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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A symptomatic hernia (most inguinal or femoral hernia, seldom epigastric, umbilical or post-operative hernia)--appeared a little while ago--originates from a preexisting, so far unknown or long since known illness. All patients with a hernia--especially those over 40 years old--are to be carefully asked for preexisting illnesses. Barium-enema and rectoscopy are not indicated at each inguinal or femoral hernia as a screening-method to exclude a symptomatic hernia; however, both methods must be employed in suspicious cases. 320 Patients with a histologically verified carcinoma of the rectum and colon had no inguinal or femoral hernia. From 387 patients with an inguinal or femoral hernia 318 patients were over 40 years old; at these patients polyps were found in five cases by rectoscopy, but never by barium-enema, and two carcinoma of the colon transverse appeared by barium-enema. A 23-years old patient with a great intraabdominal malignant tumor must be added to the sum total.
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PMID:[Symptomatic hernia (author's transl)]. 62 60

The aim of this study was to investigate the need to defunction the low anastomosis after anterior resection of the rectum with total mesorectal excision for rectal cancer. Two hundred consecutive patients (125 defunctioned, 75 non-defunctioned) undergoing low anterior resection for carcinoma were included in the study. Peritonitis requiring emergency laparotomy occurred in 8 per cent of the patients who did not have a defunctioning stoma compared with less than 1 per cent of those patients who had a defunctioning stoma (P less than 0.01). There was no mortality related to closure of the stoma but seven patients developed a faecal fistula and ten developed an incisional hernia. Despite current trends to avoid the defunctioning stoma, these results suggest that after total mesorectal excision the faecal stream should be temporarily diverted away from the anastomosis that is 6 cm or less from the anal verge to protect against potentially life-threatening anastomotic leakage.
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PMID:Risk of peritonitis and fatal septicaemia and the need to defunction the low anastomosis. 1153 84

An 11 year experience of the continent ileostomy is reported. Forty-nine patients have undergone a continent ileostomy during this period. There were 30 females and 19 males. The mean age was 35 years, the youngest 19 and the oldest 58. Forty-four patients were suffering from chronic ulcerative colitis, four from polyposis coli and one from carcinoma of the rectum and multiple colonic polyps. The majority (41) of operations were carried out as secondary procedures but eight were done as primary procedures. The follow-up varies from 11 years to three months. There were no deaths. Seventeen patients (34%) required revisional surgery for complications relating to the valve reservoir or stoma. Eleven of these were related to the valve--slipping four, prolapse five, fistula and perforation one each. Three patients had a para-ileostomy hernia and two a stricture at skin level. Four patients required excision of the reservoir with establishment of an orthodox ileostomy. Eighty-six per cent of patients are continent and never wear an appliance. The average capacity of the reservoir is 400 ml (range 150-900). Most patients catheterize three times daily (range 2-6). Eighteen per cent catheterize once at night. The average time for catheterization is 6 min. Provided the procedure is technically satisfactory the continent ileostomy is considered the operation of choice for patients requiring a permanent ileostomy.
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PMID:The continent ileostomy--an 11 year experience. 638 47

Every complication of the sigmoid stoma means a restriction of patients' quality of life. The complications of 164 patients were analyzed retrospectively (1/1996-5/1999). Indications for creation of a sigmoid stoma were malignomas of the rectum (n = 109). Hartmann's operation with or without sigmoid resection was performed in 55 patients for different reasons. Reoperation for complications was necessary in 8 patients (4.9%). Stenosis of the stoma (n = 3) and peristomal hernia (n = 2) were the most frequent complications. Other indications for reoperation were a prolapse (n = 1) of the stoma, a peristomal abscess with consecutive cutaneous necrosis (n = 1) and a metastasis of rectal cancer at the stoma site (n = 1). Operation techniques for sigmoid stoma creation and its complications are described. The own operative results are completed in an optimal manner by the work of a stoma therapist taking care of the patients both during and after hospital stay.
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PMID:[Terminal sigmoid anus praeter. Operative technique and surgical complications]. 1114 11

We describe here the first case in the literature of gallbladder strangulation within an incisional hernia. A patient with a history of rectal cancer operation presented with a "surgical abdomen" and a palpable right upper quadrant mass at the site of the previous colostomy. At surgery, a strangulated gallbladder was found in the subcutaneous tissue. Cholecystectomy was performed, and patient recovery was uneventful. If gallbladder strangulation is suspected, the surgeon should avoid forceful attempts at hernia reduction, as this may cause rupture of the gallbladder and subsequent contamination.
Hernia 2004 Dec
PMID:Gallbladder strangulation within an incisional hernia. 1503 68

Parastomal hernia is the most frequent complication of colostomy. Many surgical techniques have been postulated and prosthetic surgery seems to represents the first-choice treatment. The aim of this study is to report the surgical treatment of 4 patients that developed parastomal hernia, 3-10 months after abdominoperineal excision of the rectum and permanent sigmoidostomy due to carcinoma of the rectum. The repair was made with the use of polypropylene mesh extraperitoneally. One case of limited skin necrosis occurred without any serious consequences. No recurrence has been recorded among the patients, up to this day (follow-up period: 36 months). In conclusion, the suturing of fascial defect and the use of polypropylene mesh extraperitoneally is effective in the treatment of parastomal hernia.
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PMID:Repair of parastomal hernia with the use of polypropylene mesh extraperitoneally. 1565 7

Perineal hernia is a rare complication after major pelvic surgery. Placing non-biodegradable mesh across the pelvic inlet is the best method of repair. A 72-year-old man presented with a perineal hernia 8 years after undergoing an abdominoperineal resection because of rectal cancer. During the repair operation, intestinal spillage occurred, making it impossible to place permanent mesh as planned. Instead, we used the bladder to cover the pelvic inlet. The patient recovered well and after 35 months of follow-up, there was no evidence of hernia recurrence. When mesh placement is not feasible, this bladder mobilization technique can replace it.
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PMID:Meshless repair of perineal hernia after abdominoperineal resection: case report. 1600 59

Perineal hernia (PH) is formed by the protrusion of intra-abdominal viscera through a defect in the pelvic floor. This is a rare complication after conventional abdominoperineal resection, pelvic exanteration, proctectomy, and other pelvic procedures. The purpose of the present paper is to report 4 cases of PH after laparoscopic abdominoperineal resection for rectal cancer and to review literature data about the incidence, predisposing factors, and treatment of this challenging problem. When added to other 3 cases previously reported in the Brazilian series of laparoscopic surgery, this group of 7 cases comprises a PH incidence of 3.5% after rectal resection procedures. Surgical treatment is indicated only in symptomatic patients with no signs of cancer recurrence. Proposed methods of surgical repair include abdominal, perineal, or combined approaches to the hernia in association with the use of autologous tissues or prosthetic meshes. Preventive measures are represented by closure of the pelvic peritoneum whenever possible, primary perineal suture and wound care to avoid infection.
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PMID:Incidence and management of perineal hernia after laparoscopic proctectomy. 1634 May 72

The purpose of this study was to review and characterize the indications and early outcomes of abdominoperineal resection (APR) when used in a colorectal practice in an academic setting. Data was collected from the charts of all patients undergoing APR in a retrospective manner. Data collected included demographic information and details regarding the clinical presentation. Operative factors, information regarding the postoperative course, and morbidity and mortality were evaluated. Forty-four patients were treated with an APR in this practice between the years 1992 and 2004. The indications for operation were primary rectal cancer (n = 31), recurrent rectal cancer (n = 6), intractable Crohn disease (n = 3), anal melanoma (n = 1), cloacogenic cancer (n = 1), squamous cell cancer (n = 1), and gastrointestinal stromal tumor (n = 1). Complications in the first 60 days affected 14 patients (32%). The most common complication was intra-abdominal/pelvic abscess formation occurring in 6 of these 14 patients (43%). Additional complications in the first 60 days included rectus flap necrosis, perineal wound evisceration, prolonged ileus, and urinary retention. There was no surgical mortality. Long-term complications occurred in 7 patients (16%), with parastomal hernia being the most common (43%). Although relatively infrequently used, APR will continue to play a role for selected patients in the future. Despite the significant morbidity associated with this surgery, APR may provide beneficial treatment for select cases of low rectal cancer, end-stage inflammatory bowel disease, and anal malignancies.
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PMID:Contemporary indications for and early outcomes of abdominoperineal resection. 1646 31

About 50% of patients who have a permanent stoma experience some degree of parastomal hernia formation. To prevent this complication, the extraperitoneal route is considered to be more effective than the transperitoneal route in the case of open colorectal surgery. This technique also has superiority in avoiding postoperative intestinal obstruction. Although laparoscopic surgery for rectal cancer has not been proved to be as safe as open surgery by a randomized-controlled trial, some studies have shown the equality of long-term results with laparoscopic low anterior resection and laparoscopic abdominoperineal resection. It is anticipated that cases of laparoscopic abdominoperineal resection will increase in the near future. However, a laparoscopic technique for creation of a permanent stoma has hardly been discussed. Most operative procedures for laparoscopic stoma creation have been performed with transperitoneal route, which may cause parastomal hernia and/or intestinal obstruction. This report describes a laparoscopic technique for permanent sigmoid stoma creation through the extraperitoneal approach.
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PMID:Laparoscopic permanent sigmoid stoma creation through the extraperitoneal route. 1893 71


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