bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-118 COMPLEX INCISIONAL HERNIA AFTER BRICKER PROCEDURE. A CASE REPORT
Authors: Laguna-Hernandez P , Serrano Yebenes E , Diaz Pedrero R , Soto Schutte S , Bru Aparicio M , Allaoua Moussaoui Y , Mañes Jimenez F , Jimenez Martin R , Quiroga Valcarcel A , Cordova Garcia D , Alvarado Hurtado R , Jimenez Alvarez L , Ovejero Merino E , Medina Reinoso C , San Roman Romanillos R , Ratia Gimenez T , Gutierrez Calvo A 
Published: October 2022

Abstract

Aim
To analyze the treatment and complications of gigant paraestomal eventration with a case report and literatura review

Material and Methods
a retrospective case report from our hospital and her evolution since her urology surgery in 2011

Results
Female of 59 years old, with personal antecedents of arterial hypertension, simple cistectomy and Bricker's urinary derivation (cutaneus ureteroileostomy) in 2011 due to intersticial cistitis, parastomal incisional hernia repair with intraperitoneal mesh in 2015. The patient was derivated from urology consult for a huge paraestomal incisional hernia and personal history of obstructive uropathy and several infections of urinary tract since 2022. No obstruction clinic was associated. Elective surgery was performed with an Trasversus Abdominis Release (TAR) and moving previous urostoma: hernial sac disection and previous mesh explant. Opening Rives, Retzius spaces and transversus fasciotomy was realized. Middle line was reforzed and hernial defect was closed. Polipopilene mesh was fixed at middle line and pubis with no reabsorbible suture and reforced with haemosthatic sealant. Anterior fascia was closed fixing at middle line. At the end a new urostoma was made in ryght hypocondrium. In postoperative period the patient developed light anaemia. Following months, the patient has not other complications due to incisional hernia repair.

Conclusions
Many factors can contibute to incisional hernia such as obesity, hypertension, number of surgerys, age, sex… TAR technique can be useful with complex eventration but we can not forget the commorbilities association to this surgery (anemia, pulmonar Tromboembolism…)
P-137 DE GARENGEOT`S HERNIA: AN UNUSUAL PRESENTATION OF APPENDICITIS. CASE REPORT AND REVIEW OF THE LITERATURE
Authors: Del Campo Martín M , García Galocha J L , Flores Flores C , López Antoñanzas L , García Alonso M , Díaz González J M , Torres García A J 
Published: October 2022

Abstract

Introduction
The presence of the appendix within a femoral hernia was first described by René De Garengeot in 1731. Less than 200 cases have been reported in the literature with an incidence of 0.5–5% of all the femoral hernias.

Case Description
A 69-year-old woman presented with a 72-hour history of painful right-sided groin swelling. She denied fever or any gastrointestinal symptomatology. Clinical examination revealed a non-reducible right mass. X-ray did not show any bowel obstruction. Laboratory found an increased leukocyte count (14.10 K/μL) with 77% neutrophils. She underwent emergency surgery. An inguinotomy was performed, observing the presence of the appendix incarcerated within the femoral ring. It showed clinical signs of appendicitis with no presence of abscess or perforation. Appendectomy was performed. The hernia was repaired with a polypropylene plug fixed to Cooper's and Gimbernat's ligaments.

Discussion
De Garengeot`s hernia affects women four times more compared to men. The most common symptoms are tenderness and a groin bulge (usually right-sided). The diagnosis is usually performed intraoperatively, although CT-scan is useful as a complementary test. Due to its low incidence, there are still no standardized recommendations on the treatment of this type of hernia. The most common approach in the literature is an open surgery via inguinal incision. Laparoscopic approach has been described too. Mesh use should not be considered in a contaminated field.

Conclusion
The treatment of this entity is the emergency surgery. We should consider this type of hernia to make an early diagnosis in order to prevent complications.
P-138 PREDICTORS OF COMPLICATIONS IN COMPLEX VENTRAL HERNIA REPAIR USING POSTERIOR COMPONENT SEPARATION TECHNIQUE WITH RETRO RECTUS MESH PLACEMENT – AN OBSERVATIONAL STUDY
Authors: Kumar M , Arora A , Kumar M 
Published: October 2022

Abstract

Introduction
Incisional Hernia has an incidence ranging from 2–20%. Large and complex incisional hernias are difficult to treat with standard procedures. PCS-TAR is a relatively novel procedure. There persists a gap in knowledge regarding its outcomes, especially in the Indian population.

Aims & Objective
To identify the pre-operative clinical and radiological factors that predict the risk of re-herniation and wound and mesh-related complications after CVH (Complex Ventral Hernia)

Methodology
In a prospective observational study, patients undergoing open PCS-TAR with retro rectus mesh for Complex Ventral Hernia repair included in the study. The patient demographics, hernia characteristics, radiological details, operative data, post- operative outcomes, and follow-up data were entered in a pre-designed proforma. Data were analyzed with SPSS softwere.

Results
35 patients with CVH were included, of which 30 (85%) women and 5 men. The mean age was 51.8 years and the mean BMI was 29.7 kg/m2. The mean size of defect was 12 cm. 83% hernia were midline primary and 255 were recurrent hernias. We observed zero recurrences at six months of follow-up, but a high wound morbidity rate of up to 49%, of which most common was seroma formation. 23% of patients developed SSI.

Conclusion
In conclusion, PCS-TAR is a promising novel procedure for complex ventral hernias not amenable to primary closure using the traditional retro rectus approach, with excellent short term outcomes. Wound morbidity is a significant concern with this procedure, which can be prevented or reduced by thorough pre-operative optimization on a case-to-case basis.
P-139 THE EFFECTS OF THE INCISION TYPE ON INCISIONAL HERNIA RESULTS OF LIVING DONOR LIVER TRANSPLANT; SINGLE CENTER EXPERIENCE
Authors: Tirnova İ , Karataş C , Kanmaz T 
Published: October 2022

Abstract

Aim
We aimed to assess the effects of the chosen incision type on postoperative hernia rates of liver transplantation in this paper.

Material-Methods
During the period between the 5th September 2018 and 31st March 2022, total 210 liver transplantations were performed in the Liver Transplantation Center of Koç University Hospital. 96 pediatric and 10 deceased donor transplantations were excluded. Living donor liver transplantation (LDLT) cases in only adults were included in the trial. Total 104 patients were included. Patients divided into two groups in the manner of chosen laparotomy incision during the operation. Reverse T incisions (Group A, n=68) and Makuuchi incisions (Group B, n=36) were performed in our center during the trial period. Minimum 3 month-follow up period was performed.

Results
Demographic data (Table 1) was similar in both groups. Operation and warm ischemia durations were longer in Group B (Table 2). Postoperative immunosuppressive regimens were same protocols contains tacrolimus and prednisolone. Surgical site infection rates, relaparotomy rates, postoperative blood transfusion rates, biliar, vascular and pulmonary complication rates were also similar in both groups (Table 3). While 11 patients diagnosed with incisional hernia in Group A (%16,2), 2 patients diagnosed with incisional hernia in Group B (%5,6, p=0,212).

Conclusion
Although Makuuchi incision seems to be safer in manner of hernia rates, this couldn't be proved by statistically significance as a result of this retrospective analysis of a single center. The necessity of prospective designed trials is obvious in order to obtain more reliable results.
P-142 CLINICAL AND ECONOMIC OUTCOMES OF ABSORBABLE KNOTLESS BARBED SUTURE VERSUS OTHER CONVENTIONAL SUTURES FOR ABDOMINAL MIDLINE CLOSURE IN PATIENTS UNDERGOING OPEN HERNIA REPAIRS
Authors: Berrevoet F , Gunja N , Danker W , Schmitz N D , Tomaszewski J , Stern L , Chandak A , Van Cauteren L 
Published: October 2022

Abstract

Aim
We assessed clinical and economic outcomes of patients undergoing open hernia repair using absorbable knotless barbed suture versus conventional absorbable suture for abdominal wall closure.

Methods
This retrospective cohort study identified patients undergoing hernia repair at a single center between 2013 and 2020. Fixed follow-up of 30, 60, and 90 days were used to assess outcomes (peri-operative complications, and resource utilization). Multivariate analyses for outcomes and Cox Proportional Hazards models for time to readmission and complications were conducted.

Results
Of 821 hernia repairs, 446 used absorbable knotless barbed suture and 375 used conventional absorbable suture. Baseline characteristics were largely similar between the groups. Surgical site infections (SSI) were significantly less frequent with absorbable knotless barbed suture (60-day, 5.9% vs. 11.4%; P=0.0083; 90-day, 5.9% vs. 11.7%; P=0.006) and remained consistent after multivariate adjustment (60-day, OR [95% CI]: 0.52 [0.29–0.92]; 90-day, 0.51 [0.28–0.90]). Among patients with SSI, deep SSI were less frequent with absorbable knotless barbed suture (60-day, 9.1% vs. 35.7%; P=0.022; 90-day, 9.1% vs. 34.9%; P=0.0252). Absorbable knotless barbed suture significantly reduced the risk of peri-operative complications over time (HR 0.57 [95% CI 0.36–0.92]; P=0.0203). Hospital length of stay was, on average, 2.74 days longer in conventional absorbable suture patients (mean [95% CI] 8.75 [7.83–9.78] vs. 6.01 [5.16–6.99] days; P&lt;.0001).

Conclusions
Significant differences between sutures were seen with peri-operative infections, which occurred less frequently with absorbable knotless barbed suture and less severe. Peri-operative complications and length of stay were significantly reduced with absorbable knotless barbed suture.
P-155 ROLE OF MDT IN CPIP MANAGEMENT: LITERATURE REVIEW
Authors: Pawlak M , Alabbasi I , Cocciolo F , Wei R 
Published: October 2022

Abstract

Abstract
Chronic Post-operative Inguinal Pain (CPIP), is recognised as a long term condition and has a significant effect on patients’ quality of life. CPIP affects 18–30% of patients after an open inguinal hernia repair and 6% of patients after a laparoscopic inguinal hernia repair. CPIP result from several causes such as a pre-operative nerve lesion in other area of the body, an intra-operative nerve injury, or due to the intensity of acute post-operative inflammation and healing. a multidisciplinary clinic would be considered the best approach in order to assess patients’ pain and identify an individual management plan. This review allowed the team to choose which literature could be used to support the implementation of the clinical practice change.

Method
Literature searches were performed using PubMed and Embase databases were searched using key terms to include all related articles in the last ten years. three independent reviewers to choose included and excluded articles with two steps.

Results
Out of 25 articles found by the research, 8 articles included in this review including MDT about CPIP, meeting including criteria after the full articles reviewed. it was important to understand the nature and mechanisms of Chronic Post-operative inguinal hernia. several risk factors have been identified, which may be causing CPIP such as young age, recurrent inguinal hernia repair procedure and presence of pain before the procedure. Because of the complexity of CPIP, many authors concluding that a multidisciplinary approach should be considered the more appropriate method to ensure an effective and safe treatment. This include the need of regular follow up after an inguinal hernia repair to identify the chronic pain and establish an appropriate management plan.

Conclusions
Although the literature review enabled the team to gather useful information about the topic of the clinical practice change; it was evident that more researches and studies need to be completed in order to identify the safest and effective treatment for patients presenting with CPIP.
V-001 ROBOTIC ETEP WITH TOP DOCK: STEP BY STEP FOR A SAFE PROCEDURE
Authors: Villalobos R , Maestre Y , González Barranquero A , Olsina J 
Published: October 2022

Abstract

Introduction
Robotic surgery has evolved in the last few years. Extended total extraperitoneal approach (eTEP) has allowed a better location of the mesh avoiding contact with the bowel. The most important step for this technique is the trocars Positioning in the retrorrectal space. It will depend on the defect localization. Docking can be performed in 3 ways: Inferior (down), lateral and superior (top). The last one represents the most complex. We present a video that explains step by step how to do this technique.

Material and methods
We considered patients with M3–5W2 and W3 incisional/ventral hernias with a non-injured supraumbilical area. For the retrorrectal dissection, an optic trocar or an expander balloon were used in the left-up quadrant. Afterwards, a 12mm trocar was introduced and the pneumo initiated. At the left flank a 5mm trocar was placed to initiate the crossover with a hook. Subsequently, an 8mm trocar was place in the top midline and next the third robotic trocar at the right up quadrant. Finally, the docking was made.

Results
Twelve eTEP assisted with robot in a top dock have been performed in a safe way in patients with incisional/ventral hernias.

Conclusions
The eTEP technique assisted with robot in a top dock position allows a safe access following the steps that we learned in our experience.
V-008 ROBOTIC TOTALLY EXTRAPERITONEAL RETROMUSCULAR REPAIR OF A TYPE III PARASTOMAL HERNIA
Authors: Barranquero A G , Villalobos Mori R , Maestre González Y , Gutiérrez E , Olsina Kissler J 
Published: October 2022

Abstract

Aim
The retromuscular repair described by Pauli et al. (2016) dissects the retromuscular space, releases the transversus muscle, and lateralizes the stoma to place a retromuscular mesh. The aim was to show the results of the robotic approach for this intervention.

Material & Methods
Video description of a case report. The patient was a 71-year-old woman that underwent an abdominoperineal resection for rectal cancer in 2017 and presented with a 5.8 cm parastomal hernia without midline defects (type III of the EHS classification).

Results
Three robotic trocars were placed in the lateral of the right rectus sheath, and posteriorly a 12 mm assistance port was inserted in the left hypochondrium. The dissection began in the inferior preperitoneal space, until finding the left transversus muscle. Then, the rectus sheath was dissected superiorly and laterally. A posterior rectus sheath release was performed in a down–to–up direction, initially avoiding the parastomal hernia, which was later reduced. Posteriorly, the peritoneum was incised and then sutured to lateralize the stoma. The parastomal hernia defect and the posterior rectus sheath were equally sutured. Finally, a polyvinylidene difluoride (PVDF) mesh was placed in the retromuscular space, which was fixed with transfascial sutures to the sides of the stoma.

Conclusions
The robotic totally extraperitoneal retromuscular approach for parastomal hernias is safe and feasible, with the advantage of avoiding the intraperitoneal space.
V-013 ETEP - STEP BY STEP
Authors: Pires M , Rosas F , Neves S , Flores A , Magalhães C 
Published: October 2022

Abstract
Minimally invasive approaches are increasingly being used for the correction of abdominal wall hernias. Although laparoscopy presents as a greater technical challenge compared to classical techniques, once the learning curve is overcome, the advantages are multiple: less postoperative pain, shorter hospital stay, faster return to daily/professional activities and lower rate of surgical site infection.
The authors present the case of a 55yo women with a history of type 2 diabetes mellitus and peripheral venous insufficiency. No history of previous surgeries. The patient was referred to an appointment in the Ambulatory Surgery Centre for evaluation of a primary midline hernia. Symptoms were worsening in the last 6 months. No previous episodes of complications. Preoperative evaluation included an abdominopelvic computed tomography, which revealed a hernia sac containing only fatty tissue (no intestinal loops present) and a 19 mm hernial neck with a supra-umbilical median location. No other abdominal wall defects were evident.
The patient was proposed for a laparoscopic approach - extended totally extraperitoneal (eTEP) in ambulatory setting. The surgery and post-operative period (9 months) to date went without intercurrences.
The present video aims to demonstrate the main steps of the surgical technique applied in a tertiary centre with years of experience in laparoscopic abdominal wall surgery.
With this paper the authors pretend to demonstrate that laparoscopy may become the gold-standard in abdominal wall hernia correction as soon as the know-how and respective learning curve are aquired. Until then, these cases should continue to be referred to specialized tertiary centres.
V-042 MOVING THE CONCEPT ASSOCIATED TO LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY (LIRA) TO LATERAL HERNIA
Authors: Licardie E , Gómez P , Navarro L , Bellido A , Gómez-Menchero J , Morales-Conde S 
Published: October 2022

Abstract

Aims
Lateral hernias(LH) are rare and there are difficulties associated to minimally invasive approach, LIRA-technique has been described as an alternative to simple closure of the defect. Despite this, the indications of the concept associated to this technique are beginning to expand to other complex locations. Aims of this video is to show the surgical steps for LH where the concept associated to LIRA is followed to repair this type of hernias.

Material & Methods
56-year-old female patient without previous surgical history. Clinical examination and CT-scan showed a LH(L2) 6.4 cm in width(W2) and a length of 6.6 cm.

Results
We started by opening the peritoneum and fascia, exposing the fibers of the internal oblique and the posterior rectus sheath near the border of the defect. Then, the peritoneum and the fascia transversalis, and medially the posterior aponeurosis of the rectus muscle, are opened. Also, it is important to create a lateral peritoneum flap, using a hybrid procedure that involves a partially extraperitoneal and transabdominal (TAPE), then loop-suture are used for closing the defect. Finally, the mesh is placed intraperitoneally and partially extraperitoneal.

Conclusions
Best surgical technique for LH is still not clear. The anatomical location of these hernias is challenging, recurrence and bulging are also frequent. Since the introduction of the concept of primary closure of the hernia defect, the surgical repair of hernias in different locations has changed, although the idea of expanding the indication of LIRA could be related to better results in term of recurrences, bulging and pain.
Prefrontal and somatosensory-motor cortex effective connectivity in humans
Authors: Rolls Edmund T , Deco Gustavo , Huang Chu-Chung , Feng Jianfeng 
Published: October 2022

AbstractEffective connectivity, functional connectivity, and tractography were measured between 57 cortical frontal and somatosensory regions and the 360 cortical regions in the Human Connectome Project (HCP) multimodal parcellation atlas for 171 HCP participants. A ventral somatosensory stream connects from 3b and 3a via 1 and 2 and then via opercular and frontal opercular regions to the insula, which then connects to inferior parietal PF regions. This stream is implicated in “what”-related somatosensory processing of objects and of the body and in combining with visual inputs in PF. A dorsal “action” somatosensory stream connects from 3b and 3a via 1 and 2 to parietal area 5 and then 7. Inferior prefrontal regions have connectivity with the inferior temporal visual cortex and orbitofrontal cortex, are implicated in working memory for “what” processing streams, and provide connectivity to language systems, including 44, 45, 47l, TPOJ1, and superior temporal visual area. The dorsolateral prefrontal cortex regions that include area 46 have connectivity with parietal area 7 and somatosensory inferior parietal regions and are implicated in working memory for actions and planning. The dorsal prefrontal regions, including 8Ad and 8Av, have connectivity with visual regions of the inferior parietal cortex, including PGs and PGi, and are implicated in visual and auditory top-down attention.
Unitary synaptic responses of parvalbumin interneurons evoked by excitatory neurons in the mouse barrel cortex
Authors: Canales Alejandra , Scheuer Katherine S , Zhao Xinyu , Jackson Meyer B 
Published: October 2022

Abstract
The mammalian cortex integrates and processes information to transform sensory inputs into perceptions and motor outputs. These operations are performed by networks of excitatory and inhibitory neurons distributed through the cortical layers. Parvalbumin interneurons (PVIs) are the most abundant type of inhibitory cortical neuron. With axons projecting within and between layers, PVIs supply feedforward and feedback inhibition to control and modulate circuit function. Distinct populations of excitatory neurons recruit different PVI populations, but the specializations of these synapses are poorly understood. Here, we targeted a genetically encoded hybrid voltage sensor to PVIs and used fluorescence imaging in mouse somatosensory cortex slices to record their voltage changes. Stimulating a single visually identified excitatory neuron with small-tipped theta-glass electrodes depolarized multiple PVIs, and a common threshold suggested that stimulation elicited unitary synaptic potentials in response to a single excitatory neuron. Excitatory neurons depolarized PVIs in multiple layers, with the most residing in the layer of the stimulated neuron. Spiny stellate cells depolarized PVIs more strongly than pyramidal cells by up to 77%, suggesting a greater role for stellate cells in recruiting PVI inhibition and controlling cortical computations. Response half-width also varied between different excitatory inputs. These results demonstrate functional differences between excitatory synapses on PVIs.
Evaluation and management of cancer patients presenting with acute cardiovascular disease: a Clinical Consensus Statement of the Acute CardioVascular Care Association (ACVC) and the ESC council of Cardio-Oncology—part 2: acute heart failure, acute myocardial diseases, acute venous thromboembolic diseases, and acute arrhythmias
Authors: Gevaert Sofie A , Halvorsen Sigrun , Sinnaeve Peter R , Sambola Antonia , Gulati Geeta , Lancellotti Patrizio , Van Der Meer Peter , Lyon Alexander R , Farmakis Dimitrios , Lee Geraldine , Boriani Giuseppe , Wechalekar Ashutosh , Okines Alicia , Asteggiano Riccardo , Combes Alain , Pfister Roman , Bergler-Klein Jutta , Lettino Maddalena 
Published: October 2022

Abstract
Advances in treatment, common cardiovascular (CV) risk factors and the ageing of the population have led to an increasing number of cancer patients presenting with acute CV diseases. These events may be related to cancer itself or cancer treatment. Acute cardiac care specialists must be aware of these acute CV complications and be able to manage them. This may require an individualized and multidisciplinary approach. The management of acute coronary syndromes and acute pericardial diseases in cancer patients was covered in part 1 of a clinical consensus document. This second part focusses on acute heart failure, acute myocardial diseases, venous thromboembolic diseases and acute arrhythmias.