Guillaume Passot1, Laurent Villeneuve2, Charles Sabbagh3, Yohann Renard4, Jean-Marc Regimbeau3, Pierre Verhaeghe3, Reza Kianmanesh4, Jean-Pierre Palot4, Delphine Vaudoyer5, Olivier Glehen6, Eddy Cotte6. 1. Service de chirurgie générale, digestive et endocrinienne, CHU Lyon Sud, Hospices civils de Lyon, France; EMR 3738, Université de médecine Lyon Sud Charles Mérieux, Université Lyon 1, France. Electronic address: guillaume.passot@chu-lyon.fr. 2. EMR 3738, Université de médecine Lyon Sud Charles Mérieux, Université Lyon 1, France; Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France. 3. Service de chirurgie digestive et oncologique, CHU d'Amiens, France. 4. Service de chirurgie générale, digestive et endocrinienne, CHU de Reims, France. 5. Service de chirurgie générale, digestive et endocrinienne, CHU Lyon Sud, Hospices civils de Lyon, France. 6. Service de chirurgie générale, digestive et endocrinienne, CHU Lyon Sud, Hospices civils de Lyon, France; EMR 3738, Université de médecine Lyon Sud Charles Mérieux, Université Lyon 1, France.
Abstract
BACKGROUND: Giant ventral hernias represent a real handicap for patients and constitute a challenge for surgeons. European Hernia Society classification defines all ventral hernia over 10 cm in the same group. However, this group represents different clinical entities with numerous therapeutic possibilities, and no standardized recommendation has been made. The objective of our work was to define consensual criteria that define giant ventral hernias requiring specific management and determine management modalities. METHODS: A national survey consisting of 21 questions was proposed through a secure, anonymous internet interface and on a voluntary basis to all surgeons practising in France involved in care of patients affected by giant ventral hernias. RESULTS: For more than 68% of respondents, loss of domain and a hernia volume greater than 30% of abdominal volume were mandatory to define giant ventral hernias. Pre-operative screening should include abdominal CT scan, functional respiratory exploration, and a cardiology consultation for 98%, 71% and 50% of the respondents respectively. Respiratory and cutaneous preparations were systematically proposed before surgery by 91% and 56% of respondents. Regarding surgical techniques, none has gained the support of the majority of respondents. However, 71% of respondents use a non-resorbable mesh in retro muscular position for more than 70% of their patients treated for giant ventral hernias. CONCLUSION: Giant ventral hernias could be defined as ventral hernia larger than 10 cm with loss of domain. A specific management is advocated.
BACKGROUND:Giant ventral hernias represent a real handicap for patients and constitute a challenge for surgeons. European Hernia Society classification defines all ventral hernia over 10 cm in the same group. However, this group represents different clinical entities with numerous therapeutic possibilities, and no standardized recommendation has been made. The objective of our work was to define consensual criteria that define giant ventral hernias requiring specific management and determine management modalities. METHODS: A national survey consisting of 21 questions was proposed through a secure, anonymous internet interface and on a voluntary basis to all surgeons practising in France involved in care of patients affected by giant ventral hernias. RESULTS: For more than 68% of respondents, loss of domain and a hernia volume greater than 30% of abdominal volume were mandatory to define giant ventral hernias. Pre-operative screening should include abdominal CT scan, functional respiratory exploration, and a cardiology consultation for 98%, 71% and 50% of the respondents respectively. Respiratory and cutaneous preparations were systematically proposed before surgery by 91% and 56% of respondents. Regarding surgical techniques, none has gained the support of the majority of respondents. However, 71% of respondents use a non-resorbable mesh in retro muscular position for more than 70% of their patients treated for giant ventral hernias. CONCLUSION:Giant ventral hernias could be defined as ventral hernia larger than 10 cm with loss of domain. A specific management is advocated.
Authors: F K Azar; T C Crawford; K E Poruk; N Farrow; P Cornell; O Nadra; S C Azoury; K C Soares; C M Cooney; F E Eckhauser Journal: Hernia Date: 2017-02-08 Impact factor: 4.739
Authors: Y Yurtkap; M M J van Rooijen; S Roels; J M L Bosmans; O Uyttebroek; J F Lange; F Berrevoet Journal: Hernia Date: 2020-06-03 Impact factor: 4.739
Authors: A Tashkandi; J Bueno-Lledó; J Durtette-Guzylack; A Cayeux; R Bukhari; R Rhaeim; J M Malinovski; R Kianmanesh; Y Renard Journal: Hernia Date: 2021-03-09 Impact factor: 4.739