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Laparoscopic mesh repair of incisional hernia: an alternative to the conventional open repair? 总被引:1,自引:0,他引:1
M. Stickel M. Rentsch D.-A. Clevert T. Hernandez-Richter K. W. Jauch F. Löhe M. K. Angele 《Hernia》2007,11(3):217-222
Background Tension-free incisional hernia repair using alloplastic material increasingly replaces conventional repair techniques. This
change resulted in a decreased recurrence rate (50% vs. 10%, respectively). Recently, laparoscopic approaches for the intraperitoneal
tension-free mesh application have been introduced. The decreased trauma at the incision site and the reduction in wound infections
appear to be the main advantages. The aim of the present study was to evaluate the early and long-term complications as well
as patients’ contentment.
Methods Laparoscopic hernia repair with intraperitoneal polytetrafluroethylene (PTFE) mesh implantation was performed on 62 patients
at the Klinikum Grosshadern between 2000 and 2005 (29 males, 33 females age 60.7). Intra- and postoperative complications
were registered prospectively and retrospectively analyzed. In addition, 57 patients were evaluated for recurrence, postoperative
pain and patient contentment (median follow-up 409 days).
Results A low complication rate was observed in our patient collective. One trocar bleeding occurred. Three patients presented with
wound hematoma. The recurrence rate was 8% (2/25). Sixty-two percent of the patients were free of complaints postoperatively.
Eighty-five percent would once again choose the laparoscopic approach for incisional hernia repair.
Conclusion The laparoscopic technique was associated with a low recurrence rate, a small rate of wound infections and high patient comfort.
Thus, the laparoscopic approach for mesh implantation appears to be a safe and effective method for the treatment of incisional
hernias. The efficiency for laparoscopic intraperitoneal mesh implantation, however, should be further evaluated within a
prospectively randomized multicenter trial.
M. Stickel and M. Rentsch contributed equally. 相似文献
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Distribution of mutations in the PEX gene in families with X-linked hypophosphataemic rickets (HYP) 总被引:8,自引:0,他引:8
Rowe PS; Oudet CL; Francis F; Sinding C; Pannetier S; Econs MJ; Strom TM; Meitinger T; Garabedian M; David A; Macher MA; Questiaux E; Popowska E; Pronicka E; Read AP; Mokrzycki A; Glorieux FH; Drezner MK; Hanauer A; Lehrach H; Goulding JN; O'Riordan JL 《Human molecular genetics》1997,6(4):539-549
Mutations in the PEX gene at Xp22.1 (phosphate-regulating gene with
homologies to endopeptidases, on the X-chromosome), are responsible for
X-linked hypophosphataemic rickets (HYP). Homology of PEX to the M13 family
of Zn2+ metallopeptidases which include neprilysin (NEP) as prototype, has
raised important questions regarding PEX function at the molecular level.
The aim of this study was to analyse 99 HYP families for PEX gene
mutations, and to correlate predicted changes in the protein structure with
Zn2+ metallopeptidase gene function. Primers flanking 22 characterised
exons were used to amplify DNA by PCR, and SSCP was then used to screen for
mutations. Deletions, insertions, nonsense mutations, stop codons and
splice mutations occurred in 83% of families screened for in all 22 exons,
and 51% of a separate set of families screened in 17 PEX gene exons.
Missense mutations in four regions of the gene were informative regarding
function, with one mutation in the Zn2+-binding site predicted to alter
substrate enzyme interaction and catalysis. Computer analysis of the
remaining mutations predicted changes in secondary structure,
N-glycosylation, protein phosphorylation and catalytic site molecular
structure. The wide range of mutations that align with regions required for
protease activity in NEP suggests that PEX also functions as a protease,
and may act by processing factor(s) involved in bone mineral metabolism.
相似文献