bluuebunny/crossref_metadata_2025_split huggingface dataset:
OC-001 SINGLE-STAGED ABDOMINAL WALL RECONSTRUCTION IN CONJUNCTION WITH ENTEROCUTANEOUS FISTULA REPAIR WITH AND WITHOUT ACELLULAR DERMAL MATRICES: A SINGLE CENTRE OBSERVATIONAL COMPARISON OF SHORT-TERM OUTCOMES
Authors: Hodgkinson J , Al-Kizwini E , Leo C A , Maeda Y , Constantinides J , Mehta A , Warusavitarne J , Vaizey C 
Published: October 2022

Abstract

Aim
Single-staged abdominal wall reconstruction (AWR) with simultaneous enterocutaneous fistula (ECF) repair is safe. This study aims to evaluate short-term outcomes from AWR with ECF repair and compare short-term outcomes between two commonly used acellular dermal matrices (ADM) as well as suture repair alone, with focus on ECF recurrence.

Methods
Data were collected between 2011 and 2019 from a prospectively maintained operative database. A retrospective case-note review identifed patient demographics and post-operative outcomes. Kruskal-Wallis test was used for categorical variables and one-way ANOVA for continuous variables to evaluate between groups.

Results
One hundred and fifteen cases were performed in the study period: 70 primary suture repair, 28 Surgimend and 17 Strattice. Fifty-eight patients (50.4%) were female with a mean age of 55.3 years (SD 13.9), BMI of 26.9 (SD 5.18) and 75 (65.2%) had intestinal failure. Median length of stay was 25 days (range 7–176).
Overall, fistula recurrence rate was 10.4% (12 cases). Of these, 9 (12.8%) occurred in the suture repair group, 2 (11.8%) where a Strattice mesh was used and 1 (3.6%) where a Surgimend mesh was used (p=0.54). Forty-six patients (40%) had a Clavien Dindo complication of &gt;3 and 73 patients (53.2%) had an SSI. Mortality was low at 2.8%.

Conclusion
Single-staged AWR in conjunction with ECF repair remains a complex but safe undertaking. Initial experience suggests Surgimend is safe to use in the context of single-staged AWR and ECF recurrence rates are lower than with a comparable ADM with similar short-term outcomes.
OC-006 LAPAROSCOPIC TOTALLY EXTRA-PERITONEAL REPAIR OF BILATERAL INGUINAL HERNIAS WITH A LARGE SINGLE MESH: A SINGLE CENTER STUDY WITH MINIMUM 5 YEARS FOLLOW UP
Authors: Shaltiel T , Grassi C , Esepkina O , Issa N 
Published: October 2022

Abstract

Background
Laparoscopic totally extraperitoneal (TEP) surgery with a single large mesh is currently the technique of choice for repair of bilateral inguinal hernias in our institution. Most surgeons use two meshes for the TEP repair. We present our experience with a single mesh repair.

Material & Methods
Records of all patients who had bilateral inguinal hernia and underwent bilateral laparoscopic TEP repair at our institution, 2010–2016, were retrospectively reviewed. We excluded patients who had a conversion to transabdominal intraperitoneal or open approach.

Results
A total of 470 patients were identified. The median age of patients was 56 (IQR 1–3; 41–66) years and median BMI was 25.9 (IQR 1–3; 23.1–28.1). 18.7% of the cohort (88 patients) had previous abdominal surgery and 39 patients (8.41%) had a recurrent inguinal hernia. Median length of operation was 63 (IQR1–3; 48–89) minutes. Operative complication were bleeding (0.4%) and bladder injury (0.2%). Post operative complications occurred in 32 patients; among the complications were seroma (2.6%), hematoma (2.1%), surgical site infection (0.4%) urinary retention (1.5%) and intestinal obstruction (0.2%). Median length of hospitalization was 1 day (IQR1–3; 1–2). After a median follow up of 102 months, 36 patients had a recurrence. 20 patients (4.3%) had a re-operation for recurrent inguinal hernia. Post-operative groin pain was present in 48 patients.

Conclusion
The use of a large single mesh is an effective and safe technique for TEP repair of bilateral inguinal hernias. The recurrence rate and prevalence of post-operative pain is consistent with the results reported by others.
OC-007 RELIABLE AND COST-EFFECTIVE METHOD OF GROIN HERNIA SURGERY, BASED ON OPEN PRE-PERITONEAL APPROACH AND ORIGINAL MESH FIXATION
Authors: Podpriatov S , Podpryatov S , Bondar S , Levytska O 
Published: October 2022

Abstract

Aim
To analyze the results of original technique for groin hernia (GH) repair, via open preperitoneal approach (OPPA) had proposed by L.M.Nyhus.

Material & Methods
There were 161 patients 22–87 years old; in 25 cases GH were recurrent. After OPPA, the spermatic cord, inguinal ligament, interior inguinal ring and abdominal wall defect were always in full vision. GH sack was removed into abdominal cavity. The mesh, having spermatic cord got through a special orifice in it, was fixed to inguinal ligament along it full length, and to rectus abdominis muscle’ lateral edge. Inguinal abdominal wall defect was covered from within by mesh under visual and palpable control.

Results
Operation time takes 42.5±9.1 minutes for simple GH, and 103.5±21.4 minutes for irreducible inguinal-scrotal hernia. General burden of surgery was correspondent to minimal invasive. Follow-up to work became from 3–5th day. For 12 months 107 (60.9%) patients were followed, no hernia recurrence was found.

Conclusions
Our method has basic prevalence over: i) possibility of one-day surgery (longer hospitalization if comorbidities); ii) cost-saving because needn't in laparoscopic equipment; iii) simplicity and high reliability because of visual anatomic controlled mesh fixation and positioning for the total closing of groin gap. It may pretend for a proper approval at EHS guidelines. The learning curve and additional points, such as type and quantity of fixation points, best of mesh to be used, should be discussed after the further evaluation.
OC-010 RESULTS OF PREHABILITATION IN PATIENTS WITH COMPLEX ABDOMINAL WALL DEFECTS
Authors: De Jong D , Wegdam J , Nienhuijs S , De Vries Reilingh T 
Published: October 2022

Abstract

Aim
Complex abdominal wall reconstruction (CAWR) remains challenging, even in expert centers. Complication rates are still high, especially in patients with modifiable risk factors (MRF) like obesity, smoking, or diabetes. For several surgical trajectories, prehabilitation of MRF has shown to reduce complication rate. The purpose of this study was to determine the effect of prehabilitation in high risk MRF patients undergoing CAWR on convalescence.

Materials and Methods
A retrospective cohort study was performed in an expert hernia center. All patients undergoing complex abdominal wall defect reconstruction (hernia width beyond 10 cm, contaminated surgical field or relevant comorbidities) between 2015 and 2019 were included. Each patient was discussed in a multidisciplinary meeting, after which those referred for prehabilitation were compared to those with direct approval. Focus of a supervised preconditioning program could be weight loss, smoking cessation, physical training or a combination.

Results
From 418 patients discussed, 259 patients underwent CAWR and were included for analysis, of which 126 (49%) underwent prehabilitation. Hernia and intra-operative characteristics were comparable. BMI (28vs30, p&lt;0.001), HbA1c (41vs48, p=0.014), active smokers (4%vs25%, p&lt;0.001) and risk factors (14%vs48%, p&lt;0.001) were higher in the latter group. After prehabilitation, characteristics were comparable. There were no significant differences in postoperative outcome measures (hospital stay 6[5–8]vs6[5–8] days, p=0.908, complication rate 39%vs33%, p=0.190).

Conclusions
Prehabilitation of modifiable risk factors is profitable in patients planned for CAWR. Subsequent postoperative results were comparable to those without or with less risk factors: prehabilitation downgrades high risk patients to low risk patients. Prospective research is advised.
OC-011 PREOPERATIVE BOTULINUM TOXIN A INJECTION CAN ACHIEVE SIMILAR OUTCOMES AS COMPONENT SEPARATION TECHNIQUES IN COMPLEX ABDOMINAL WALL RECONSTRUCTION WITH DECREASED MORBIDITY– A PROPENSITY-SCORED MATCHED STUDY
Authors: Marturano M , Ayuso S , Ku D , Raible R , Lopez R , Colavita P , Augenstein V , Heniford B T 
Published: October 2022

Abstract

Aims
CST have been effective in closing large defects but at the sacrifice of fascia and muscle and often increasing complication rates. Preoperative BTA has emerged as an adjunct to aid in fascial closure. Little data exist comparing pre-operative BTA versus CST, and our aim was to do so in a matched study.

Materials & Methods
A 3:1 propensity matched study of patients from a single institution hernia database undergoing AWR from 2016 to 2021 with BTA versus CST was performed based on BMI, defect width, hernia volume, and CDC wound classification. Demographics, operative characteristics, and outcomes were evaluated.

Results
35 BTA vs 105 CST matched patients were analyzed. Hernia defects and volume were large for both the CST and BTA groups (mean size:286.2+179.9cm2vs289.7+162.4cm2;p=0.73) (mean volume:1498.3+2043.4cm3vs2914.7+6539.4cm3;p=0.35). CDC wound classifications were equivalent (CDC3 and 4–39.1%vs40.0%;p=0.97). CST was more frequently performed in European Hernia Society M1 hernias (21% vs 2.9%;p=0.01). The BTA group had fewer surgical site occurrences (SSO) (32.4%vs11.4%;p=0.02) and surgical site infections (SSI) (11.7%vs0%;p=0.04). There was no difference in fascial closure (90.5%vs100%;p=0.11)) or recurrence (12.4%vs2.9%;p=0.10) with similar median follow-up (22.8+29.7vs 9.8+12.7months;p=0.13). In multivariate analysis, BTA was associated with lower rates of SSO (OR=5.3; 95% CI [1.4–34.4]).

Conclusion
There was no difference in fascial closure rates or in hernia recurrence between the two groups. Pre-operative BTA can thereby achieve similar outcomes as CST while concurrently decreasing the frequency of SSO. This similarity in outcomes is upheld when comparing BTA to both ACST and PCST separately.
OC-018 ASSESSMENT OF A SUPPORT GARMENT IN RELATION TO A PARASTOMAL BULGE – A QUALITATIVE STUDY
Authors: Krogsgaard M , Borglit T B , Theisen S Z , Rothmann M J 
Published: October 2022

Abstract

Aim
To investigate patients’ experiences of the assessment of support garments in relation to a parastomal bulge.

Material and Methods
A qualitative study with 11 in-depth semi-structured interviews. A preceding systematic literature review and a small field study conducted before the study informed the main topics in the interview guide.

Results
Garments had to fit patients’ needs and personal preferences; being comfortable, flexible and user-friendly. When comorbidities, e.g., incontinence, poor balance, arthritis and visual impairment were not accounted for, garments were unmanageable to patients. Patients needed guidance on how to apply and use the garment. Lack of hands-on guidance left patients confused and helpless with unworn garments. Re-assessment of a garment necessitated several visits to the manufacturer, was time-consuming and stressful for patients and required patients’ physical and mental resources. The garment created new possibilities and challenges; well-assessed garments reduced symptoms from the parastomal bulge while poorly assessed worsened or induced new symptoms and ended up unworn.

Conclusion
Exploring patients’ expectations, symptoms, needs and comorbidity were vital for patients’ subsequent use and benefit of garments. Tailor-made information, guidance and professional assistance are important in the assessment process. Interventions to support a patient-centred, individual and systematic approach are warranted.
OC-025 STRATEGY FOR SURGICAL TREATMENT OF GIANT INGUINOSCROTAL HERNIA - SERIES OF 21 CONSECUTIVE PATIENTS DURING 15 YEARS
Authors: Zuvela M , Galun D , Bogdanovic A , Palibrk I , Velickovic J , Djukanovic M , Zivanovic M , Zuvela M , Zuvela M 
Published: October 2022

Abstract

Aim
To present our strategy for surgical treatment of patients with giant inguinoscrotal hernia whose hernia defect is ≥10 cm or who have a loss of domain.

Material and methods
Between January 2006 - January 2022, 21 consecutive patients with giant inguinoscrotal hernia and high risk of postoperative intra-abdominal hypertension were managed. The hernia was repaired in the following manner: modified Rives technique performed through direct inguinal approach in 10 patients; additional procedures were needed to reduce the volume of organs returned to the abdomen in four patients; the primary abdominal cavity was enlarged by various components separation techniques with or without mesh hernioplasty in seven patients.

Results
The hernia defect size was in range 7–17 cm. In three patients the contents of the hernia sac accounted for more than 50% of the intestines: entire large bowel without the rectum, ileum, jejunum except proximal 15 cm and greater omentum). Postoperative complications occurred in eight patients were: scrotal hematoma, deep mesh infection, seroma and hydrocele. There were three postoperative deaths: 12 hours, 17 and 42 days after the surgery because ischemic enteritis, cerebrovascular stroke and heart failure, respectively.

Conclusion
Our strategy consisting of modified Rives technique performed through direct inguinal approach with or without additional procedures to reduce the volume of organs returned to the abdomen or to enlarge the primary abdominal cavity can be a good solution for giant inguinoscrotal hernias. Procedure is followed by the risk of deadly complications and requires trained team in intesive care unit.
OC-031 INCIDENCE AND RISK FACTORS FOR RECURRENCE OF RIVES-STOPPA REPAIR FOR INCISIONAL HERNIAS. TWENTY-YEAR RETROSPECTIVE ANALYSIS OF LONG-TERM OUTCOMES OF DIFFERENT MESH REPAIRS
Authors: Oprea V , Toma M , Buia F , Leuca D , Gheorghescu D , Grad O , Chiorescu S 
Published: October 2022

Abstract

Objective
the aim of this study was to determine the long-term recurrence and complication rates following Rives-Stoppa repair of midline incisional hernias with different types of synthetic materials.

Patients and Methods
medical files of 1628 patients with midline incisional hernias who underwent abdominal wall reconstruction using Rives-Stoppa repair between January 1999 and December 2019 were reviewed. All patients followed up after 1 month, 6 months, and 1year later and after that yearly.

Results
until 2007, 674 patients were operated on with available meshes for that time (mosquito net – 135, polyester mesh – 322, and polypropylene mesh – 217). After 2007, polypropylene meshes were used in 1054 patients (heavyweight in 428 patients and lightweight meshes in 626). The global recurrence rate after a mean follow-up of 96.5 months in the first group of patients was 13.3% and in the second group was 7.13% (mean follow-up of 108.4 months). The infection rate was 16.8% versus 9.2% with an increased incidence at 30 days (84 vs 62 patients). The hematoma rate was equally distributed. Seroma formation was almost 2.5-fold increased in the first group of patients (21.3% vs 8.7%). Increased rate of seroma formation were associated with mosquito net (OR = 1.7; 95% CI = 0.5–1.3; p=o.o2), heavyweight type type (OR = 0.9; 95 CI = 0.07–0.4; p=o.o31). Infection was associated with the usage of mosquito net, heavyweight type, and polyester mesh.

Conclusions
the lightweight mesh offers a safe method for abdominal wall reconstruction.
OC-040 RETAINER I (RETENTION OF URINE AFTER INGUINAL HERNIA ELECTIVE REPAIR), A PROSPECTIVE, INTERNATIONAL, MULTICENTRE COHORT STUDY
Authors: Croghan S , Fullard A , Fleming C ,   I S R C
Published: October 2022

Abstract

Aim
Post-operative urinary retention (POUR) is a recognised complication of inguinal hernia repair (IHR). Reported incidence is variable, and reporting of risk factors, contradictory. We aimed to report the rate, risk factors and impact of POUR post IHR.

Methods
A prospective international observational study was performed with 4 week data collection from each centre (March-November 2021). Patients undergoing elective open/minimally-invasive IHR were eligible. Exclusion criteria included a urethral catheter at baseline. Preoperative/intraoperative/postoperative variables were analysed and data recorded via REDCap. Multivariate analysis was performed with a primary outcome of development of POUR. Secondary outcomes were risk factors for, and implications of, POUR.

Results
4,153 patients (205 centres; 35 countries) were registered. Mean age was 54.7 years (18–95) and BMI 26.5 (16–6). 80.4% (n=3167) were performed open and 17% (n=674) minimally-invasively. The overall rate of POUR was 5.8% (n=225) and increasd &gt;9% in male patients aged &gt;65 years old. Risk factors associated with POUR included: higher preoperative IPSS scores (mean 9.4 vs 5.6 in non-POUR cohort, p&lt;0.001), diagnosis of BPH (p&lt;0.001), pre-operative constipation (p=0.009) defined as no bowel opening for two days pre-operatively and pre-operative post void residual volumes (&lt;0.001). 37% of patients developing POUR required an unplanned hospital admission.

Conclusion
This study suggests a global POUR rate of approximately 5% following elective IHR and confirm a significant impact of POUR on patients and hospital services. Findings highlight several risk factors and confirm the IPSS score as a potential risk stratification tool.
OC-047 LEARNING CURVE IN HERNIA SURGERY- A REGISTER BASED STUDY
Authors: Bladin O , Young N , Nordquist J , Roy J , Järnbert Pettersson H , Sandblom G , Löfgren J 
Published: October 2022

Abstract

Aim
The purpose of this study was to investigate the learning curve of open anterior mesh repair for groin hernia by assessing hernia recurrence rates, surgical complications, and operative times in relation to the number of procedures performed by surgical trainees.

Materials & Methods
Nationwide data on open anterior mesh repair for groin hernia performed by surgical residents were collected from the Swedish Hernia Register between 2005 and 2020. Data were analyzed in a cohort of procedures carried out by surgeons performing their first registered repair as resident. Repairs performed by surgeons who had carried out less than 30 repairs or any repair 1992–2005 were excluded.

Results
The study group consisted of 38 854 repairs carried out by 663 surgeons. The complication rate increased from 298/9884 (3.0%) the first 15 repairs performed to 396/10978 (3.6%) repairs 31–60 and then decreased to 4/945 (0.4%) for repairs performed after the first 240 ones. Mean operation time decreased from 79 minutes (standard deciation [SD] 26 minutes) the first 15 repairs to 60 minutes (SD 23 minutes) for repairs performed after the first 240 ones. Recurrence rates remained unchanged during the learning curve.

Conclusions
It is safe for resident surgeons to perform uncomplicated, elective, anterior groin hernia mesh repair after having completed of at least 60 procedures.
OC-050 “HAPPY TO CLOSE?”: THE RELATIONSHIP BETWEEN SURGICAL EXPERIENCE AND INCISIONAL HERNIA RATES FOLLOWING ABDOMINAL WALL CLOSURE IN COLORECTAL SURGERY
Authors: Smith L , Fegan G , Torkington J 
Published: October 2022

Abstract

Introduction
Incisional Hernia (IH) is a common complication of colorectal surgery. Given high recurrence rates and associated morbidity, emphasis must be on prevention of IH. There is an association between surgeon volume and outcomes in hernia surgery, yet little evidence regarding impact of the experience of the surgeon performing abdominal wall closure (AWC) on IH rate.
Our aim was to assess the rates of IH at 1 year following surgery between Registrar and Consultant surgeons in patients undergoing elective colorectal surgery.

Methods
Patients undergoing elective surgery for colorectal cancer between 2014–2018 were identified through the Hughes Abdominal Repair Trial (HART), a prospective, multicentre randomised control trial. Grade of surgeon performing AWC was categorised into “Registrar” and “Consultant” and compared with IH detected at clinical examination at 1 year following surgery.

Results
663 patients were suitable for inclusion. 44% were closed by registrars (n=289). Groups were comparable in BMI, previous surgery and pre-operative IH. The rate of IH in patients closed by registrars was significantly higher than those closed by consultants (20% vs 12%, p&lt;0.01). Patients who underwent AWC by a registrar were 88% more likely to develop IH at 1 year (OR 1.88, 95%CI 1.23–2.86, p&lt;0.01).

Conclusion
Patients who undergo AWC by a registrar have an increased risk of developing IH compared to those closed by a consultant. Further work is needed to determine the impact of supervised and un-supervised trainees on IH rates, but AWC should be treated as training time rather than coffee time.
OC-052 A CHANGE IN PRESENTATION OF PARAOESOPHAGEAL HIATUS HERNIA REQUIRING SURGICAL INTERVENTION IN A DISTRICT GENERAL HOSPITAL IN THE NORTHERN REGION OF THE UNITED KINGDOM
Authors: Chen E , Ng C E , Toumi Z 
Published: October 2022

Abstract

Aim
The incidence of paraoesphageal hiatus hernia (PEH) has changed over the last several years. This study aims to ascertain the difference in the presentation of PEH requiring operative intervention at our unit because of the COVID-19 pandemic

Material & Methods
We conducted a retrospective review of procedures performed by a single surgeon for PEH in a district general hospital. We compared cases from 2016 to March 2020 and during the initial period of the COVID-19 pandemic in 2020.

Results
39 consecutive cases were identified undergoing PEH related procedures. The median age was 66 (IQR 26), with slight female predominance (M:F ratio of 5:6). 28 cases (71.8%) were performed as elective cases.
After the 2020 March lockdown, there were 10 cases of PEH repair performed with 78% performed as emergency procedures, compared to 30 cases in the preceding 5 years and 10% performed as emergency cases. Chi-square test to examine the association between COVID-19 pandemic and emergency procedure, X2(1, N=39)=14.199, p=0.000164.
Pre-COVID19 the types of procedures included 76.7% were fundoplication with suture crural closure, 10% were fundoplication with mesh repair, 3.3% biological mesh repair, 3.3% with suture closure of the crural and 6.7% had suture gastropexy. During the COVID-19 period, 44.4% were gastropexy, 33.3% were gastrostomy tube insertion and 22.2% fundoplication performed.

Conclusion
We have seen significantly more emergency PEH related procedures performed and using a variety of procedures. This leads to the consideration of whether current emergency general surgery training can equip trainees for future independent practice.