Incisional hernia in pediatric surgery – experience at a single UK tertiary centre

Mullassery, Dhanya; Pedersen, Ami; Robb, Andrew; Smith, Nicola

doi:10.1016/j.jpedsurg.2016.06.013

Cited by 17 publications

(25 citation statements)

References 22 publications

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“…11 In a series of infants having undergone primary abdominal surgery before 6 months of age, the incidence of incisional hernia was 2.3%, which is comparable to our results. 23 A very high incidence (40%) of early (i.e., until 45 days post HPE) inguinal hernias has recently been reported. 11 An earlier series found 8% inguinal hernias post HPE up to 55 months post HPE, 24 still significantly more common than in the general population.…”

Section: Herniasmentioning

confidence: 99%

Perioperative Complications after Kasai Hepatoportoenterostomy: Data from the Swiss National Biliary Atresia Registry

Calinescu¹,

Wilde²,

Korff

et al. 2019

Eur J Pediatr Surg

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Introduction Hepatoportoenterostomy (HPE) is the first-line treatment for biliary atresia (BA) patients. This study aims to describe perioperative complications after HPE and to analyze their impact on outcome. Materials and Methods Patients with HPE (Swiss National Biliary Atresia Registry, 1994–2017) were retrospectively analyzed. Perioperative complications were defined as complications occurring up to 30 days after surgery. Surgical complications were defined as directly related to the surgical act; medical complications were defined as any other deviation from the uneventful postoperative course. Results Sixty-two patients were included. Median age at HPE was 63 days (18–126). Twenty six patients out of 62 (42%) had ≥ 1 complications: 6/62 (10%) surgical, 24/62 (39%) medical, that is, we observed 7 surgical and 28 medical complications. As for medical complications, cholangitis was the most frequent: 19/28 (68%). Lower gestational age at birth correlated with more overall complications (p = 0.02). Age, weight at HPE, syndromic BA, and postoperative steroid administration were not significantly correlated. There were no perioperative deaths. Perioperative complications did not correlate with overall survival (p = 0.14) and survival with native liver (p = 0.55). Conclusion HPE is often associated with perioperative medical complications. Lower gestational age at birth was significantly associated with more complications. Perioperative complications had no impact on overall outcome.

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Section: Herniasmentioning

confidence: 99%

Perioperative Complications after Kasai Hepatoportoenterostomy: Data from the Swiss National Biliary Atresia Registry

Calinescu¹,

Wilde²,

Korff

et al. 2019

Eur J Pediatr Surg

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“…Over a 6-year period at a single center, incisional hernia repair was performed in 6 of a total of 255 children who had initially undergone open (4) or laparoscopic (2) pyloromyotomy, 16 reflecting an incisional hernia rate of 2.52%.…”

Section: Incisional Herniamentioning

confidence: 99%

Perioperative Complications of Surgery for Hypertrophic Pyloric Stenosis

Kelay

Hall

2018

Eur J Pediatr Surg

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Pyloromyotomy is the tried and tested surgical procedure for successful operative treatment of pyloric stenosis. Over time, the operative approach has evolved to take advantage of cosmetically superior incisions and more recently minimally invasive surgery. During and following surgery, complications are uncommon. The specific complications of an inadequate pyloromyotomy requiring repeated procedure and mucosal perforation during an overzealous pyloromyotomy represent the ends of a spectrum within which sits the perfect procedure. Here, we discuss these specific complications together with the other potential complications following surgery for hypertrophic pyloric stenosis, including anesthetic considerations.

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“…In our study population OH occurred at both sides of the abdomen and occurred independent of closure of the fascia. Although Cost noted no statistically significant relationship between the development of a hernia and port location, port size or fascial closure status in children undergoing urological laparoscopic surgery, others do recommend fascial closure 16,27,28 . It should be taken into account that the proportional size relationship of the trocar versus the intestines is the same when using large (10 mm) trocars in adults and recommends closure as well 29 .…”

Section: Discussionmentioning

confidence: 96%

Comparison of laparoscopic and open pyloromyotomy: Concerns for omental herniation at port sites after the laparoscopic approach

Bunder

Heurn

Derikx

2020

Sci Rep

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comparison of laparoscopic and open pyloromyotomy: concerns for omental herniation at port sites after the laparoscopic approach fenne A. i. M. van den Bunder * , ernest van Heurn & Joep p. M. Derikx pyloromyotomy is a common surgical procedure in infants with hypertrophic pyloric stenosis and can be performed with a small laparotomy or laparoscopically. No specific complications have been documented about one of the approaches. We aim to study (severity of) complications of pyloromyotomy and to compare complications of both approaches. children undergoing pyloromyotomy between 2007 and 2017 were analyzed retrospectively. Complication severity was classified using the Clavien-Dindo classification. We included 474 infants (236 open; 238 laparoscopic). 401 were male (85%) and median (IQR) age was 33 (19) days. There were 83 surgical complications in 71 patients (15.0%). In the open group 45 infants (19.1%) experienced a complication vs. 26 infants in the laparoscopic group (10.5%)(p = 0.013). Severity and quantity of postoperative complications were comparable between both groups. Serosal tears of the stomach (n = 19) and fascial dehiscence (n = 8) occurred only after open pyloromyotomy. Herniation of omentum through a port site occurred only after laparoscopy (n = 6) and required re-intervention in all cases. In conclusion, the surgical complication rate of pyloromyotomy was 15.0%. Serosal tear of the stomach and fascial dehiscence are only present after open pyloromyotomy and omental herniation after laparoscopy respectively. the latter complication is underestimated and requires attention.

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Incisional hernia in pediatric surgery – experience at a single UK tertiary centre

Cited by 17 publications

References 22 publications

Perioperative Complications after Kasai Hepatoportoenterostomy: Data from the Swiss National Biliary Atresia Registry

Perioperative Complications after Kasai Hepatoportoenterostomy: Data from the Swiss National Biliary Atresia Registry

Perioperative Complications of Surgery for Hypertrophic Pyloric Stenosis

Comparison of laparoscopic and open pyloromyotomy: Concerns for omental herniation at port sites after the laparoscopic approach

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