Progressive Preoperative Pneumoperitoneum Experience in the Reconstruction of Incisional Ventral and Inguinoescrotal Hernias with Loss of Domain
Fecha
2019-10Resumen
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Abstract
Introduction
The progressive preoperative pneumoperitoneum (PPP) has been described as a safe technique for the management of complex incisional ventral associated with loss of domain. There is insufficient evidence of the efficacy of PPP to expand the abdominal cavity volume and surgical outcomes.
Methods
Evaluate the efficacy to expand the abdominal cavity with PPP and to explore the outcomes of our retrospective cohort of 17 patients who underwent PPP and operative repair for these complex incisional ventral and inguinoscrotal hernias with loss of domain, in a university hospital between 2015 and 2017 in Bogota, Colombia.
Results
Seventy percent were male (±59 y/o) with predominantly midline incisional ventral hernias. Tomography guided percutaneous insertion of the peritoneal catheter was performed 95% of the cases. Imaging demonstrated a significant increase of the average volume of the abdominal initial cavity (7649.85 cc) and after the PPP (10155.93 cc) with a p = 0.000, representing a gain of 2506 cc (95% CI: 1657, 8 cc - 3354, 2cc), and an increase of 32.7% with respect to the initial average volume. The rotation of anterior components with sandwich mesh was the most frequently performed surgical procedure (n=15). All our cases had final closure of the abdominal wall. The most common postoperative complications where Clavien-Dindo I and II (n=6) of nine patients. No evidence of clinical recurrence in the postoperative follow-up.
Conclusion
PPP is a safe complementary technique which increased the volume of the abdominal cavity and permitted the final closure of the abdominal wall in all our cases, impacting positively their quality of life.
Keywords
URI
http://repositorio.mederi.com.co/handle/123456789/504https://www.sciencedirect.com/science/article/pii/S1072751519315169
Colecciones
- Investigación clínica [389]