RESUMO
PURPOSE: A residual bulge in the lateral abdominal wall is a reason for patient dissatisfaction after flank hernia repair (FHR). We hypothesized that combining a laparoscopically-placed intraperitoneal mesh (IPOM) with onlay hernia repair performed through a small open incision would increase repair durability and decrease such residual bulges. We aim to report our medium-term outcomes with this technique. METHODS: Patients who have undergone FHR using the technique described above from March 2013 through June 2017 were identified in a prospectively maintained database. Outcomes of interest included surgical site infections (SSI), surgical site occurrences (SSO), surgical site occurrences requiring procedural intervention (SSOPI) and hernia recurrence. RESULTS: Sixteen patients were identified (62% females; mean age 59 ± 8 years, mean body mass index 29.5 kg/m2). Mean hernia width was. 6.4 ± 3 cm and 31% were recurrent hernias previously repaired through an onlay approach. Mean operative time was 159 ± 40 min, fascial closure was achieved in all cases, and there were no intraoperative complications. Median length of stay was 3 days (IQR 3-4), and there were no unplanned readmissions or reoperations. At a median 37-month follow-up (IQR 21-55), wound morbidity rate was 12.5% (2 seromas). There were no SSI/SSOPI and one hernia recurrence (6%) was detected at 12 months postoperatively. CONCLUSION: Combining laparoscopic IPOM with open onlay hernia repair resulted in low recurrence and acceptable wound morbidity rates, with no residual bulges noted at medium-term follow-up. Further studies with larger number of patients and other surgeon's experiences are necessary to determine the role of such technique in the surgical armamentarium for flank hernia repair.
Assuntos
Parede Abdominal/cirurgia , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Hérnia Incisional/cirurgia , Laparoscopia/métodos , Cirurgiões , Telas Cirúrgicas , Músculos Abdominais/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Recidiva , ReoperaçãoAssuntos
Colangiopancreatografia Retrógrada Endoscópica , Duodenoscópios , Cálculos Biliares/cirurgia , Derivação Gástrica , Complicações Pós-Operatórias/cirurgia , Esfinterotomia Endoscópica , Estômago/cirurgia , Adulto , Colangiografia , Estudos de Viabilidade , Cálculos Biliares/diagnóstico , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico , ReoperaçãoRESUMO
This work aimed to evaluate the Deladenus siricidicola, Bedding (Neotylenchidae)parasitism in adults Sirex noctilio, Fabricius, 1793 (Hymenoptera: Siricidae). Timber was sampled by cutting out pieces of 0.80 m in length in Sirex noctilio attacked and Deladenus siricidicola inoculated Pinus taeda. Longs were 15-20 cm in diameter, according to the tree age. Samples were packed in gauze-cages, for daily observations, till S. noctilio adults emergence. The emerged insects were transported, in plastic containers to the laboratory, where they were sectioned and dissected under stereoscopic microscopy to observ the nematode occurrence. From the initially proposed ten units, nine of them were evaluated in a total of 1,810 emerged adult insects, being 1,441 males and 369 females. Nematode parasitism was shown in 267 males and 74 females, in a total of 341 infected insects (18.84 percent)
Assuntos
Animais , Masculino , Feminino , Antinematódeos , Himenópteros/parasitologia , Nematoides , Análise de VariânciaRESUMO
This work aimed to evaluate the Deladenus siricidicola, Bedding (Neotylenchidae) parasitism in adults Sirex noctilio, Fabricius, 1793 (Hymenoptera: Siricidae). Timber was sampled by cutting out pieces of 0.80 m in length in Sirex noctilio attacked and Deladenus siricidicola inoculated Pinus taeda. Longs were 15-20 cm in diameter, according to the tree age. Samples were packed in gauze-cages, for daily observations, till S. noctilio adults emergence. The emerged insects were transported, in plastic containers to the laboratory, where they were sectioned and dissected under stereoscopic microscopy to observ the nematode occurrence. From the initially proposed ten units, nine of them were evaluated in a total of 1,810 emerged adult insects, being 1,441 males and 369 females. Nematode parasitism was shown in 267 males and 74 females, in a total of 341 infected insects (18.84%).
Assuntos
Himenópteros/parasitologia , Nematoides/isolamento & purificação , Análise de Variância , Animais , Feminino , MasculinoRESUMO
The xyloglucan from cotyledons of Hymenaea courbaril was hydrolysed with endo-(1,4)-beta-D-glucanase (cellulase) and analysed by TLC and HPAEC. The limit digest was different from those obtained from xyloglucans of Tamarindus indica and Copaifera langsdorffii. On treatment with nasturtium beta-galactosidase, two main oligosaccharides were detected by TLC and HPAEC. Using a process of enzymatic sequencing involving alternate treatments with a pure xyloglucan oligosaccharide-specific alpha-xylosidase, and a pure beta-glucosidase, both from nasturtium, their structures were deduced to be XXXG and a new oligosaccharide XXXXG. These structures were confirmed by 1H NMR. The relative proportions of XXXG and XXXXG indicate that approximately half of the subunits in Hymenaea xyloglucan are based on the new oligosaccharides. In the native polymer the XXXXG subunits are likely to carry galactosyl substituents in varying proportions, since cellulase hydrolysates contained many bands which were converted to XXXXG on hydrolysis with nasturtium beta-galactosidase. Although no comparative studies on the physico-chemical properties of Hymenaea courbaril xyloglucan have yet been performed, our results indicate that this polymer is less interactive with iodine when compared with T. indica and C. langsdorffii xyloglucans, suggesting that changes in conformation may occur due to the presence of XXXXG.