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At least 1,117 records · Page 62Linked to original sources
PubMedDate not supplied

[One-stage "forced" closure of large congenital defects of the abdominal wall with mechanical ventilation and curarization. Clinical evaluation].

Advantages of primary fascial closure of abdominal wall defects are mainly in reducing the number of staged procedures with related complications and the need of multiple operation. Nevertheless correction of large defects still remains a challenge to pediatric surgeon. Postoperative paralysis and mechanical ventilation after intraoperative milking of intestinal content and abdominal muscles stretching have been reported to reduce the risks of "forced" primary closure. A series of 64 Omphalocele and Gastroschisis has been reviewed. Associated anomalies are still the main cause of mortality among Omphalocele. Prematurity plays a secondary role on survival of Gastroschisis cases; deaths were mainly due to sepsis. Primary respiratory insufficiency affected a large number of Giant Omphalocele cases (larger than 5 cm with herniated liver) and was associated to a restricted chest structure. All these cases died in the first weeks of life. Primary closure with or without postoperative paralysis and mechanical ventilation showed to reduce in a significant way the postoperative complication rate compared to staged procedures. Mortality and hospital stay were not significantly influenced by different kinds of surgical treatment among Omphalocele. Associated anomalies are an unavoidable limiting factor to survival. Among Giant Omphalocele the use of aggressive primary fascial closure with ventilatory support showed in our hands to be a safe procedure provided that a preoperative selection of cases on the basis of chest X-ray and blood gases has been made.

Abdominal Muscles↗
PubMed1996

Rectus turnover flaps for the reconstruction of large midline abdominal wall defects.

Large midline abdominal hernias are reconstructed with bilateral rectus turnover flaps in a series of 15 patients. Each rectus muscle is turned over from a retracted lateral position to the midline, providing a complete abdominal closure with fascia and muscle. The repairs were frequently reinforced with synthetic materials, but synthetic material was not placed over bowel and simply sutured to the edge of a large hernial defect. The rectus turnover method of reconstruction appears to have significant advantages over the use of synthetic material alone. Successful hernia repair was accomplished in all patients. The surgical technique and complications encountered are described in detail.

Abdomen↗
PubMed1983

Repair of large midline abdominal-wall hernias by a running strip of abdominal skin.

Our experience with a full-thickness running strip of abdominal skin for the treatment of large midline abdominal hernias has been very positive. The mechanical properties of the skin strip allow one to reestablish a normal anatomy by bringing the rectus muscle in contact. Clinical and histologic studies have shown that the full-thickness skin rapidly loses its epidermal components and appears to transform itself into a dense connective tissue very similar to normal aponeurosis.

Abdomen↗
PubMedDate not supplied

[Actinomycosis of the abdominal wall. Report of a case].

We report a primary case of Actinomycosis of the abdominal wall. The diagnosis is obtained on the basis of the CT-scan and the pathological examination. The treatment is a surgical excision and a long term administration of antibiotics.

Abdominal Muscles↗
PubMed2001

Early imaging of integration response to polypropylene mesh in abdominal wall by environmental scanning electron microscopy: comparison of two placement techniques and correlation with tensiometric studies.

The repair of incisional hernias has taken advantage of the strength provided by prosthetic mesh grafts, but the best position for inserting the materials has not been conclusively established. Environmental scanning electron microscopy (ESEM) provides imaging of biologic samples with minimal manipulation. We used ESEM for early imaging of the integration response to polypropylene meshes placed in two anatomic positions in the abdominal wall and correlated results with tensiometric studies. Two macroporous polypropylene prostheses were implanted in a rat model--one on the abdominal aponeurotic layer and one on the peritoneal surface--without creating a wall defect. Studies were performed over implantation intervals of 7, 15, and 30 days in strips obtained from the polypropylene fiber-receptor repair tissue interface. Microscopic appearance, tensile strength, percent elongation, and stiffness were evaluated. Meshes implanted on the abdominal aponeurotic layer showed better early tissue incorporation (higher collagen deposition, capillary density, cell accumulation) and increased tensile strength, reflecting tighter anchorage to the abdominal wall. The percent elongation increased from day 7 to day 30 after implantation, mainly in the deep stratum. The ESEM images correlated well with biomechanical results, indicating the potential of this technique as a powerful, effective tool for use in wound-healing studies.

Abdominal Muscles↗
PubMed2004

Abdominal wall lift versus positive-pressure capnoperitoneum for laparoscopic cholecystectomy: randomized controlled trial.

OBJECTIVE: To compare intraoperative cardiac function, postoperative cognitive recovery, and surgical performance of laparoscopic cholecystectomy with abdominal wall lift (AWL) versus positive-pressure capnoperitoneum (PPCpn). SUMMARY BACKGROUND DATA: AWL has been proposed as an alternative approach to PPCpn to avoid adverse cardio-respiratory changes. However, the workspace obtained with the AWL is less optimal than PPCpn and previous studies documenting delayed postoperative recovery of consciousness following PPCpn have not assessed mental alertness despite its importance. METHODS: Forty operations were randomized into AWL and PPCpn. A standard anesthetic protocol was followed. Cardiac indices were measured with an esophageal Doppler machine. An auditory vigilance test was used to measure alertness level following extubation. All operations were videotaped and human reliability assessment techniques were used to identify surgical errors. RESULTS: There was a significant reduction in cardiac output during the first 20 minutes following CO2 insufflation in the PPCpn group, whereas in the AWL group it did not exhibit any significant change. Patients in AWL arm had better vigilance scores at 90 and 180 minutes following extubation compared with the PPn group (P < 0.05). Significantly more surgical errors were observed during surgery with AWL than with PPCpn (7.1 +/- 1.1; versus 2.9 +/- 0.4; P = 0.001). CONCLUSIONS: The AWL approach avoids fall in cardiac output associated with PPCpn during laparoscopic surgery and is associated with a more rapid recovery of postoperative cognitive function compared with PPCpn. However, AWL increases the level of difficulty in the execution of the operation.

Abdominal Wall↗
PubMed1988

Injury to the abdominal wall musculature: the full spectrum of traumatic hernia.

It is unusual for all anterior abdominal wall muscles to be disrupted in blunt trauma. We have described such a case, which necessitated reevaluation of the recommendations for treatment of traumatic hernia. We have proposed a method of classification of the different types of traumatic hernias so that treatment can be tailored.

Abdominal Muscles↗
PubMed1977

Resection of the abdominal wall in metastasis from cancer of the bladder, kidney or colon.

Metastases in the abdominal wound occur in about 1% of a material of bladder tumors and less frequently in renal or colon carcinoma. They are sometimes accompanied by metastases elsewhere. Even if the abdominal wall metastases are very large, extensive resection of all layers of the wall may enable the patient to survive for more than 5 years. Free skin grafts are sometimes sufficient to cover the defect. There is no herniation and no impairment of respiration. Metastases in the vicinity of a colostomy or ileostomy may necessitate an operation. Radiation does not appear to provide any relief.

Abdominal Muscles↗
PubMed2006

Neonatal abdominal wall urinoma due to rupture of anterior urethral diverticulum.

An anterior urethral valve with diverticulum is an uncommon cause of congenital urethral obstruction and urinary extravasation compared with a posterior urethral valve. We report a neonate presenting with an abdominal wall urinoma caused by rupture of an anterior urethral diverticulum. Urine drainage via urethral catheter was effective to resolve the abdominal urinoma. Voiding cystourethrogram performed 6 months after an endoscopic incision of the distal margin of the diverticulum revealed a normal urethra with smooth voiding. To our knowledge, no similar case has been reported previously.

Abdominal Wall↗
PubMed2000

[Complete remission after abdominal wall metastasis from uterine cervical cancer on a laparoscopic trochar site: a case report].

Abdominal wall metastasis to laparoscopic trochar sites after preoperative staging procedure is rare for uterine cervix cancer. Prognosis is unfavorable. We report a case of metastasis to a laparoscopic trochar site in a patient with a stage IIB cervical cancer with no nodal involvement who is alive four and a half years after radical surgery and radiotherapy.

Abdominal Muscles↗
PubMed1993

A one-year experience in the antenatal evaluation of suspected abdominal wall and bowel defects at a military tertiary referral center.

A variety of fetal abdominal wall defects and bowel anomalies are detected or suspected antenatally at institutions providing primary, secondary, and tertiary level care. Presented is a summary of a 1-year experience at a tertiary care center demonstrating a working referral network and its advantages. Of the 10 cases presented, 8 were referred and 2 originated from within our institution. The initial diagnosis was uncertain or differed from the final diagnosis in half of referred cases. Within the military, a reliable route for referral enhances prenatal evaluation and provides intensive neonatal support at delivery if needed and more immediately available surgery if indicated.

Abdominal Muscles↗
PubMedDate not supplied

[The use of Plastex-type synthetic mesh in the surgery of abdominal wall defects].

The study analyzes a statistical series of 45 patients suffering from large abdominal wall defects and who were managed by plastic surgery with "Plastex" type synthetic mesh, in the period 1 Jan. 1995-1 Apr. 1998. One of the treatment's basic principles is the preserving of the peritoneal pouch from the hernia sac, which must be fixed on the internal side of the synthetic material that replaces the musculoaponeurotic defect. The authors emphasize the low incidence of complications and the absence of recurrences when they used the "Plastex" type synthetic mesh, very well tolerated by the surrounding tissues. For all these reasons, the authors warmly recommend it for plastic surgery in all incisional hernias, because their coming out shows the poor quality of the local musculoaponeurotic material.

Abdominal Muscles↗