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At least 793 records · Page 44Linked to original sources
PubMed1992

Characteristics of prosthetic mesh and autogenous fascia in abdominal wall reconstruction after prolonged implantation.

This study evaluated two types of prosthetic mesh and autogenous fascia in long-term abdominal wall reconstruction for rats. Marlex mesh, Gore-Tex patch, and autogenous fascia were implanted and left in place for 1 year. Materials were removed and evaluated using tensile strength of the material, tensile strength of the suture line, and adhesions. No change in the tensile strength of any of the materials were found at 1 year follow-up. Tensile strengths were significantly greater for Gore-Tex patch and Marlex mesh than the autogenous fascia. The Marlex mesh, however, had a weak and a strong tensile strength direction. These were significantly different (p < 0.05). Suture line tensile strength was greater for autogenous fascia and Marlex mesh than it was for the Gore-Tex patch, which was significantly weaker (p < 0.05). The greatest number of adhesions were seen in the Marlex mesh group. No significant difference was present in adhesions between Gore-Tex patch and autogenous fascia. In summary, autogenous fascia showed virtually no adhesions and good suture line strength. While it was the weakest of the three materials examined, the strength was still within the normal range and adequate for abdominal wall reconstruction.

Abdominal Muscles↗
PubMed1987

[A case of recurrence of gastric cancer with an abdominal wall tumor responding to intratumoral OK-432 administration].

Intratumoral administration of 5 K.E. OK-423 was given every other day for a patient with an abdominal wall recurrence of gastric cancer. After a total dose of 465 K.E. the abdominal tumor turned necrotic and its demarcation was monitored. Finally, the tumor separated and fell from the abdominal wall. Histologically, marked infiltration of neutrophils, lymphocytes, and macrophages were observed in the cancerous tissue. Clinically, local pain lessened and the serum CEA level decreased. PPD and PHA skin tests were markedly stimulated. A long term small-dose intratumoral administration of OK-432 seemed to be effective for a local recurrence of gastric cancer.

Abdominal Muscles↗
PubMed2006

The use of prosthetics in abdominal wall reconstruction.

Large ventral or incisional hernias are often difficult to manage. Most commonly patients are referred to reconstructive surgeons after multiple failed attempts of hernia repair. The use of prosthetic and bioprosthetic materials have aided greatly in the management of complex abdominal wall defects. A full understanding of the advantages and disadvantages of specific prosthetic materials available, and the associated complications of use, remains elusive, however. This article provides information concerning the applications of appropriate prosthetic material for temporary or permanent closure of difficult abdominal wall defects.

Abdominal Wall↗
PubMedDate not supplied

The use of dermis to reconstruct the musculo-aponeurotic element of the anterior abdominal wall.

The use, in two patients, of a free graft of dermis to reconstruct the musculo-aponeurotic element of the anterior abdominal wall is described, one with a defect of the left epigastric region following resection of a desmoid tumour, the other with a periumbilical defect of the entire thickness of the abdominal wall following resection of a fungating colonic carcinoma, the latter patient with an adjacent left iliac defunctioning colostomy. A latissimus dorsi myocutaneous free flap was used to provide overlying cover for the graft.

Abdominal Muscles↗
PubMedDate not supplied

Costs and benefits of laparoscopic cholecystectomy: abdominal wall lifting vs. pneumoperitoneum procedure.

BACKGROUND/AIMS: Gasless laparoscopic surgery using the abdominal wall lifting (AWL) method was first developed in Japan and has been used in various surgical fields. The AWL method allows the use of conventional reusable surgical instruments. The purpose of this study was to compare the cost-effectiveness of laparoscopic cholecystectomy (LSC) using the AWL method in relation to that using pneumoperitoneum (P) method. METHODOLOGY: Retrospective analysis of 431 LSC procedures between 1991 and 2004 was performed. The two surgical groups consisted of consecutively operated patients with a diagnosis of cholecystolithiasis or gallbladder polyps. One group consisted of 224 LSC procedures performed using the P method from 1992 to 1998 and the other group comprised 207 LSC performed using the AWL method from 1998 to 2004. All instruments used in the P method were disposable, whereas trocars, scissors, dissectors, graspers and L-hook electrodes (excluding clips) used in the AWL method were reusable. Hospital expenses, length of hospital admission and complication rates were analyzed. RESULTS: Mean hospital cost per case for LSC using the AWL method (dollars 6743) was 7% less expensive than that using the P method (dolars 7215). Costs of operative equipment contributed to the difference (mean dollars 912 per case) in total cost. Conversion to open cholecystectomy occurred in 6 cases (2.9%) using the AWL method and 7 cases (3.1%) using the P method. There were no significant differences in length of hospital admission or complication rates between the two groups. CONCLUSIONS: LSC using AWL method was less expensive than that using P method. This is mainly due to the use of reusable instruments in the AWL method. If LSC is performed using the AWL method instead of using disposable equipment, considerable savings can be achieved without compromising patient safety.

Abdominal Wall↗
PubMed1993

Impaired respiratory function in infants with anterior abdominal wall defects.

Respiratory function at follow-up was assessed in 13 infants who had undergone surgical repair of an anterior abdominal wall defect. Six infants had exomphalos and seven had gastroschisis. The infants were delivered at a median gestational age of 36 weeks (range, 32 to 38 weeks). Respiratory function was assessed by measurement of functional residual capacity (FRC) at a median postnatal age of 5 months (range, 1 to 10 months). Although there was no significant difference in the FRC of the infants with gastroschisis compared with those with exomphalos, the study group's mean FRC (25 mL/kg) was significantly lower than that of 50 healthy control infants (mean, 30 mL/kg; 95% CI, +/- 6 mL/kg). Five infants had an FRC below the 95% confidence limit of the normal range. These data suggest that infants with anterior abdominal wall defects may have impaired antenatal lung growth.

Abdominal Muscles↗
PubMed1999

Enhanced continent mechanism of tapered ileum by extramural support from pouch-abdominal wall: an experimental study in dogs.

PURPOSE: To construct a reliable continent tube, which is easy to catheterize, we created and evaluated a new continent cutaneous diversion using a tapered ileum combined with extramural support from the pouch-abdominal wall. MATERIALS AND METHODS: Six dogs underwent a procedure in which two ileal segments were tapered and anastomosed to the ileal pouch. One of the segments (continent) was placed between the back surface of the rectus muscle and the wall of the ileal pouch creating a continent tube. The other segment (control) was brought out into the abdominal skin directly without any support from the pouch-abdominal wall. Urodynamic and radiological studies were carried out postoperatively in all dogs. RESULTS: In the continent tubes, the maximum closure pressure with a full pouch was significantly higher than those with an empty pouch (p<0.01). The maximum closure pressures of the continent tubes were significantly higher than those of the control tubes when the pouch was empty (p<0.01). The leak point pressures of the continent tubes were significantly higher than those of the control tubes (p<0.001). In all dogs, the retrograde radiogram of the continent tubes showed perfect canalization without stenosis. CONCLUSION: This study suggests that the continent mechanism of tapered ileum can be greatly enhanced by fixing it between the abdominal and pouch walls, also allowing easy catheterization in contrast to the submucosal tunnel technique.

Abdominal Muscles↗
PubMed1993

Synovial sarcoma of the abdominal wall.

BACKGROUND: Synovial sarcoma usually arises in the extremities and in close proximity to large joints. Reported examples arising in the anterior abdominal wall are rare. Because most accounts from this location consist of case reports, neither clinical nor prognostic features have been well delineated. METHODS: Twenty-seven synovial sarcomas of the abdominal wall (SSAW), retrieved from the Soft Tissue Registry of the Armed Forces Institute of Pathology, were reviewed and analyzed retrospectively. Immunohistochemical stains were performed in 18 cases. RESULTS: There were specimens from 12 male and 15 female patients, ranging in age from 8 to 58 years (median, 23 years). The tumors were classified as biphasic (14), predominantly monophasic fibrous (8), and poorly differentiated (5) types. The neoplasms occasionally were cystic and typically reacted, at least focally, with antibodies directed against keratin and/or epithelial membrane antigen. Eight tumors were smaller than 5 cm.; 17 tumors were 5 cm or larger in size. Dimensions were not recorded in two cases. Follow-up, ranging from 1 to 264 months, was obtained in 18 cases. Nine individuals were alive and well and eight were dead of disease at median follow-up intervals of 98 and 26 months, respectively. One patient was dead with disease, possibly secondary to chemotherapy-related causes. All nine patients who have died had clinical evidence of metastatic disease. Patients who presented with tumors 5 cm or larger had a less favorable outcome than whose with tumors smaller than 5 cm. (58% versus 40% mortality). A positive correlation was noted between increased mitotic activity and the mortality rate. Although patients with biphasic and predominantly monophasic fibrous tumors had a similar mortality rate (40% for both groups), patients with poorly differentiated synovial sarcoma fared worse (100% mortality). In general, poorly differentiated synovial sarcomas had a higher mitotic rate than either biphasic or monophasic fibrous examples. No appreciable difference in survival was evident based on the age at presentation (< 15 versus > or = 15 years of age). CONCLUSIONS: The survival rate for patients with SSAW is similar to that reported for synovial sarcoma in general. A high mitotic rate and the poorly differentiated subtype of synovial sarcoma both were associated with a poor prognosis and, to some extent, appear interrelated. Less favorable behavior also was noted when the tumors were large (> or = 5 cm). Pluripotential or arthrogenous mesenchyme may be implicated in the pathogenesis of these tumors.

Abdominal Muscles↗
PubMed1987

Giant desmoid tumor of the abdominal wall masquerading as recurrent testicular cancer.

A huge abdominal mass developed 4 years after successful chemotherapy and laparotomy for stage III embryonal testicular cancer. Complete surgical extirpation proved that this lesion was a desmoid tumor of the abdominal wall and not a recurrent germ cell neoplasm. Fortunately, this mass was excised and not treated by aggressive chemotherapy.

Abdominal Neoplasms↗
PubMed2005

Anterior abdominal wall synovial sarcoma: a rare presentation.

Synovial sarcoma usually arises in the extremities and in close proximity to large joints. Primary synovial sarcoma of the anterior abdominal wall is rare. A 17-year-old girl was admitted to the hospital with a palpable abdominal mass, and there was a 9.5 cm x 7.5 cm x 6-cm lobulated, cystic, and semisolid lesion of in the external oblique abdominal muscle shown on the abdominal magnetic resonance image. She was then operated and pathology was consistent with synovial sarcoma. The presence of synovial sarcoma in extraarticular sites such as the abdominal wall argues against an origin from arthrogenous mesenchyme.

Abdominal Neoplasms↗
PubMed1976

Repair of massive abdominal wall defects. Combined use of pneumoperitoneum and Marlex mesh.

The most important aspects of repairing massive hernias, eventrations, or surgically created abdominal wall defects are preoperative preparation of the patient and conservative judgment in indications for use of prosthetic material. Before operation, most patients (excluding those with trauma or severe sepsis) can be prepared electively by progressive preoperative pneumoperitoneum. The procedure is safe, simple, and effective. As described, it involves no special techniques or equipment and may be carried out as an inpatient or outpatient procedure. Prosthetic material should be used only to obviate tension on a suture line, for this must scrupulously be avoided. It should not be used routinely as onlay grafts in small or moderate hernias as primary fascial suturing gives better results with few wound complications when closure without tension is possible. Progressive preoperative pneumoperitoneum, combined when necessary with Marlex mesh to obviate tension, enables closure of even gigantic defects. The technique avoids the severe and sometimes fatal preliminary complications resulting from sudden increase in abdominal pressure and diaphragmatic elevation that accompany replacement of abdominal viscera that have lost their "right of domain" with large hernias or abdominal wall defects. This technique also markedly diminishes postoperative pain and aids satisfactory pulmonary management and thus permits early postoperative mobilization and discharge from the hospital.

Abdominal Muscles↗