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

On the basis of the anatomophysiological assumption that the abdominal oesophagus is kept in its seat by the meso-oesophagus and that the complex functional role of the gastro-oesophageal junction is conditioned essentially by the inferior oesophageal sphincter under the influence of intra-abdominal and endogastric pressure variables, posterior gastro-oesophagophreno-plasty (p.g.p.p.) is proposed to offset the destruction or severe insufficiency of the meso-oesophagus and hence for the treatment of hiatal hernia and of regurgitation. This retro-oesophageal tuberous valve involves simultaneous fixation of the stomach and oesophagus to the pillars of the diaphragm, first on the right and then on the left, and the fixation of the fundus to the left diaphragmatic dome. Anterior gastro-oesophago-phreno-plasty is proposed on the basis of the finding that damage of any kind to the meso-oesophagus can cause the oesophagus to rise in the chest and thus disturb inferior sphincter function and possibly lead to the onset of regurgitation and hernia. The pre-oesophageal tuberous valve employed involves simultaneous fixation of stomach and oesophagus to the pillars of the diaphragm, first left and then right, and the fixation of the fundus to the left diaphragmatic dome. Anterior plasty is almost always confined to patients who have undergone vagotomy of the trunk without complex isolation of the oesophagus.
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PMID:[Posterior gastro-esophago-phreno-plasty (PGEPP) in the treatment of hiatal hernia and of esophagogastric reflux. Experience in over 500 cases. Anterior gastro-esophago-phreno-plasty (AGEPP) in the prevention of sliding hiatal hernia and of esophagogastric reflux. Experience in over 300 cases]. 46 Jun 30

Intermittent clinical manifestations, the representative one of which is claudication, can be classified into two types; neurogenic and vasculogenic. Although cauda equina lesions are well known as a neurogenic cause, spinal disorders, especially cervical or thoracic cord lesions, have been paid more attention to by several authors recently. We encountered a 42-year-old man with cervical soft disc hernia and ossification of longitudinal ligament, who showed intermittent rectal dysfunction evoked by walking. This peculiar clinical manifestation successfully disappeared after surgical decompression of the spinal cord. Such an interesting case has not been reported in the world literature. The patient was admitted because of numbness in both hands. Neurological examinations on admission showed neither motor weakness nor abnormally increased tendon reflex. Hypesthesia and hypalgesia were noticed below the Th4 dermatome on both sides. Adding to those symptoms, he complained of fecal incontinence evoked by walking 100 meters. This rectal dysfunction became gradually worse. At last he showed fecal incontinence after walking only 10 meters. This was ten days after his admission. Myelogram and computed tomographic scan revealed a cervical soft disc hernia at the C5/6 level and findings of OPLL at the C5 and C6 level. Anterior cervical approach for OPLL and soft disc was used for bone graft insertion from the C4 to the C7 vertebral body. The rectal dysfunction completely disappeared after the operation. The possible mechanisms of intermittent rectal dysfunction evoked by walking were discussed.
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PMID:[A case report of cervical disc hernia presenting fecal incontinence evoked by walking; spinal intermittent rectal dysfunction]. 157 69

Cervical spondylotic myelopathy usually arises in patients in their late 40s or early 50s, most frequently at the C5/6 and C6/7 levels. Recently, excellent results have been attained with microsurgery in cases of cervical spondylosis. On the other hand, treatment of cervical spondylotic myelopathy in patients with athetoid dystonic cerebral palsy entails several problems. The authors report three cases of such troublesome myelopathy. A 34-year-old male with severe athetoid movement showed cervical spondylotic myelopathy. Myelography and magnetic resonance (MR) imaging demonstrated compression of the spinal cord through the C3-C5 levels. A 47-year-old female with athetoid dystonic cerebral palsy presented myelopathy. Myelography and MR imaging showed instability and spinal cord compression at the C5/6 level. A 34-year-old male with spasmodic torticollis showed C6 radiculopathy due to cervical disc hernia at the C5/6 level. Cervical anterior decompression with interbody fusion brought temporary improvement in all the three patients. However, such problems as slippage of Halo-vest, difficulty in eating during Halo-vest fixation, relapse of neurological deficit, were experienced. Due to postoperative cervical instability, cervical laminectomy is considered to be contraindicated in such patients. Anterior decompression with bone fusion has been reported effective, but, if athetoid dystonia continues, there is a potential for myelopathic deterioration due to spondylotic changes adjacent to the fused vertebrae.
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PMID:[Surgical treatment of cervical spondylotic radiculomyelopathy with abnormal involuntary neck movements. Report of three cases]. 248 93

From 1958 to March 1987 we corrected 704 patients with pectus excavatum. The condition occurred more frequently in boys (544 patients) than girls (160 patients). In the majority of patients (86%), the defect was evident at birth or within the first year of life. Musculoskeletal abnormalities were identified in 133 patients (scoliosis, 107; kyphosis, 4; myopathy, 3; Poland's syndrome, 3; Marfan's syndrome, 2; Pierre Robin syndrome, 2; prune belly syndrome, 2; neurofibromatosis, 3; cerebral palsy, 4; tuberous sclerosis, 1; and congenital diaphragmatic hernia, 2). Sixteen patients had associated congenital heart disease. A family history of chest wall deformity was present in 37% of the cases and a history of scoliosis in 11%. Surgical correction was performed using a uniform technique for bilateral subperichondrial resection of the deformed costal cartilages and sternal osteotomy resecting a wedge of the anterior cortex and fracturing the posterior cortex. Anterior displacement was maintained with silk sutures closing the osteotomy defect. In 28 early cases, the sternum was secured by intramedullary fixation with a Steinman pin. All repairs were completed with a low complication rate (4.4%; pneumothorax, 11; wound infection, 5; wound hematoma, 3; wound dehiscence, 5; pneumonia, 3; seroma, 1; hemoptysis, 1; hemopericardium, 1). Six complications were associated with Steinman pin fixation (hemoptysis, seroma, hemopericardium, pneumothorax, 3). Major recurrence occurred in 17 patients (2.7%) and led to revision in 12. Satisfactory long-term results were achieved in the remaining 687 patients, with follow-up ranging from 2 weeks to 27 years. Mean follow-up was 4.3 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical repair of pectus excavatum. 320 60

Anterior diaphragmatic hernias are a relatively rare finding. They can occur on either side of the body. We diagnosed and treated a Morgagni hernia during laparoscopic cholecystectomy.
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PMID:Morgagni hernia: incidental repair during laparoscopic cholecystectomy. 761 43

Herniation of the calcified nucleus pulposus is a rare complication of intervertebral disc calcification in children. Surgical intervention is rarely indicated in the majority of such cases. This paper reports a 12-year-old boy with a calcified nucleus pulposus at C7-T1 which had ruptured into the spinal canal, causing dissociated motor loss. Anterior discectomy and fusion were performed and the patient's muscle weakness markedly improved after surgery.
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PMID:Herniation of calcified cervical intervertebral disc causes dissociated motor loss in a child. 827 61

Twenty-seven patients underwent consecutive elective laparoscopic repair of paraesophageal hiatal hernia between October 1992 and June 1997. There were 24 females and 3 males. The average age was 68 years (range, 46-86) and average weight was 173 pounds (range, 122-243 lb.). Presenting symptoms were: postprandial epigastric pain or pressure in 19 patients, postprandial dyspnea in 7 patients, anemia in 5 patients, postprandial vomiting of food in 5 patients, and 1 patient had postprandial palpitation. Heartburn was present in 9 patients. Five patients had a history of symptoms of intermittent volvulus. History of hiatal hernia was present in 19 patients ranging from 6 months to 38 years in duration. The operative procedure included a laparoscopic reduction of the herniated stomach, excision of the hernia sac, and closure of the diaphragmatic defect with placement of mesh graft. Anterior gastropexy was performed on all patients except two who had a Nissen fundoplication due to severe reflux symptoms. Seven patients had laparoscopic cholecystectomy at the same time and one patient had an excision of a small benign gastric leiomyoma of the fundus. The average operative time was 2:54 hours (range, 1:35-4:05 hrs.). The average hospital stay was 3.8 days (range, 2-8 days). One patient had a postoperative stroke and recovered quickly. Follow-up of 1 to 56 months showed no recurrence of the hernia. Two patients complained of some epigastric pain and six patients had occasional mild reflux that was easily controlled medically. Laparoscopic repair of paraesophageal hernia is a safe procedure with a short hospital stay and recovery time. Using mesh graft decreases the risk of developing an iatrogenic parahiatal hernia. The addition of Nissen fundoplication is not necessary unless the patient has objective findings of reflux.
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PMID:Laparoscopic repair of paraesophageal hiatal hernia. 969 97

This study analyzed the results of anterior transvertebral herniotomy for cervical disk herniation to assess the utility of this procedure. Anterior transvertebral herniotomy was performed in 24 patients who had cervical disk herniation without spinal canal stenosis. In most patients, a good result was obtained, but simultaneous or subsequent anterior intervertebral fusion was necessary in four patients. In one (4%) patient, the two adjacent vertebrae had fused spontaneously. The best indication for this treatment judging from the postoperative results is a large disk hernia associated with either myelopathy or radiculopathy, but without spinal canal stenosis.
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PMID:Anterior transvertebral herniotomy for cervical disk herniation. 1071 Jan 43

We report on a new method of incisional hernia repair applicable to any size. With exception of an area 1 cm medial of the m. rectus abdominis where the strip penetrates the anterior wall of the rectus sheath for a better fixation, the muscle ist looped in a loose way with a 2 cm wide band of polypropylene (Prolene(R)) on both sides at a distance of 2 cm depending on the size of the hernial opening. Different models of strips were used in 27 % of the cases adapted to anatomical particularities of the hernial opening. Anterior and posterior wall of the rectus sheath are closed by a continuous panacryl suture which covers the strip. Because of the wide subcutaneous excavation extending to the lateral margin of the rectus sheath an extensive drainage by Redon-Drainages as well as compression bandages are important therapeutical procedures until formation of seromas has finished. For perioperative antibiotic prophylaxis we used Cefuroxime (3 x 1,5 i. v.). From 07/1999 until 10/2001 75 patients underwent an operation in our department. The direct postoperative complications observed were: Seroma formation up to 300 ml after discharge in 5 patients (6,6 %) and wound infections in 2 patients (2,8 %). In none of the cases the mesh had to be removed. In a follow-up period of 6 to 24 months we found 2 recurrences in 60 patients (3,3 %). These were related to technical failures of the beginning. 64.9 % of the patients were free of complaints after 6 months and almost 96 % after one year. Only 3 patients (4 %) had to take analgetic drugs occasionally. With regard to the mobility of the abdominal wall we found no measurable limitation. The method of Rectusbanding is easy to learn for every surgeon and with little material the mesh-strip can be fixed safely. It can be cut to individual sizes and shapes adapted to the fascial proportions of the hernial opening.
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PMID:[Rectusbanding by polypropylene-mesh--a new method for incisional hernia repair]. 1212 85

Laparoscopic inguinal hernia repair is still not the gold standard for repair although mesh implantation is unequivocally accepted as an integral part of any groin hernia repair. The aim of the study was to compare the results of anterior preperitoneal (APP) mesh repair with totally extra peritoneal (TEP) repair for inguinal hernias. The prospective study was conducted on 241 patients with 247 hernias (from January 2000 to June 2004). Anterior preperitoneal repair was done in 121 patients and 120 patients were subjected to TEP repair. Repair in both groups was done by using Prolene mesh of size 6x4 in. or 6x6 in. intraoperative and postoperative parameters and complications were recorded and the patients were followed up to 1 year post-surgery. For both unilateral and bilateral inguinal hernias, mean operative time was significantly more in patients of TEP repair as compared to APP repair (P<0.001) and significantly more patients had peritoneal tears in the TEP group (P<0.001). Patients undergoing TEP repair, however, had significantly less postoperative pain (P<0.05) and postoperative hospital stay (P<0.05) and return to work was significantly earlier is this group (P<0.01 and P<0.001). There was no difference in the recurrence rate between the two groups. Patients with inguinal hernias undergoing laparoscopic repair recover more rapidly, and have less incidence of postoperative pain. But it takes significantly more time to perform than APP repair and also the incidence of peritoneal tear is higher.
Hernia 2006 Apr
PMID:Laparoscopic total extraperitoneal repair versus anterior preperitoneal repair for inguinal hernia. 1647 62


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