nach oben

Hernia

Erschienen in:

27.01.2018 | Review

Incidence, etiology, management, and outcomes of flank hernia: review of published data

verfasst von: D. J. Zhou, M. A. Carlson

Erschienen in: Hernia | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To review the published data describing the incidence, etiology, management, and outcomes of flank hernia.

Methods

A retrospective review of articles identified with an online search (using the terms “flank hernia”, “flank bulge”, “lateral hernia”, “retroperitoneal aorta hernia”, and “open radical nephrectomy”) was performed. Studies exclusively on lumbar hernia or subcostal hernia were excluded.

Results

All articles retained for analysis (N = 26) were uncontrolled series or case reports; there were no controlled trials. The incidence of incisional hernia in the flank was ~ 17% (total patients analyzed = 1,061). Flank hernia repair was accomplished successfully with a variety of techniques, with overall mean rates of perioperative complications, chronic post-procedure pain, and recurrence equal to 20, 11, and 7%, respectively. Mesh utilization was universal.

Conclusions

The available data of outcomes of flank hernia repair are not of high quality, and recommendations essentially consist of expert opinions. Operative approach (open vs. laparoscopic) and mesh insertion details have varied, but reasonable results appear possible with a number of techniques.

Nur mit Berechtigung zugänglich

Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Pascual MH, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RKJ, Simons MP, Smietanski M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13(4):407–414. https://doi.org/10.1007/s10029-009-0518-x CrossRefPubMedPubMedCentral

Edwards C, Geiger T, Bartow K, Ramaswamy A, Fearing N, Thaler K, Ramshaw B (2009) Laparoscopic transperitoneal repair of flank hernias: a retrospective review of 27 patients. Surg Endosc 23(12):2692–2696. https://doi.org/10.1007/s00464-009-0477-4 CrossRefPubMed

Phillips MS, Krpata DM, Blatnik JA, Rosen MJ (2012) Retromuscular preperitoneal repair of flank hernias. J Gastrointest Surg 16(8):1548–1553. https://doi.org/10.1007/s11605-012-1890-x CrossRefPubMed

Ballard JL, Abou-Zamzam AM Jr, Teruya TH, Harward TR, Flanigan DP (2006) Retroperitoneal aortic aneurysm repair: long-term follow-up regarding wound complications and erectile dysfunction. Ann Vasc Surg 20(2):195–199. https://doi.org/10.1007/s10016-006-9014-2 CrossRefPubMed

Bayazıt Y, Arıdogan IA, Tansug Z, Ünsal I, Erken U (2001) Morbidity of flank incision in 100 renal donors. Int Urol Nephrol 32:709–711CrossRefPubMed

Bender JS, Dennis RW, Albrecht RM (2008) Traumatic flank hernias: acute and chronic management. Am J Surg 195(3):414–417. https://doi.org/10.1016/j.amjsurg.2007.12.004 (discussion 417) CrossRefPubMed

Chatterjee S, Nam R, Fleshner N, Klotz L (2004) Permanent flank bulge is a consequence of flank incision for radical nephrectomy in one half of patients. Urol Oncol 22(1):36–39. https://doi.org/10.1016/S1078-1439(03)00099-1 CrossRefPubMed

Crouzet S, Chopra S, Tsai S, Kamoi K, Haber GP, Remer EM, Berger AK, Gill IS, Aron M (2014) Flank muscle volume changes after open and laparoscopic partial nephrectomy. J Endourol 28(10):1202–1207. https://doi.org/10.1089/end.2013.0782 CrossRefPubMed

Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM, Clayman RV (2000) Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol 164(4):1153–1159CrossRefPubMed

10.

Fei Y, Li L (2010) Comparison of two repairing procedures for abdominal wall reconstruction in patients with flank hernia. Chin J Repar Reconstr Surg 24(12):1506–1509

11.

Flowers JL, Jacobs S, Cho E, Morton A, Rosenberger WF, Evans D, Imbembo AL, Bartlett ST (1997) Comparison of open and laparoscopic live donor nephrectomy. Ann Surg 226(4):483–489 (discussion 489-490) CrossRefPubMedPubMedCentral

12.

Gardner GP, Josephs LG, Rosca M, Rich J, Woodson J, Menzoian JO (1994) The retroperitoneal incision: an evaluation of postoperative flank ‘bulge’. Arch Surg 129(7):753–756CrossRefPubMed

13.

Hemal AK, Kumar A, Kumar R, Wadhwa P, Seth A, Gupta NP (2007) Laparoscopic versus open radical nephrectomy for large renal tumors: a long-term prospective comparison. J Urol 177(3):862–866. https://doi.org/10.1016/j.juro.2006.10.053 CrossRefPubMed

14.

Honig MP, Mason RA, Giron F (1992) Wound complications of the retroperitoneal approach to the aorta and iliac vessels. J Vasc Surg 15(1):28–33 (discussion 33-24) CrossRefPubMed

15.

Kercher KW, Heniford BT, Matthews BD, Smith TI, Lincourt AE, Hayes DH, Eskind LB, Irby PB, Teigland CM (2003) Laparoscopic versus open nephrectomy in 210 consecutive patients: outcomes, cost, and changes in practice patterns. Surg Endosc 17(12):1889–1895. https://doi.org/10.1007/s00464-003-8808-3 CrossRefPubMed

16.

Kirby LB, Rosenthal D, Atkins CP, Brown GA, Matsuura JH, Clark MD, Pallos L (1999) Comparison between the transabdominal and retroperitoneal approaches for aortic reconstruction in patients at high risk. J Vasc Surg 30(3):400–405CrossRefPubMed

17.

Klop KW, Hussain F, Karatepe O, Kok NF, Ijzermans JN, Dor FJ (2013) Incision-related outcome after live donor nephrectomy: a single-center experience. Surg Endosc 27(8):2801–2806. https://doi.org/10.1007/s00464-013-2811-0 CrossRefPubMed

18.

Luc G, David A, Couzi L, Midy D, Collet D, Dubuisson V (2014) Lateral incisional hernia after renal transplantation: a comparative study. World J Surg 38(11):2791–2796. https://doi.org/10.1007/s00268-014-2689-6 CrossRefPubMed

19.

Matsen SL, Krosnick TA, Roseborough GS, Perler BA, Webb TH, Chang DC, Williams GM (2006) Preoperative and intraoperative determinants of incisional bulge following retroperitoneal aortic repair. Ann Vasc Surg 20(2):183–187. https://doi.org/10.1007/s10016-006-9021-3 CrossRefPubMed

20.

Patel PP, Warren JA, Mansour R, Cobb WS, Carbonell AM (2016) A large single-center experience of open lateral abdominal wall hernia repairs. Am Surg 82(7):608–612PubMed

21.

Petersen S, Schuster F, Steinbach F, Henke G, Hellmich G, Ludwig K (2002) Sublay prosthetic repair for incisional hernia of the flank. J Urol 168(6):2461–2463. https://doi.org/10.1097/01.ju.0000037777.97208.c8 CrossRefPubMed

22.

Pezeshk RA, Pulikkottil BJ, Bailey SH, Schaffer NE, Reece EM, Thornton NJ, Gupta AR, Hoxworth RE (2015) An evidence-based model for the successful treatment of flank and lateral abdominal wall hernias. Plast Reconstr Surg 136(2):377–385. https://doi.org/10.1097/PRS.0000000000001432 CrossRefPubMed

23.

Purnell CA, Park E, Turin SY, Dumanian GA (2016) Postoperative flank defects, hernias, and bulges: a reliable method for repair. Plast Reconstr Surg 137(3):994–1001. https://doi.org/10.1097/01.prs.0000479987.80490.5c CrossRefPubMed

24.

Sieunarine K, Lawrence-Brown MM, Goodman MA (1997) Comparison of transperitoneal and retroperitoneal approaches for infrarenal aortic surgery: early and late results. Cardiovasc Surg 5(1):71–76CrossRefPubMed

25.

Veyrie N, Poghosyan T, Corigliano N, Canard G, Servajean S, Bouillot JL (2013) Lateral incisional hernia repair by the retromuscular approach with polyester standard mesh: topographic considerations and long-term follow-up of 61 consecutive patients. World J Surg 37(3):538–544. https://doi.org/10.1007/s00268-012-1857-9 CrossRefPubMed

26.

Zhu X, Yang X, Hu X, Zhang X (2016) Retroperitoneoscopic versus open surgical radical nephrectomy for 152 Chinese patients with large renal cell carcinoma in clinical stage cT2 or cT3a: a long-term retrospective comparison. J Cancer Res Ther 12(2):805–810. https://doi.org/10.4103/0973-1482.186693 CrossRefPubMed

27.

Zieren J, Menenakos C, Taymoorian K, Muller JM (2007) Flank hernia and bulging after open nephrectomy: mesh repair by flank or median approach? Report of a novel technique. Int Urol Nephrol 39(4):989–993. https://doi.org/10.1007/s11255-007-9186-x CrossRefPubMed

28.

Montes-Tapia F, Cura-Esquivel I, Gutierrez S, Rodriguez-Balderrama I, de la O-Cavazos M (2016) Congenital lateral abdominal wall hernia. Pediatr Int. https://doi.org/10.1111/ped.12976 PubMed

29.

OCEBM Levels of Evidence Working Group (2011) “The Oxford 2011 Levels of Evidence”. Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653. Accessed 25 May 2017

30.

Grant MJ, Booth A (2009) A typology of reviews: an analysis of 14 review types and associated methodologies. Health Inf Libr J 26(2):91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x CrossRef

31.

Israelsson LA, Millbourn D (2013) Prevention of incisional hernias: how to close a midline incision. Surg Clin N Am 93(5):1027–1040. https://doi.org/10.1016/j.suc.2013.06.009 CrossRefPubMed

32.

Hesselink VJ, Luijendijk RW, de Wilt JH, Heide R, Jeekel J (1993) An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 176(3):228–234PubMed

33.

Hoer J, Lawong G, Klinge U, Schumpelick V (2002) Factors influencing the development of incisional hernia. A retrospective study of 2,983 laparotomy patients over a period of 10 years. Chirurg 73(5):474–480. https://doi.org/10.1007/s00104-002-0425-5 CrossRefPubMed

34.

Itatsu K, Yokoyama Y, Sugawara G, Kubota H, Tojima Y, Kurumiya Y, Kono H, Yamamoto H, Ando M, Nagino M (2014) Incidence of and risk factors for incisional hernia after abdominal surgery. Br J Surg 101(11):1439–1447. https://doi.org/10.1002/bjs.9600 CrossRefPubMed

35.

Hoffman RS, Smink DS, Noone RB, Noone RB Jr, Smink RD Jr (2004) Surgical repair of the abdominal bulge: correction of a complication of the flank incision for retroperitoneal surgery. J Am Coll Surg 199(5):830–835. https://doi.org/10.1016/j.jamcollsurg.2004.07.009 CrossRefPubMed

36.

Al-Hilli Z, Deasy J, Keaveny J (2010) Flank hernia secondary to phenol nerve block. Irish J Med Sci 179(3):451–453. https://doi.org/10.1007/s11845-009-0312-x CrossRefPubMed

37.

Timmermans L, Klitsie PJ, Maat AP, de Goede B, Kleinrensink GJ, Lange JF (2013) Abdominal wall bulging after thoracic surgery, an underdiagnosed wound complication. Hernia 17(1):89–94. https://doi.org/10.1007/s10029-012-0971-9 CrossRefPubMed

38.

Raffetto JD, Cheung Y, Fisher JB, Cantelmo NL, Watkins MT, Lamorte WW, Menzoian JO (2003) Incision and abdominal wall hernias in patients with aneurysm or occlusive aortic disease. J Vasc Surg 37(6):1150–1154CrossRefPubMed

39.

Carmo M, Colombo L, Bruno A, Corsi FR, Roncoroni L, Cuttin MS, Radice F, Mussini E, Settembrini PG (2002) Alteration of elastin, collagen and their cross-links in abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 23(6):543–549CrossRefPubMed

40.

Yannam GR, Gutti TL, High R, Stevens RB, Thompson JS, Morris MC (2011) Experience of laparoscopic incisional hernia repair in kidney and/or pancreas transplant recipients. Am J Transpl 11(2):279–286. https://doi.org/10.1111/j.1600-6143.2010.03351.x CrossRef

41.

Petro CC, Orenstein SB, Criss CN, Sanchez EQ, Rosen MJ, Woodside KJ, Novitsky YW (2015) Transversus abdominis muscle release for repair of complex incisional hernias in kidney transplant recipients. Am J Surg 210(2):334–339. https://doi.org/10.1016/j.amjsurg.2014.08.043 CrossRefPubMed

42.

Wang AS, Armstrong EJ, Armstrong AW (2013) Corticosteroids and wound healing: clinical considerations in the perioperative period. Am J Surg 206(3):410–417. https://doi.org/10.1016/j.amjsurg.2012.11.018 CrossRefPubMed

43.

Halm JA, Lip H, Schmitz PI, Jeekel J (2009) Incisional hernia after upper abdominal surgery: a randomised controlled trial of midline versus transverse incision. Hernia 13(3):275–280. https://doi.org/10.1007/s10029-008-0469-7 CrossRefPubMedPubMedCentral

44.

Deerenberg EB, Harlaar JJ, Steyerberg EW, Lont HE, van Doorn HC, Heisterkamp J, Wijnhoven BP, Schouten WR, Cense HA, Stockmann HB, Berends FJ, Dijkhuizen FP, Dwarkasing RS, Jairam AP, van Ramshorst GH, Kleinrensink GJ, Jeekel J, Lange JF (2015) Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. Lancet 386(10000):1254–1260. https://doi.org/10.1016/S0140-6736(15)60459-7 CrossRefPubMed

45.

Pans A, Elen P, Dewe W, Desaive C (1998) Long-term results of polyglactin mesh for the prevention of incisional hernias in obese patients. World J Surg 22(5):479–482 (discussion 482-473) CrossRefPubMed

46.

Caro-Tarrago A, Casas CO, Salido AJ, Guilera ED, Fernandez FM, Guillen VV (2014) Prevention of incisional hernia in midline laparotomy with an onlay mesh: a randomized clinical trial. World J Surg 38(9):2223–2230. https://doi.org/10.1007/s00268-014-2510-6 CrossRefPubMed

47.

Janes A, Cengiz Y, Israelsson LA (2009) Preventing parastomal hernia with a prosthetic mesh: a 5-year follow-up of a randomized study. World J Surg 33(1):118–121. https://doi.org/10.1007/s00268-008-9785-4 (discussion 122-113) CrossRefPubMed

48.

Beadles CA, Meagher AD, Charles AG (2015) Trends in emergent hernia repair in the United States. JAMA Surg 150(3):194–200. https://doi.org/10.1001/jamasurg.2014.1242 CrossRefPubMed

49.

Baumann DP, Butler CE (2012) Lateral abdominal wall reconstruction. Semin Plast Surg 26(1):40–48. https://doi.org/10.1055/s-0032-1302465 CrossRefPubMedPubMedCentral

50.

Akinduro OO, Jones F, Turner J, Cason F, Clark C (2015) Rare case of a strangulated intercostal flank hernia following open nephrectomy: a case report and review of literature. Int J Surg Case Rep 17:143–145. https://doi.org/10.1016/j.ijscr.2015.11.015 CrossRefPubMedPubMedCentral

51.

Holihan JL, Henchcliffe BE, Mo J, Flores-Gonzalez JR, Ko TC, Kao LS, Liang MK (2016) Is nonoperative management warranted in ventral hernia patients with comorbidities?: A case-matched, prospective, patient-centered study. Ann Surg 264(4):585–590. https://doi.org/10.1097/SLA.0000000000001865 CrossRefPubMed

52.

Fitzgibbons RJ Jr, Ramanan B, Arya S, Turner SA, Li X, Gibbs JO, Reda DJ, Investigators of the Original T (2013) Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias. Ann Surg 258(3):508–515. https://doi.org/10.1097/SLA.0b013e3182a19725 CrossRefPubMed

53.

Bilimoria KY, Liu Y, Paruch JL, Zhou L, Kmiecik TE, Ko CY, Cohen ME (2013) Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg 217(5):833–842. https://doi.org/10.1016/j.jamcollsurg.2013.07.385 CrossRefPubMedPubMedCentral

54.

Hall DE, Arya S, Schmid KK, Carlson MA, Lavedan P, Bailey TL, Purviance G, Bockman T, Lynch TG, Johanning JM (2017) Association of a frailty screening initiative with postoperative survival at 30, 180, and 365 days. JAMA Surg 152(3):233–240. https://doi.org/10.1001/jamasurg.2016.4219 CrossRefPubMed

55.

Liang MK, Holihan JL, Itani K, Alawadi ZM, Gonzalez JR, Askenasy EP, Ballecer C, Chong HS, Goldblatt MI, Greenberg JA, Harvin JA, Keith JN, Martindale RG, Orenstein S, Richmond B, Roth JS, Szotek P, Towfigh S, Tsuda S, Vaziri K, Berger DH (2017) Ventral hernia management: expert consensus guided by systematic review. Ann Surg 265(1):80–89. https://doi.org/10.1097/SLA.0000000000001701 CrossRefPubMed

56.

Hope WW, Hooks WB 3rd (2013) Atypical hernias: suprapubic, subxiphoid, and flank. Surg Clin N Am 93(5):1135–1162. https://doi.org/10.1016/j.suc.2013.06.002 CrossRefPubMed

57.

Varela JE, Kane K (2009) Laparoscopic repair of large flank hernia staged with laparoscopic sleeve gastrectomy in the morbidly obese. Surg Obes Relat Dis 5(4):513–516. https://doi.org/10.1016/j.soard.2008.12.004 CrossRefPubMed

58.

Moreno-Egea A, Torralba-Martinez JA, Morales G, Fernandez T, Girela E, Aguayo-Albasini JL (2005) Open vs laparoscopic repair of secondary lumbar hernias: a prospective nonrandomized study. Surg Endosc 19(2):184–187. https://doi.org/10.1007/s00464-004-9067-7 CrossRefPubMed

59.

Stoikes N, Quasebarth M, Brunt LM (2013) Hybrid ventral hernia repair: technique and results. Hernia 17(5):627–632. https://doi.org/10.1007/s10029-013-1092-9 CrossRefPubMed

60.

Griniatsos J, Eugenia Y, Anastasios T, Christos T, Theodoros D (2009) A hybrid technique for recurrent incisional hernia repair. Surg Laparosc Endosc Percutaneous Tech 19(5):e177–e180. https://doi.org/10.1097/SLE.0b013e3181bb859c CrossRef

61.

Orthopoulos G, Kudsi OY (2018) Feasibility of robotic-assisted transabdominal preperitoneal ventral hernia repair. J Laparoendosc Adv Surg Tech. https://doi.org/10.1089/lap.2017.0595 (ePub before print 2 Jan 2018)

62.

Wang SC, Singh TP (2017) Robotic repair of a large abdominal intercostal hernia: a case report and review of literature. J Robot Surg 11(2):271–274. https://doi.org/10.1007/s11701-017-0675-3 CrossRefPubMed

63.

Huntington CR, Augenstein VA (2016) Laparoscopic repair of flank hernias. In: Novitsky WY (ed) Hernia surgery: current principles. Springer International Publishing, Cham, pp 261–272. https://doi.org/10.1007/978-3-319-27470-6_25

64.

Wilson KL, Davis MK, Rosser JC Jr (2012) A traumatic abdominal wall hernia repair: a laparoscopic approach. JSLS 16(2):287–291CrossRefPubMedPubMedCentral

65.

Gagner M, Milone L, Gumbs A, Turner P (2010) Laparoscopic repair of left lumbar hernia after laparoscopic left nephrectomy. JSLS 14(3):405–409. https://doi.org/10.4293/108680810X12924466007322 CrossRefPubMedPubMedCentral

66.

Shekarriz B, Graziottin TM, Gholami S, Lu HF, Yamada H, Duh QY, Stoller ML (2001) Transperitoneal preperitoneal laparoscopic lumbar incisional herniorrhaphy. J Urol 166(4):1267–1269CrossRefPubMed

67.

Sahoo MR, Bisoi S, Mathapati S (2013) Polypropelene mesh eroding transverse colon following laparoscopic ventral hernia repair. J Minim Access Surg 9(1):40–41. https://doi.org/10.4103/0972-9941.107139 CrossRefPubMedPubMedCentral

68.

Tandon A, Shahzad K, Pathak S, Oommen CM, Nunes QM, Smart N (2016) Parietex Composite mesh versus DynaMesh(R)-IPOM for laparoscopic incisional and ventral hernia repair: a retrospective cohort study. Ann R Coll Surg Engl 98(8):568–573. https://doi.org/10.1308/rcsann.2016.0292 CrossRefPubMedPubMedCentral

69.

Atikeler MK, Yuzgec V, Gecit I (2005) A giant incisional flank hernia. Int Urol Nephrol 37(4):699–700. https://doi.org/10.1007/s11255-005-0245-x CrossRefPubMed

Titel: Incidence, etiology, management, and outcomes of flank hernia: review of published data
verfasst von: D. J. Zhou
M. A. Carlson
Publikationsdatum: 27.01.2018
Verlag: Springer Paris
Erschienen in: Hernia / Ausgabe 2/2018
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-018-1740-1

Neu im Fachgebiet Chirurgie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2018

What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

Preventing parastomal hernia with modified stapled mesh stoma reinforcement technique (SMART) in patients who underwent surgery for rectal cancer: a case–control study

Laparoscopic repair of traumatic flank hernias

Management of skin and subcutaneous tissue in complex open abdominal wall reconstruction

TRIBUTE to Jean Henri ALEXANDRE—now leaving the EHS board

Comparing different modalities for the diagnosis of incisional hernia: a systematic review

Update Chirurgie