Laparoscopic repair of poststernotomy subxiphoid epigastric hernia

Landau, Ofer; Raziel, Asnat; Matz, A.; Kyzer, S; Haruzi, I.

doi:10.1007/s004640090011

Cited by 29 publications

(29 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Reported incidence of subxiphoid incisional hernia has ranged from 1% to 4.2% [1,2]. The subxiphoid hernia is known for its repair complexities and high recurrence rate because the subxiphoid area is a complex structure consisting of boney structures, the rectus abdominis muscles, linea alba , and the diaphragm [1-5]. Few studies have reported on subxiphoid incisional hernia while numerous studies that focused on abdominal incisional hernias have been reported [6-8].…”

Section: Introductionmentioning

confidence: 99%

Subxiphoid Incisional Hernia Development after Coronary Artery Bypass Grafting

Kim

Hwang

et al. 2012

Korean J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

BackgroundMedian sternotomy can weaken the upper abdominal wall and result in subxiphoid incisional hernia. We evaluated risk factors associated with the development of subxiphoid incisional hernias after coronary artery bypass grafting (CABG).Materials and MethodsOf 1,656 isolated CABGs performed between January 2001 and July 2010, 1,599 patients who were completely followed up were analyzed. The mean follow-up duration was 49.5±34.3 months. Subxiphoid incisional hernia requiring surgical repair developed in 13 patients (0.8%). The hernia was diagnosed 16.3±10.3 months postoperatively, and hernia repair was performed 25.0±26.1 months after the initial operation. Risk factors associated with the development of subxiphoid incisional hernia were analyzed with the Cox proportional hazard model.ResultsFive-year freedom from the hernia was 99.0%. Univariate analysis revealed that female sex (p=0.019), height (p=0.019), body surface area (p=0.046), redo operation (p=0.012), off-pump CABG (p=0.049), a postoperative wound problem (p=0.041), postoperative bleeding (p=0.046), and low cardiac output syndrome (p<0.001) were risk factors for the development of the hernia. Multivariable analysis showed that female sex (p=0.01) and low cardiac output syndrome (p<0.001) were associated with subxiphoid hernia formation.ConclusionFemale sex and postoperative low cardiac output syndrome were risk factors of subxiphoid hernia. Therefore, special attention is needed for patients with high-risk factors.

show abstract

Section: Introductionmentioning

confidence: 99%

Subxiphoid Incisional Hernia Development after Coronary Artery Bypass Grafting

Kim

Hwang

et al. 2012

Korean J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…A review of 113 patients treated for subxiphoid incisional hernia, published before 2009, remains the main source of data on this particular topic [159]. Three different authors have described twenty-one laparoscopic procedures with recurrence rates ranging from 10 to 33 % [160][161][162]. Those results are likely related to the learning curve of the technique [162].…”

Section: Subxiphoid and Subcostal Incisional Herniasmentioning

confidence: 99%

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

et al. 2015

View full text Add to dashboard Cite

The availability of recent level 1 evidence (a meta-analysis of 10 RCTs) allowed to recommend that not only laparoscopic repair is an acceptable alternative to the open repair, but also it is advantageous in terms of shorter hospital stay and wound infection rate. This conclusion appears to be extremely relevant in a clinical setting. Indications about specific conditions could also be issued: laparoscopy is recommended for the treatment of recurrent ventral hernias and obese patients, while it is a potential option for compensated cirrhotic and childbearing-age female patients. Many relevant and controversial topics were thoroughly examined by this consensus conference for the first time. Among them are the issue of safety of the intraperitoneal mesh placement, traditionally considered a major drawback of the laparoscopic technique, the role for the biologic meshes, and various aspects of the laparoscopic approach for particular locations of the defect such as the abdominal border or parastomal hernias.

show abstract

“…Landau et al [9], for example, had recurrence rates (10%) lower than the majority of studies, however in the surgical technique, closure of the abdominal fascia was not carried out, and therefore the criteria to assess whether or not the hernia was recurrent was unclear. To avoid the occurrence or recurrence of incisional hernias, the line of the suture should be able to hold the edges of the aponeurosis together in position for the duration of the postoperative period [14].…”

Section: Discussionmentioning

confidence: 99%

“…The use of laparoscopic surgery to place surgical mesh [9], on the other hand, had a recurrence rate of 10% over a follow up period of 20 to 42 months.…”

Section: Introductionmentioning

confidence: 99%

Simple technique of subxiphoid hernia correction carries a low rate of early recurrence: A retrospective study

et al. 2017

View full text Add to dashboard Cite

BackgroundSubxiphoid incisional hernia occurs as a complication following median sternotomy and are difficult to repair. We present recent data of a standardized technique for correction of subxiphoid incisional hernias, and discuss possible anatomical and surgical factors related to recurrence of the hernia.MethodsA retrospective study with medical records analysis of patients submitted to surgical correction of subxiphoid incisional hernias through standardized treatment between July 2014 and September 2016. All procedures were carried out using the same standardized technique, surgical materials (threads and meshes) and pre- and post-operative care.ResultsAll of the surgical procedures carried out were elective. The hernia defect varied between 5 cm and 16 cm (mean of 7.4 cm); the procedure lasted between 32 and 75 min; the mean time of hospital stay was 2.2 days (range from 1 to 5 days). In five patients the correction of subxiphoid incisional hernia was carried out concurrently with another procedure. No death occurred as a result of the operations. Five patients had minor postoperative complications. Follow up time was between 7 and 33 months, with a recurrence rate of 0% at the time of writing.ConclusionsDespite the limitations of a short follow up period, the surgical technique described presented low rates of early recurrence by closing the hernia defect, using relaxing incisions in the musculature and aponeurosis and surgical mesh.

show abstract

Laparoscopic repair of poststernotomy subxiphoid epigastric hernia

Abstract: Laparoscopic repair of a poststernotomy subxiphoideal epigastric hernia is feasible and has a low rate of minor complications. Our review of the literature indicates that this technique produces a better outcome than the conventional open repair.

Cited by 29 publications

References 5 publications

Subxiphoid Incisional Hernia Development after Coronary Artery Bypass Grafting

Subxiphoid Incisional Hernia Development after Coronary Artery Bypass Grafting

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

Simple technique of subxiphoid hernia correction carries a low rate of early recurrence: A retrospective study

Contact Info

Product

Resources

About