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

The twenty most asked and answered questions about advances in hernia surgery are enumerated. These inquiries have been collected over 20 consecutive years of exhibiting at a scientific booth at the American College of Surgeons conventions. The questions generally are concerned with synthetic patches, the use of local anesthesia, and, more recently, the "tension free" hernia repairs. The treatment of hernial sacs, the diagnosis, prevention and treatment of postoperative pain, the Shouldice Clinic repair, the importance of Cooper's ligament, and the cause, prevention, and treatment of recurrences are also examined.
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PMID:Twenty questions about hernioplasty. 174 84

In the first part the authors report their experience in Hernia surgery from 1980 to 1989. The comparison between 4 personal series shows that local anesthesia favoured short hospital stay, that the length of hospital stay decreased from 95% of more than 7 days hospitalization to 49% of less than 2 days; local anesthesia has almost suppressed post-anesthetic functional, respiratory and urinary troubles; no patient operated under local died; lastly the recurrence rate has not been related to hospital stay duration. Comments follow on Ambulatory surgery in general, technical and deontological principles. Ambulatory and short stay hospitalization in Hernia Surgery, and on advantages and pitfalls of these type of Surgery. The authors conclude on the feasibility, acceptability, benefits and usefulness of to day ambulatory surgery in hernia repair in the frame of a Universitary Hospital Center.
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PMID:[Short hospital stay, a step towards ambulatory surgery for hernia repair in 1990?]. 177 42

Pediatric surgical operations performed on an ambulatory basis in a practice are still rare in Germany. Prerequisites, indications, possibilities and limitations are presented. Some 869 operations were performed under general anesthesia within 21 months. Of the children 70% were under 5 years of age. The postoperative results were evaluated by means of a questionnaire in 352 children. Early complications occurred in five instances (1.4%) and late complications in one child (0.3%); hernia recurrence). Observing the possibilities and limitations, ambulatory pediatric surgery yields good results and takes the peculiarities of children into consideration.
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PMID:[Ambulatory pediatric surgery--possibilities and limits]. 179 31

In a prospective randomized trial we analyzed the perioperative management, complications, and the recurrence rate of inguinal hernia repair using either resorbable (polydioxanone, PDS) or non-absorbable (polyamide, Ethilon) suture material. From January 1988 to June 1989, 484 consecutive transversalis fascia repairs were performed in 425 adult patients with inguinal or femoral hernia. Local anaesthesia was used in 273 cases. At least one year postoperatively, 390 patients with 445 repairs had a clinical follow-up. The recurrence rate after 360 primary herniae was 3.3% (Ethilon 2.3%, PDS 4.3%) while 5.9% rerecurrences were found following operation for recurrent hernia (Ethilon 2.5%, PDS 8.9%). The differences in the recurrence rates following the use of polyamide or polydioxanone were not statistically significant. Complications occurred in 5.2%. The postoperative hospital stay averaged 3.8 days and work was resumed after a mean of 3.9 weeks.
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PMID:[Early results of transversalis-plasty. A prospective randomized comparison of non-resorbable and resorbable sutures]. 190 93

Between October 1988 and March 1990 a controlled, prospective study was conducted comparing the operative methods of Bassini and Shouldice for hernia repair. On 100 patients (11 female, 89 male) the Shouldice-technique was used, on 55 patients (6 female, 49 male) the Bassini-technique. Most patients were operated under local anesthesia. No significant difference was noted between the two groups regarding the postoperative complication rate (hematoma, wound infection). However, patients had a shorter hospital stay after the Shouldice operation. Six patients (10.9%) had recurrent hernia after the Bassini procedure, one patient (1%) after the Shouldice procedure. An increased risk for recurrent disease was found in patients with the Bassini operation who already had recurrent hernia. Because of the significant shorter hospital stay and the significant lower incidence of recurrent hernia, we abandoned the operative method of Bassini in favour of the Shouldice procedure.
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PMID:[Bassini or Shouldice operation?]. 193 47

Eighty-six consecutive patients with congenital diaphragmatic hernia presenting within 6 hours of birth to a regional neonatal surgical unit were reviewed. Patients were managed under a policy of delayed surgery which has evolved during the 6-year study period. Overall survival (to leave hospital) was 70.9%. There were only seven postoperative deaths (10.3% of operations). Analysis of the 25 deaths in the light of postmortem findings and published exclusion criteria indicates that the availability of extracorporeal membrane oxygenation would have made little difference to overall survival.
Anaesthesia 1991 Oct
PMID:Timing of surgery in congenital diaphragmatic hernia. Low mortality after pre-operative stabilisation. 144 55

Controversy regarding the management of inguinal hernias in young infants stimulated this study. It was our hypothesis that inguinal hernia in young infants can and should be repaired at the time of presentation. In order to address this issue, the following questions were examined: How frequently are these hernias incarcerated and how should this be managed? What is the best timing of repair? Should the asymptomatic contralateral groin be explored? How do the recurrence and complication rates compare with those in older children? Have advances in anesthesia affected the treatment of these infants? The records of 384 infants less than 2 months of age who underwent inguinal herniorrhaphy from January 1985 to January 1990 at Children's Hospital and Medical Center in Seattle were reviewed. Nearly one fourth (24%) of the patients had incarcerated hernias. Preoperative reduction was successful 96% of the time. The hernia was then repaired within 48 hours. Six patients required urgent operation, but bowel resection was not necessary in any. Contralateral groin exploration was performed 96% of the time and was positive in 85%. The recurrence rate was 1.0%. Complications occurred in 2.3% of patients. There were no hernia-related deaths. Spinal anesthesia was used in 63 patients with no postoperative apnea. An aggressive approach toward prompt repair of hernias in this age group can result in a very low incidence of hernia-related complications. Repair can be carried out safely in the first 2 months of life with recurrence and complication rates comparable with those in older children. Spinal anesthesia may lower the rate of postoperative apnea.
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PMID:Inguinal hernia repair in early infancy. 203 44

We retrospectively studied 295 men who had undergone herniorrhaphy under spinal or general endotracheal anesthesia to determine the incidence of postoperative urinary retention and to assess factors influencing it. The type and location of hernia had no effect on retention. In contrast, the use of general anesthesia, patient age above 53 years, and perioperative administration of more than 1,200 mL of fluid were significantly associated with an increase in retention. Our results suggest that urinary retention after herniorrhaphy may be prevented by limiting the amount of fluid given perioperatively and by using a spinal anesthetic, especially in older patients.
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PMID:Factors influencing postoperative urinary retention in patients undergoing elective inguinal herniorrhaphy. 203 61

Between March 1989 and August 1990, we performed 21 stapled J pouch ileonal procedures (20 ulcerative colitis [UC], 1 familial polyposis [FP]) without an ileostomy in 19, of whom 13 were taking prednisone and eight underwent semi-emergent surgery for uncontrollable bleeding. During the same time, an additional four patients required a standard ileonal procedure. The results of anal manometry and clinical function were compared to 25 patients who had previously undergone mucosal stripping and a sutured J pouch ileoanal anastomoses with a temporary diverting ileostomy between October 1982 and August 1990. During this same time period, an additional 19 patients underwent an anti-peristaltic reversed J pouch and 18 an S pouch, for a total of 83 ileoanal procedures. The reversed J pouch had a lower stool frequency than a standard J pouch but had an unacceptable incidence of complications and problems with pouch emptying. The S pouch had a stool frequency similar to the standard J pouch but provided greater length in patients with a short mesentery. Stapled J pouch ileoanal patients had a better (p less than 0.02) maximum and sphincter resting pressure (46 +/- 11 versus 34 +/- 12 mmHg), fewer (p less than 0.05) night-time accidents (22% versus 68%), daytime (17% versus 55%) or night-time (28 versus 61%) spotting, or use of a protective pad at night (11% versus 42%) than nonstapled J pouch ileoanal patients. Stool frequency was similar in the two groups. All but one UC patient had residual disease at the anastomosis. Anal mucosa between the dentate line and stapled anastomosis was 1.8 +/- 1.3 cm (range, 0 to 3.5 cm). Complications in the nonstapled J pouch group included 4 pouches excised (2 for complications, 2 for excessive stool frequency), 1 pelvic abscess, 2 stenosis requiring dilation under anesthesia, 1 enterocutaneous fistula after ileostomy closure, 1 ileostomy site hernia, and 2 small bowel obstructions. Of the 65 patients who underwent ileostomy closure in the entire series, 8 (12%) developed a complication requiring surgical intervention. Complications in the stapled group included 1 anastomotic leak, 1 pouch leak, and 1 pelvic abscess. Patients were managed successfully with drainage (all 3) and diverting ileostomy (1). One patient developed stenosis requiring dilation under anesthesia. The stapled J pouch ileoanal anastomosis is a simpler, safer procedure with less tension than a standard handsewn J pouch but leaves a very small cuff of residual disease. It provides significantly better stool control and may obviate the need for an ileostomy with its complications.
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PMID:Stapled ileoanal anastomosis for ulcerative colitis and familial polyposis without a temporary diverting ileostomy. 203 92

Serum bupivacaine concentrations were measured in 12 children who underwent elective herniotomy and who received analgesia in the form of wound infiltration. Mean (SD) peak concentration was 0.36 (0.14) micrograms/ml and time to peak concentration was 14.6 (7.2) minutes after infiltration of 1.25 mg/kg of bupivacaine. These concentrations are lower than those associated with other local anaesthetic blocks and well below potentially toxic levels. Wound infiltration provides a simple, effective and safe method of providing postoperative analgesia for hernia repair in children.
Anaesthesia 1991 Jun
PMID:Serum bupivacaine concentrations following wound infiltration in children undergoing inguinal herniotomy. 204 76


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