High incidence of inguinal hernias among patients with congenital abdominal wall defects: a population-based case-control study

The aim of this nationwide population-based case-control study was to assess the incidence of inguinal hernia (IH) among patients with congenital abdominal wall defects. All infants born with congenital abdominal wall defects between Jan 1, 1998, and Dec 31, 2014, were identified in the Finnish Register of Congenital Malformations. Six controls matched for gestational age, sex, and year of birth were selected for each case in the Medical Birth Register. The Finnish Hospital Discharge Register was searched for relevant diagnosis codes for IH, and hernia incidence was compared between cases and controls. We identified 178 infants with gastroschisis and 150 with omphalocele and selected randomly 1968 matched, healthy controls for comparison. Incidence of IH was significantly higher in gastroschisis girls than in matched controls, relative risk (RR) 7.20 (95% confidence interval [CI] 2.25-23.07). In boys with gastroschisis, no statistically significant difference was observed, RR 1.60 (95% CI 0.75-3.38). Omphalocele was associated with higher risk of IH compared to matched controls, RR 6.46 (95% CI 3.90-10.71), and the risk was equally elevated in male and female patients.Conclusion: Risk of IH is significantly higher among patients with congenital abdominal wall defects than in healthy controls supporting hypothesis that elevated intra-abdominal pressure could prevent natural closure of processus vaginalis. Parents should be informed of this elevated hernia risk to avoid delays in seeking care. We also recommend careful follow-up during the first months of life as most of these hernias are diagnosed early in life.</p

VIDEOAVUSTEINEN RINTAONTELON TÄHYSTYKSESSÄ TEHTÄVÄ KEUHKOSYÖPÄKIRURGIA VERRATTUNA AVOKIRURGIAAN SUOMESSA

The aim of this study was to clarify significant differences in outcomes between two surgical treatment methodmethods for primary lung cancer. Also, the factors affecting these differences were under our exploration. The most important factorsMain outcome measures were overall mortality, postoperative cancer-recurrence-free survivaltime and postoperative complications. The study included 488 patients operated between the years 2006 and 2016 at . The data was gathered from the patient records of Turku University Hospital Vaasa Central Hospital and Jyväskylä Central Hospital3 tertiary surgical centers. There were 130 patients (26.6% from all patients) who were operated with the VATS (Video Assisociated Thoracoscopy) technique and 358 patients (73.4% from all patients) with theopen surgery (thoracotomy)thoracotomic technique. The median follow-up time for patients was 3.2 +/- 2.4 years and during. that time 193 (39.5%) patients stayed symptom free post-operatively. From these symptomless patients 58 (11.9% from all patients) were VATS and 135 (27.7% from all patients) thoracotomically operated. 210 (43.0%) patients reported post-operative symptoms. 55 (11.2% from all patients) from these patients were from the VATS group and 155 (31.8% from all patients) from the thoracotomy group. In the VATS group the three years survival rate was 82.8% ja in the thoracotomy group 74.8%. This difference was not statistically significant. In the VATS group the three-3 year survival prognosis was at least as long as in the thoracotomysimilar compared with the open group (82.8% vs. 74.8%, p=0.27). There was a statistically insignificant difference in the renewal of the cancer between these two surgical methods (p=0.78). In the VATS group the cancer-free time up to three years was statistically significant.Cancer-free survival was better after VATS up to 3 years, but similar between groups by 5 years (p=0.78). After three years the advantage was lost, and the graphs crossed (p=0.78). In the VATS group there was a statistically significantly less of postoperative complications when compared to thoracotomy groupIn-hospital postoperative complications (any Clavien-Dindo –class) were less frequent with VATS (19.6% vs 35.8%, p<0.0001). In conclusion, the studyresults suggested that the oncological responseults with the VATS techniqueare was at least as good as theequal to open thoracotomic technique althoughsurgery, but havingwith significantly fewerless injurious effectspostoperative complications

High incidence of inguinal hernias among patients with congenital abdominal wall defects: a population-based case-control study.

The aim of this nationwide population-based case-control study was to assess the incidence of inguinal hernia (IH) among patients with congenital abdominal wall defects. All infants born with congenital abdominal wall defects between Jan 1, 1998, and Dec 31, 2014, were identified in the Finnish Register of Congenital Malformations. Six controls matched for gestational age, sex, and year of birth were selected for each case in the Medical Birth Register. The Finnish Hospital Discharge Register was searched for relevant diagnosis codes for IH, and hernia incidence was compared between cases and controls. We identified 178 infants with gastroschisis and 150 with omphalocele and selected randomly 1968 matched, healthy controls for comparison. Incidence of IH was significantly higher in gastroschisis girls than in matched controls, relative risk (RR) 7.20 (95% confidence interval [CI] 2.25-23.07). In boys with gastroschisis, no statistically significant difference was observed, RR 1.60 (95% CI 0.75-3.38). Omphalocele was associated with higher risk of IH compared to matched controls, RR 6.46 (95% CI 3.90-10.71), and the risk was equally elevated in male and female patients. Conclusion: Risk of IH is significantly higher among patients with congenital abdominal wall defects than in healthy controls supporting hypothesis that elevated intra-abdominal pressure could prevent natural closure of processus vaginalis. Parents should be informed of this elevated hernia risk to avoid delays in seeking care. We also recommend careful follow-up during the first months of life as most of these hernias are diagnosed early in life.Peer reviewe