias (IHs) after open repair of an abdominal aortic aneurysm (AAA) is high. Several randomized controlled trials have reported favorable results with the use of prophylactic mesh to prevent IHs, without increasing complications. In this analysis we report on the results of the 60-month follow-up of the PRIMAAT trial (Ann Surg 2016; 263(4): 638–45).

Methods
In a prospective, multicenter, open label, randomized design, patients were randomized between prophylactic retrorectus mesh reinforcement (MESH group), and primary closure of their midline laparotomy after open AAA repair (NOMESH group). This article reports on the results of clinical follow-up after 60 months. If performed, ultrasonography or computed tomography were used for the diagnosis of IHs.

Results
Of the 120 randomized patients, 114 were included in the intention-to-treat analysis. Thirty-three patients in the NOMESH group (33/58–56.9%) and 34 patients in the MESH group (34/56–60.7%) were evaluated after 5 years. The cumulative incidence of IHs in the NOMESH group was 32.9% after 24 months and 49.2% after 60 months. No incisional hernias were diagnosed in the MESH group. In the NOMESH group, 21.7% (5/23) underwent reoperation within 5 years due to an IH.

Conclusion
Prophylactic retrorectus mesh reinforcement after midline laparotomy for the treatment of AAAs safely and effectively decreases the rate of IHs. The cumulative incidence of IHs after open AAA repair, when no mesh is used, continues to increase during the first 5 years after surgery, which leads to a substantial rate of hernia repairs.
OC-074 BILAYERED RETICULAR AND LAMINAR POLYPROPYLENE MESH AS A USEFUL TEMPORARY ABDOMINAL CLOSURE FOR THE MANAGEMENT OF THE OPEN ABDOMEN
Authors: Lopez Monclus J , Muñoz Rodriguez J , Roman Garcia De Leon L , Polaino Moreno V , Suarez Sanchez M , Gil Cidoncha L , Martin Rodrigo P , Lucena De La Poza J L , Robin A , Blazquez Hernando L , Garcia Ureña M A 
Published: October 2022

Abstract

Aim
To demonstrate the utility of a bilayered reticular and laminar polypropylene (PLP) mesh as a temporary abdominal closure device for the management of the open abdomen.

Patients And Methods
Prospective multicentric study including consecutive patients with open abdomen of any etiology. A bilayerede PLP mesh is used as temporary abdominal closure. The mesh has a 30×40 cm laminar PLP intraperitoneal layer that is fully deployed covering the viscera, and a 30x 40 cm large pore PLP layer that is trimmed to the size of the defect and sutured to the border of the fascia. Depending on the evolution time and the clinical situation of the patient, successive plicatures of the reticular PLP are performed to reduce the fascial defect. At the end, the mesh is explanted, and a complete fascial closure is attempted.

Results
Eighteen patients were included. Etiologies of the open abdomen were vascular (22%), trauma (28%) and sepsis (50%). There were 72% female patients, mean age of 60 years (range 19–81). Four patients died in the first 72 hours due to complications of their pathology. The other 14 patients survived, with a mean time of open abdomen of 15 days (range 1–43). In all cases a total fascial closure was achieved, with absence of adhesions between the visceral and the parietal peritoneum. No complications related with the mesh took place during the follow up

Conclusion
Temporary abdominal closure with a bilayered reticular and laminar polypropylene mesh is efficient and safe, with a 100% rate of fascial closure
OC-078 LAP-T LAPAROSCOPIC GAS-LESS TECHNIQUE FOR THE REPAIR OF RECTUS MUSCLES DIASTASIS AND HERNIA IN ATHLETES
Authors: Pozzi G 
Published: October 2022

Abstract

Background/Aim
Diastasis of Rectus Abdominis Muscles (DRAM) in athletes is typically associated with muscle and fascial tearing and fracture and umbilical/epigastric hernias. Parietal damage is generally located on midline, subjected to continuous efforts and overload. Contrarily to repair of DRAM consequent to pregnancy or obesity, in athletes, the trigger of injury will persist after repair. LAP-T Technique aims at Mini-Invasive restoration of anatomy and physiologic functionality through laparoscopic tailored suture&mesh repair, allowing return to full sport activity.

Methods
96 cases from January 2010 to May 2021, minimum follow-up of 12 months. Elected patients: athletes, under 60 years old, BMI &lt; 30, ASA1 – ASA2, with maximum IRD 10cm and associated AWR. Rectus muscles are re-approximated from xiphoid to pubis with tailored sutures, and hernia defect repaired, using laparoscopic running self-locking barbed sutures. Entire procedure is performed in gas-less laparoscopy (3mmHg). Considering persistence of triggering cause after repair in athletes, the repair is consolidated placing an intra-peritoneal mesh. 10–15 days from surgery, patients start following a tailored rehabilitation program up to full resumption of sport activity.

Results
In all patients, AW anatomy and physiological functionality were successfully restored, any hernia repaired, with the restitution ad integrum of the AW; no higher pain related to the continuous suturing has been reported compared to bridge IPOM laparoscopic repair, while allowing for physiologic outcome and stronger repair. No intra operative bleeding, no seroma formation, chronic pain, nor mesh infection. All athletes retrieved full sport activity at pre-hernia and DRAM level. 98% follow up at 12 months, 91% at 24, with no recurrences observed.

Conclusions
LAP-T technique proved to be feasible technique for Athletes, allowing for sound and anatomic reconstruction of DRAM, associated hernias, and musculo-fascial tearing, with reduced trauma, fast recovery and full resumption of sport activity.
OC-081 VALIDATION OF THE DATA QUALITY OF THE SPANISH INCISIONAL HERNIA SURGERY REGISTRY (EVEREG). PILOT STUDY
Authors: Olona C , Pereira J A , Comas J , Protti G P , Alonso V , Amador S , Bombuy E , Mitru C , Gimeno M , López-Cano M 
Published: October 2022

Abstract

Aim
The Spanish Incisional Hernia Surgery Registry (EVEREG) is promoted by the Abdominal Wall section of the Spanish Association of Surgeons, starting data collection in July 2012 and currently has more than 13,500 cases.
The objective of this study is to validate the data collected through a pilot audit process

Material & Methods
A sample of hospitals participating in the EVEREG registry since 2012 is selected. Patients registered in these centers in the period 2012–2019 are included. A stratified random sampling is carried out, with the inclusion of 10% of registered cases per center with a minimum of 20.
In the 2020–2021 period, a selection of researchers, different from that of the center to be audited, checks the concordance between the registry data and the data collected in the patient's clinical history, either in person or online.

Results
330 patients have been analyzed, out of a total of 2673 registered, in 9 participating centers. The average accuracy has been 95.7% (99.1–79.35%). With 1.5% incorrect data and 2.28% missing data

Conclusions
This is the first validity study of an abdominal wall registry
The accuracy greater than 95% obtained allows us to determine an excellent quality in the data collection of the EVEREG registry. We believe that the confirmation of these data in all the centers participating in the registry would guarantee the quality of the studies carried out and their comparison with other international registries
P-005 LAPAROSCOPIC INGUINAL HERNIOPLASTY USING TRANSABDOMINAL PREPERITONEAL APPROACH (TAPP) IN YOUNG SURGEONS: A PERSONAL EXPERIENCE
Authors: Trujillo Díaz J , Jezieniecki Fernández C , Gómez López J R , Concejo Cutoli P , Martínez Moreno C , Atienza Herrero J , Herreros Rodríguez J , Beltrán De Heredia Rentería J , Martin Del Olmo J C 
Published: October 2022

Abstract

Aims
We present short-term results from the personal series of laparoscopic TAPP inguinal hernia procedures performed during the 1st year of postgraduate in General Surgery.

Material and Method
Retrospective study where we analyzed our database of patients diagnosed with inguinal hernia undergoing surgical treatment using laparoscopic approach-TAPP.

Results
A total of 77 patients diagnosed with inguinal hernia underwent laparoscopic treatment using the TAPP approach (men: 90%, age: 61(RIQ: 4 2.5–68 years)). LOS:1(RIQ:1–2 days). BMI: 2 7.3±3.3kg/m2. Overweight(57.1%).
Hernia characteristics: bilateral(84.4%), inguino-scrotal(10.4%), Lateral 66.2%), Medial(7.8%), Mixed(24.7%) and Femoral 1.3%).
Overall complications: 8(10.4%). Serious and intraoperative: 0%. Seroma: 10.4%. Hematoma: 10.4%. ISQ: 0%. Recurrence: 1(1.3%).
We performed an analysis comparing(X2) the patients operated on during the first 6 months(Period A) vs. those operated on in the second 6 months(Period B), and obtained the following results in terms of inguino-scrotal hernias (0% vs. 18.6% p = 0.008), mod-large hernias : type 2–3(44.1% vs. 65.1% p=0.065), non-fixation of the mesh(14.7% vs. 51.2% w=0.001), surgical time&lt;60min(5.9% vs. 46.5% w&lt;0.05), global complications (5.9% vs. 11.6% p=0.38), recurrence(2.9% vs. 0% p=0.25).

Conclusions
The laparoscopic approach to inguinal hernia offers the advantages of minimally invasive surgery: less postoperative pain, fewer complications, shorter hospital stay, and early return to usual physical activities. It is a technique that requires a learning curve but it is possible to be performed safely and effectively by a young surgeon under the supervision of a more experienced surgeon,without increasing the rate of intraoperative or postoperative complications, with short surgical times and with successful results.
P-009 OPEN VS LAPAROSCOPIC VS ROBOT-ASSISTED INGUINAL HERNIA REPAIR: A CASE SERIES
Authors: Valsamidis A , Allah Alnabhan A , Nielsen K A , Pedersen A K , Helligsø P , Mogensen C B , Nielsen M F 
Published: October 2022

Abstract

Aim
Minimally invasive inguinal hernia repair is thought to be associated with fewer complications. To address this hypothesis, we compared short- and long-term complications in patients undergoing elective open (Lichtenstein), laparoscopic (TAPP) and robot-assisted inguinal hernia repair (rTAPP).

Material & Methods
Patients undergoing either, Lichtenstein, TAPP or rTAPP at our institution between January 1st 2017 and December 30th 2019 were retrospectively identified. Short (haematoma, seroma, surgical-site infections) and long-term complications (chronic pain, recurrence) were recorded and compared between groups.

Results
636 patients were included in the study. 370 were treated with Lichtenstein, 125 TAPP and 141 with rTAPP. There was a significant overweight of men in all groups (p &lt; 0,001). Among the rTAPP group, the overall rate of complications was reduced (open: 10.0%; laparoscopic: 8.8%; robot-assisted 5.7%) while the presence of chronic pain was slightly more prevalent (Lichtenstein: 1.6%; TAPP: 1.6%; rTAPP: 2.1%). The rate of recurrence was lower following rTAPP (Lichtenstein: 3.8%; TAPP: 2.4%; rTAPP: 1.4%). Same day discharged was more likely following the open technique (open: 88.9%; laparoscopic: 78.4%; robot-assisted 78.7%). Nevertheless, these results were not statistically significant (p&gt;0.05).

Conclusions
The present case series demonstrates a comparable rate of short and long-term complications following open and minimally invasive inguinal hernia repair. The trend towards a lower overall complications rate and recurrence rate, though not statistically significant, implies that minimally invasive surgery might be associated with a lower complication and recurrence rate. However, a larger prospective study design with a longer follow-up is needed to test this hypothesis.
P-010 NYHUS AS A TREATMENT FOR STRANGULATED INGUINAL HERNIA: EXPERIENCE IN A SPECIALIZED ABDOMINAL WALL UNIT
Authors: Infantes Ormad M , Curado Soriano A , Montemuiño Chulian N , Valera Sanchez Z , Naranjo Fernandez J R 
Published: October 2022

Abstract

Aim
We present our experience in the repair of strangled inguinal hernias using Nyhus technique.

Material and methods
Retrospective review from 2019 to 2021 of 39 patients operated on for strangulated inguinal hernia who underwent a subsequent repair with cavity exploration using Nyhus technique, with a minimum follow-up of 12 months. There were 39 patients (77% men/23% women) with a mean age of 67 years (range 45–87 years), of which 41% were smokers, 22% obese, 10% cardiopaths and 22% COPD. 28% of hernias were recurrent.

Results
Of the 39 patients operated, intestinal resection and anastomosis were necessary in two patients; seroma was observed in 3 patients (10%), SSI in 2 patients (6%), hematoma in 4 patients (12%). During follow-up, recurrence has only been recorded in 2 patients(6%).

Conclusions
Anterior repair is the most widely used technique today for the repair of strangled inguinal hernia due to its simplicity and reproducibility. In many centers, a laparoscopic approach is being imposed, which allows, in addition to the repair of the hernia, a correct revision of the intestinal package in cases of doubtful viability. However, few surgeons today master the open preperitoneal technique, so useful in cases of recurrences, complex hernias and especially in emergencies.
The Nyhus technique is a very useful technical option in the repair of strangled inguinal hernias, allowing access with wide visibility and possibility of safe intestinal resection without the need for general anesthesia.
P-012 ESTABLISHING THE NORTH-WEST LONDON MDT FOR COMPLEX ABDOMINAL RECONSTRUCTION: OUR EXPERIENCE
Authors: Grove T , Howell A M , Kontovounisios C , Nicolay C , Mehta A , Warren O 
Published: October 2022

Abstract

Aim
Complex patients have been shown to have favourable outcomes when managed under the care of the multi-disciplinary teams (MDT) 1,2. In 2019 we published our experience of a single centre complex AWH MDT and advocated its use 3 in line with EHS and a collaborative group from AWRE 2020 4,5.

Expansion
Further development has led to the set-up of a regional, tertiary, complex, abdominal wall reconstruction MDT service. This has facilitated identification of patients who will ultimately benefit from management of the regional AWH MDT surgical teams undertaking the most complex of abdominal wall procedures together.
Since 2021 our regional MDT discussed 87 cases including tertiary referrals from within and out with the immediate geographical area. 71 abdominal wall hernias including 15 recurrent, 6 with concurrent parastomal hernias, 9 parastomal hernias and one perineal hernia.

Progression
The development of virtual conferencing services has allowed the MDT improved access for healthcare professionals. With resources for benign cases becoming increasing restricted, having an MDT approved management plan for patients streamlines services and allows costs to be rationalised. Scheduling joint operations between different hospitals facilitates pooling of expertise for difficult cases.
We are developing an online registry for involved abdominal wall units to allow data sharing, service evaluation and improve accountability.

Conclusion
Appreciation of complex abdominal wall surgery as a stand-alone sub-specialty is increasing and there is a consensus among hernia surgeons that these patients should be managed by the MDT in specialist centres by specialist surgeons enhancing learning, proficiency, and accountability.
P-028 POSTOPERATIVE ASSESSMENT OF PAIN AFTER LICHTENSTEIN TENSION-FREE MESH INGUINAL HERNIA REPAIR
Authors: Katsaros I , Vafias E , Athanassiou K , Floros C , Karakeke M , Gkogkos S , Giaga E , Kyriakidis A 
Published: October 2022

Abstract

Background-Aim
Effective postoperative pain management is vital for the well being of the patients after inguinal hernia repair. The aim of this study was to assess the analgesic efficacy and safety of parecoxib sodium versus diclofenac sodium following inguinal hernia repair.

Material & Methods
Patients that underwent from 1/1/2019 to 31/12/2020 an Lichtenstein tension free inguinal hernia repair at General Hospital of Amfissa were included in this study, They were randomly assigned to receive postoperatively parecoxib 40mg twice daily iv (group A), or diclofenac 75mg twice daily im (Group B). Tramadol 50mg iv was used as “rescue” treatment. Pain Rating System (PRS) was utilized for pain assessment.

Results
214 patients (162 males, 52 females) with a mean age of 72 (26–93) years were included in this study. Patients receiving parecoxib sodium experienced significantly lower PRS scores at 6 hours postoperatively (2.2 vs 3.1) and 24hrs postoperatively (1.2 vs 2.0). Fifty-nine patients (27.8%) needed a “rescue” analgesic treatment with the majority of them (43 patients) belonging to the Group B. 96.7% of total patients left the hospital on 1st postoperative day without needing any additional analgesic treatment.

Conclusions
Administration of parecoxib sodium 40mg twice daily is more effective than diclofenac for pain management after inguinal hernia repair.
P-033 RATIONALE FOR BILATERAL TAPP IN INGUINAL HERNIA AND NON-OVERGROWTH OF THE VAGINAL APPENDIX PERITONEUM ON THE CONTRALATERAL SIDE
Authors: Feleshtynsky Y , Shtaier A 
Published: October 2022

Abstract

Introduction
When performing TAPP overgrown vaginal appendage of the peritoneum is diagnosed on the contralateral side quite often. The question remains whether it is necessary to perform bilateral TAPP in unoccupied vaginal appendix.

Aim
To increase the effectiveness of TAPP in inguinal hernias combined with unhealed vaginal appendages contralaterally.

Materials and methods
An analysis of surgical treatment of 22 patients with bilateral TAPP who were diagnosed with vaginal appendix nonunion. All patients were men aged 25–65 years. Prior to surgery, it was agreed with patients that in case of nonunion of the vaginal appendix on the opposite side bilateral TAPP will be performed. For comparison, the efficacy of unilateral TAPP was evaluated in 21 patients with laparoscopically diagnosed non-overgrown vaginal appendix on the contralateral side.

Results
Among 22 patients with bilateral TAPP, the postoperative treatment was uncomplicated, postoperative pain was rated 2–3 points on a visual-analog scale. There was no postoperative wound infection. The duration of hospitalization was 2 + 1.2 days and was comparable to patients underwent unilateral TAPP. Long-term results were assessed by re-examinations and questionnaires, ultrasound examination, in 6–18 months. No complaints or recurrence of hernia were detected. A contralateral hernia developed in 9 (42.9%) patients of the control group at 6 to 12 months, which was scheduled for repeat TAPP.

Conclusion
TAPP requires diagnosis of bilateral inguinal area and bilateral TAPP in case of non-overgrowth of the vaginal peritoneal process, which reduces the likelihood of inguinal hernia on the contralateral side.
P-040 DIFFUSE LARGE CELL B LYMPHOMA TYPE ACTIVATED B CELL (MANTLE LYMPHOMA) AS A DIFFERENTIAL DIAGNOSIS OF INGUINAL HERNIA. A RARE FINDING
Authors: Gómez Torres I , Menor P D , Alcobilla E , Ridaura N , López E , Ponce P , Monzó C , Laguna M 
Published: October 2022

Abstract

Introduction
Mantle cell lymphoma is a rare type of B-cell non-Hodgkin lymphoma. It represents 7% of lymphomas in Europe, with an incidence of between 4 and 8 cases/year per million-hab. More frequent in men with a 4:1 ratio and middle-age.
We present a diagnosed clinical case of MCL with an infrequent presentation.

Material & Methods
A 70-year-old male affected by left inguinal tumor after physical exertion 6 months before the consultation.
Abdominal ultrasound and CT scan describe an extra testicular 3cm lesion with irregular edges without extension to other structures with possible signs of malignancy.
Surgery is performed with the lesion bloc excision including left test and elements of the spermatic cord.

Results
The analysis of Pathological Anatomy shows us as a result a diffuse large cell B Lymphoma type Polymorphic Mantle Cell Lymphoma.
The postoperative extension study (PET) shows no residual tumor or medullary involvement, suggestive of stage I.

Discussion
MCL is a rare type of lymphoma, characterized by translocation (11;14) (q13; q32) leading to overexpression of cyclin D1.
Most common presentation of MCL is B symptoms (up to 40%) fever, night sweats. Others include asthenia, nighttime pruritus, adenopathies, and hepatic or splenic enlargement.
Finally, CML can present with extranodal disease, digestive system, respiratory system, nervous system, endocrine or salivary glands.
It is a highly aggressive type of lymphoma that is usually diagnosed in advanced stages (90% cases), with poor prognosis with a life expectancy of 4 years despite optimal treatment.
Current treatment consists of a combination of chemotherapy and immunotherapy.
P-041 THE IMPACT OF COVID-19 ON ELECTIVE INGUINAL HERNIA REPAIR: A SINGLE-CENTER EXPERIENCE
Authors: Katsaros I , Kyriakidis V , Vafias E , Athanassiou K , Floros C , Karakeke M , Gkogkos S , Kyriakidis A 
Published: October 2022

Abstract

Background – Aim
Inguinal hernia repair is among the most common surgical operations worldwide with over 20 million performed yearly. During the COVID-19 pandemic most elective hernia repairs were canceled, leading to potentially detrimental effects on the patients suffering from them. The aim of this study was to assess the impact of the pandemic on inguinal hernias and elucidate its consequences.

Material & Methods
Patients that underwent inguinal hernia repair at General Hospital of Amfissa from March 2018 to March 2022 were included in this study. Patients were divided into two groups before (Group A) and after (Group B) March 2020, the date on which the first lockdown was implemented in Greece.

Results
Overall, 407 patients (382 males & 25 females) with a mean age of 69 (24–93) were included in this study. A 27.5% decrease in total surgeries was found during the Group B (236 vs 171 patients), but emergency surgeries significantly increased (17.3% vs 43.9%). Furthermore, there was a statistically significant increase in strangulated cases (15.3% vs 40.4%) and cases warranting a bowel resection (13.6% vs 39.2%). Mean length of hospital stay also significantly increased over Group B period (1.69 vs 3.02 days).

Conclusions
Policies leading to cancelation of elective surgeries and reallocation of healthcare facilities in order to confront the COVID-19 pandemic have led to a significant delay in the management of inguinal hernias. Thus, a steep increase in emergency cases was observed, as a greater part of theses hernias are being left untreated and subsequently strangulated.