Biomedical subjects

J C Mayagoitia

Publications and source records attributed to J C Mayagoitia.

3 recordsLinked to original sources

PubMed2006

Predictive factors comparison of complications and recurrences in three tension-free herniorraphy techniques.

Inguinal herniorraphy is one of the most common surgeries performed. Avoiding hernia recurrence is a primary concern. Hence, it is necessary to analyze the predictive factors of postoperative complications and recurrence. To compare the predictive factors of postoperative complications and recurrences of hernias among three tension-free open herniorraphy techniques. Five hundred and fifty-one inguinal hernia patients, operated on with one of three tension-free anterior approach herniorraphy techniques, were included in a cohort study. The three techniques were: Lichtenstein (n=214), Mesh-Plug (n=201) and Prolene Hernia System (PHS, n=136). The patients were evaluated at 15 days, 1 month, 6 months and then every year up to 5 years after hernioplasty. The variables evaluated were recurrences and postoperative complications. Relative risk was estimated from a univariate analysis of the presumable risk values, after which a multivariate analysis was carried out. Complications [n=27, (4.9%)] were more frequently associated with incarcerated hernia, a coexisting disease at the time of operation, hospitalization longer than 1 day, previous herniorraphy, a herniary ring larger than 4.5 cm and a history of postoperative complications. Recurrence was greater for the Mesh-Plug group [n=5 (2.5%), RR: 4.35 (CI: 0.85-22.23)] than for the Lichtenstein [n=2 (0.9%), RR: 0.63 (0.06-3.87)] and PHS [n=0 (0%), RR de 0 (0-2.39)] groups. The presence of coexisting disease during hernioplasty, incarcerated hernia and an extended hospital stay are predictive factors for hernia complications. Previous herniorraphy, a herniary ring larger than 4.5 cm and postoperative complications are predictive factors for hernia recurrence.

Comorbidity↗

PubMed2005

Preoperative progressive pneumoperitoneum in patients with abdominal-wall hernias.

Induction of preoperative progressive pneumoperitoneum is an elective procedure in patients with hernias with loss of domain. A prospective study was carried out from June 2003 to May 2005 at the Hospital de Especialidades, Instituto Mexicano del Seguro Social, Leon, Mexico. Preoperative progressive pneumoperitoneum was induced using a double-lumen intraabdominal catheter inserted through a Veress needle and daily insufflation of ambient air. Variables analyzed were age, sex, body mass index, type, location and size of defective hernia, number of previous repairs, number of days pneumoperitoneum was maintained, type of hernioplasty, and incidence of complications. Of 12 patients, 2 were excluded because it was technically impossible to induce pneumoperitoneum. Of the remaining 10 patients, 60% were female and 40% were male. The patients' average age was 51.5 years, average body mass index was 34.7, and evolution time of their hernias ranged from 8 months to 23 years. Nine patients had ventral hernias and one had an inguinal hernia. Pneumoperitoneum was maintained for an average of 9.3 days and there were no serious complications relating to the puncture or the maintenance of the pneumoperitoneum. One patient who previously had undergone a mastectomy experienced minor complications. We were able to perform hernioplasty on all patients, eight with the Rives technique, one with supra-aponeurotic mesh, and one using the Lichtenstein method for inguinal hernia repair. One patient's wound became infected postoperatively. Preoperative progressive pneumoperitoneum is a safe procedure that is easy to perform and that facilitates surgical hernia repair in patients with hernia with loss of domain. Complications are infrequent, patient tolerability is adequate, and the proposed modification to the puncture technique makes the procedure even safer.

Abdominal Wall↗

PubMed2003

Inguinal hernioplasty with the Prolene Hernia System.

Most tension-free hernia repair techniques achieve 0.1%-0.4% recurrence rates in patients with primary hernias. Currently, the Lichtenstein technique is considered to be the criterion standard. The Prolene Hernia System (PHS) is a recently introduced hernia-repair device that combines three proven mechanisms of action. We retrospectively reviewed early and late complications in 250 patients who underwent inguinal hernioplasties-125 performed with the Lichtenstein technique and 125 performed with the PHS-from March 1998-October 2002. Patients who underwent Lichtenstein hernia repair had nine complications, and those who underwent PHS surgery had only two; none of the complications were serious. Older male patients who underwent Lichtenstein hernia repair were more likely to have complications ( P=0.04). One patient in the Lichtenstein group had a recurrence of his hernia, but there were no recurrences in the PHS group. In conclusion, the results of inguinal hernioplasties performed with the PHS are comparable to those achieved with Lichtenstein hernia repair, the criterion standard technique.

Adolescent↗