Editorial

4 pages, 397 KiB

Open AccessEditorial

Improving Patient Outcomes in Abdominal Surgery

by Claudia Brusasco, Giada Cucciolini, Andrea Barberis, Carlo Introini, Fabio Campodonico and Francesco Corradi

J. Clin. Med. 2024, 13(7), 1993; https://doi.org/10.3390/jcm13071993 - 29 Mar 2024

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Abstract

Post-operative acute kidney injury (PO-AKI) is a frequent complication described in 15% of non-cardiac surgeries, 30% of cardiac surgeries, and 52% of patients requiring intensive post-operative care [...] Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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Research

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15 pages, 2447 KiB

Open AccessArticle

Harnessing Non-Thermal Plasma to Supercharge Recovery in Abdominal Surgeries: A Pilot Study

by Benjamín G. Rodríguez-Méndez, Régulo López-Callejas, Antonio Mercado-Cabrera, Rosendo Peña-Eguiluz, Raúl Valencia-Alvarado, Mario Betancourt-Ángeles, Guillermo Berrones-Stringel and César Jaramillo-Martínez

J. Clin. Med. 2024, 13(2), 408; https://doi.org/10.3390/jcm13020408 - 11 Jan 2024

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Abstract

(1) Background: This study aims to evaluate the efficacy and safety of non-thermal plasma (NTP) therapy in accelerating wound healing in patients who have undergone laparoscopic and open surgeries. (2) Methods: NTP was applied using a needle-type reactor with an irradiance of 0.5 [...] Read more.

(1) Background: This study aims to evaluate the efficacy and safety of non-thermal plasma (NTP) therapy in accelerating wound healing in patients who have undergone laparoscopic and open surgeries. (2) Methods: NTP was applied using a needle-type reactor with an irradiance of 0.5 W/cm² on the surgical wounds of fifty patients after obtaining informed consent. Three NTP treatments, each lasting three minutes, were administered hourly. (3) Results: The pilot study showed that NTP-treated surgical wounds healed completely without any signs of infection, dehiscence, pain, or itching. Notably, patients reported minimal pain after the NTP treatment. Visual assessments conducted twenty-four hours after surgery revealed no redness or fluid discharge. Comparisons with traditionally sutured wounds indicated that NTP-treated wounds healed at a rate equivalent to seven days. (4) Conclusions: The application of NTP in laparoscopic and open wounds proved safe and effective, expediting the wound healing process and eliminating clinical risks post-surgery. Significantly, NTP facilitated a healing rate within twenty-four hours, equivalent to seven days for suture-treated wounds, significantly reducing the hospitalization time to a single day. These findings highlight the potential of NTP to be a transformative approach for promoting postoperative recovery. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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8 pages, 240 KiB

Open AccessArticle

Perioperative Intravenous Amino Acid Infusion in Major Urologic Surgery

by Claudia Brusasco, Fabio Maria Valenzi, Marco Micali, Marco Ennas, Antonia Di Domenico, Federico Germinale, Federico Dotta, Andrea Benelli, Fabio Campodonico, Giada Cucciolini, Antonio Carbone, Carlo Introini and Francesco Corradi

J. Clin. Med. 2023, 12(20), 6614; https://doi.org/10.3390/jcm12206614 - 19 Oct 2023

Cited by 1 | Viewed by 1469

Abstract

Post-operative acute kidney injury (PO-AKI) is a serious complication that may occur after major abdominal surgery. The administration of intravenous perioperative amino acids (AAs) has been proven to increase kidney function and has some beneficial effects to prevent PO-AKI. The aim of this [...] Read more.

Post-operative acute kidney injury (PO-AKI) is a serious complication that may occur after major abdominal surgery. The administration of intravenous perioperative amino acids (AAs) has been proven to increase kidney function and has some beneficial effects to prevent PO-AKI. The aim of this study was to establish if the perioperative infusion of AAs may reduce the incidence of PO-AKI in patients undergoing major urological minimally invasive surgery. From a total of 331 patients, the first 169 received perioperative crystalloid fluids and the following 162 received perioperative AA infusions. PO-AKIs were much higher in the crystalloid group compared to the AA group (34 vs. 17, p = 0.022) due to a lower incidence of KDIGO I and II in the AA group (14 vs. 30 p = 0.016). The AA group patients who developed a PO-AKI presented more risk factors compared to those who did not (2 (2-4) vs. 1 (1-2), p = 0.031) with a cut-off of 3 risk factors in the ROC curve (p = 0.007, sensitivity 47%, specificity 83%). The hospital length of stay was higher in the crystalloid group (p < 0.05) with a consequent saving in hospital costs. Perioperative AA infusion may help reduce the incidence of PO-AKI after major urological minimally invasive surgery. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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Graphical abstract

11 pages, 2928 KiB

Open AccessArticle

A Novel Mutation of MSH2 Gene in a Patient with Lynch Syndrome Presenting with Thirteen Metachronous Malignancies

by Ugne Silinskaite, Edita Gavelienė, Rokas Stulpinas, Ramunas Janavicius and Tomas Poskus

J. Clin. Med. 2023, 12(17), 5502; https://doi.org/10.3390/jcm12175502 - 24 Aug 2023

Viewed by 1076

Abstract

Lynch syndrome (LS), also known as hereditary nonpolyposis colorectal cancer (HNPCC), accounts for 2–3% of all colorectal cancers. This autosomal dominant disorder is associated with a predisposition to endometrial, stomach, small bowel, pancreatic, biliary tract, ovary, urinary tract, brain, and skin tumors. Lynch [...] Read more.

Lynch syndrome (LS), also known as hereditary nonpolyposis colorectal cancer (HNPCC), accounts for 2–3% of all colorectal cancers. This autosomal dominant disorder is associated with a predisposition to endometrial, stomach, small bowel, pancreatic, biliary tract, ovary, urinary tract, brain, and skin tumors. Lynch syndrome is caused by the mutation of the MLH1, MSH2 (EPCAM), MSH6, and PMS2 genes. In this article, a case study of a 70-year-old female patient with Lynch syndrome is presented. Over a span of 30 years, the patient underwent multiple surgical procedures for a total of thirteen different malignancies. She was found to have a deleterious pathogenic gene MSH2 (NM_000251.2) variant (mutation) c.1774_1775insT in the 12th exon. This variant, c.1774_1775insT, represents a novel finding, as it has not been previously reported in existing databases or literature. No other case of 13 metachronous tumors in a patient with Lynch syndrome was found in the literature. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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13 pages, 1320 KiB

Open AccessArticle

Long-Term Oncological and Functional Outcomes after Laparoscopic Partial Nephrectomy with Hyperselective Embolization of Tumor Vessels in a Hybrid Operating Room

by Ulysse Frantz, Antoine Bouvier, Thibaut Culty, Merzouka Zidane, Souhil Lebdai and Pierre Bigot

J. Clin. Med. 2023, 12(16), 5167; https://doi.org/10.3390/jcm12165167 - 08 Aug 2023

Viewed by 763

Abstract

Laparoscopic partial nephrectomy (LPN) after hyperselective embolization of tumor vessels (HETV) in a hybrid operating room (HOR) that combines traditional surgical equipment with advanced imaging technology, is a non-clamping surgical approach to treat localized kidney tumors that has shown promising short-term results. The [...] Read more.

Laparoscopic partial nephrectomy (LPN) after hyperselective embolization of tumor vessels (HETV) in a hybrid operating room (HOR) that combines traditional surgical equipment with advanced imaging technology, is a non-clamping surgical approach to treat localized kidney tumors that has shown promising short-term results. The aim of this study was to evaluate the long-term oncological and functional outcomes of this procedure. All consecutive patients treated for a localized kidney tumor by LPN after HETV between May 2015 and October 2022 in a single academic institution were included in the study. Clinical, pathological and biological data were collected prospectively in the uroCCR database. We evaluated intraoperative data, postoperative complications, surgical margin and modification of renal function after surgery. We included 245 patients. The median tumor size was 3.2 (2.5–4.4) cm. The R.E.N.A.L. complexity was low, medium and high for 104 (43.5%), 109 (45.6%) and 26 (10.9%) patients, respectively. Median LPN time was 75 (65–100) min and median blood loss was 100 (50–300) mL. Surgical postoperative complications occurred in 56 (22.9%) patients with 17 (5.7%) major complications. The median Glomerular Function Rate variation at 6 months was −7.5 (−15–−2) mL/min. Malignant tumors were present in 211 (86.1%) patients, and 12 (4.9%) patients had positive surgical margins. After a median follow-up of 27 (8–49) months, 20 (8.2%) patients had a tumor recurrence and 4 (1.6%) died from cancer. At 5 years, disease free survival, cancer specific survival and overall survival rates were 84%, 96.8% and 88.3%, respectively. Performing LPN after HETV in a HOR is a safe and efficient non-clamping approach to treat localized kidney tumors. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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8 pages, 947 KiB

Open AccessArticle

Evaluating the Natural History of Groin Hernia from an “Unplanned” Watchful Waiting Strategy

by Marco Ceresoli, Stella Konadu Adjei Antwi, Megi Mehmeti, Serena Marmaggi, Marco Braga and Luca Nespoli

J. Clin. Med. 2023, 12(12), 4127; https://doi.org/10.3390/jcm12124127 - 19 Jun 2023

Cited by 1 | Viewed by 1060

Abstract

Groin hernia is one of the most common surgical diagnoses worldwide. The indication for surgery in asymptomatic or mildly symptomatic patients is discussed. Some trials have demonstrated the safety of a watchful waiting strategy. During the pandemic, waiting lists for hernia surgery dramatically [...] Read more.

Groin hernia is one of the most common surgical diagnoses worldwide. The indication for surgery in asymptomatic or mildly symptomatic patients is discussed. Some trials have demonstrated the safety of a watchful waiting strategy. During the pandemic, waiting lists for hernia surgery dramatically increased the opportunity to evaluate the natural history of groin hernias. The present study aimed to evaluate the incidence of emergency hernia surgery in a large cohort of patients that were selected and were waiting for elective surgery. This is a retrospective cross-sectional cohort study including all patients evaluated and selected for elective groin hernia surgery at San Gerardo Hospital between 2017 and 2020. Elective and emergency hernia surgeries were recorded for all patients. The incidence of adverse events was also evaluated. Overall, 1423 patients were evaluated, and 964 selected patients (80.3%) underwent elective hernia surgery, while 17 patients (1.4%) required an emergency operation while waiting for an elective operation. A total of 220 (18.3%) patients were still awaiting surgery in March 2022. The overall cumulative risk levels for emergency hernia surgeries were 1%, 2%, 3.2%, and 5% at 12, 24, 36, and 48 months, respectively. There was no association between longer waiting periods and an increased need for emergency surgery. Our study indicates that up to 5% of patients with groin hernia require emergency surgery at 48 months from the evaluation; the increased waiting time for surgery for elective groin hernia repair was not associated with an increased incidence of adverse events. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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12 pages, 1144 KiB

Open AccessArticle

Liver Transplantation in Patients with Portal Vein Thrombosis: Revisiting Outcomes According to Surgical Techniques

by Domenico Pinelli, Matteo Cescon, Matteo Ravaioli, Flavia Neri, Annalisa Amaduzzi, Matteo Serenari, Greta Carioli, Antonio Siniscalchi and Michele Colledan

J. Clin. Med. 2023, 12(7), 2457; https://doi.org/10.3390/jcm12072457 - 23 Mar 2023

Cited by 1 | Viewed by 1334

Abstract

Surgical strategies for graft portal vein flow restoration vary from termino-terminal portal vein anastomosis to more complex bypass reconstructions. Although the surgical strategy strongly influences the post-operative outcome, the Yerdel grading is still commonly used to determine the prognosis of patients with portal [...] Read more.

Surgical strategies for graft portal vein flow restoration vary from termino-terminal portal vein anastomosis to more complex bypass reconstructions. Although the surgical strategy strongly influences the post-operative outcome, the Yerdel grading is still commonly used to determine the prognosis of patients with portal vein thrombosis (PVT) undergoing liver transplantation (LT). We retrospectively reviewed the cases of LT performed on recipients with complex PVT at two high-volume transplantation centres. We stratified the patients by the type of portal vein reconstruction, termino-terminal portal vein anastomosis (TTA) versus bypass reconstruction (bypass group), and assessed a multivariable survival analysis. The rate of mortality at 90 days was 21.4% for the bypass group compared to 9.8% in the TTA group (p = 0.05). In the multivariable correlation analysis, only a trend for greater risk of early mortality was confirmed in the bypass groups (HR 2.5; p = 0.059). Yerdel grade was uninfluential in the rate of early complications. A wide range of surgical options are available for different situations of PVT which yield an outcome unrelated to the Yerdel grading. An algorithm for PVT management should be based on the technical approach and should include a surgically oriented definition of PVT extension. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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8 pages, 705 KiB

Open AccessArticle

A Peritoneal Purse-String Suture Prevents Symptomatic Lymphoceles in Retzius-Sparing Robot-Assisted Radical Prostatectomy

by Niklas Harland, Mohammed Alfarra, Eva Erne, Moritz Maas, Bastian Amend, Jens Bedke and Arnulf Stenzl

J. Clin. Med. 2023, 12(3), 791; https://doi.org/10.3390/jcm12030791 - 19 Jan 2023

Cited by 3 | Viewed by 1328

Abstract

Background: The retzius-sparing approach for robotic-assisted radical prostatectomy (RARP) has been increasingly adopted. Symptomatic lymphoceles are a widespread complication of RARP with pelvic lymph node dissection. Here, we present a new technique, the peritoneal purse-string suture (PPSS), that seems to reduce the rate [...] Read more.

Background: The retzius-sparing approach for robotic-assisted radical prostatectomy (RARP) has been increasingly adopted. Symptomatic lymphoceles are a widespread complication of RARP with pelvic lymph node dissection. Here, we present a new technique, the peritoneal purse-string suture (PPSS), that seems to reduce the rate of symptomatic lymphoceles following retzius-sparing RARP with extended pelvic lymph node dissection (ePLND). Methods: The radical prostatectomy and bilateral lymphadenectomy are performed through three separate peritoneal openings. The PPSS uses a single suture in a way similar to a purse-string suture; the openings of both lymphadenectomy fields are widened, and the rectovesical opening from the prostatectomy is simultaneously closed. This report retrospectively evaluates the perioperative and postoperative outcomes of two consecutive patient cohorts undergoing RARP with ePLND by a single surgeon between May 2015 and June 2019, one cohort prior to introducing PPSS as control (n = 145) and the other after introducing PPSS (n = 91). Results: The two study groups were comparable on baseline characteristics, except ASA. There were no Clavien–Dindo grade IV-V complications, and comparable rates of grade I-III complications. The difference in postoperative lymphocele formation was 22% in PPSS versus 27% in the control group (p = 0.33). The rate of symptomatic lymphoceles was significantly lower in the PPSS group (3% vs. 10%, p = 0.047). Conclusion: The PPSS is a feasible procedure that reduces symptomatic lymphoceles in patients undergoing RARP with a retzius-sparing approach. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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9 pages, 259 KiB

Open AccessArticle

Low Intra-Abdominal Pressure with Complete Neuromuscular Blockage Reduces Post-Operative Complications in Major Laparoscopic Urologic Surgery: A before–after Study

by Claudia Brusasco, Federico Germinale, Federico Dotta, Andrea Benelli, Giovanni Guano, Fabio Campodonico, Marco Ennas, Antonia Di Domenico, Gregorio Santori, Carlo Introini and Francesco Corradi

J. Clin. Med. 2022, 11(23), 7201; https://doi.org/10.3390/jcm11237201 - 04 Dec 2022

Cited by 6 | Viewed by 1886

Abstract

Most urological interventions are now performed with minimally invasive surgery techniques such as laparoscopic surgery. Combining ERAS protocols with minimally invasive surgery techniques may be the best option to reduce hospital length-of-stay and post-operative complications. We designed this study to test the hypothesis [...] Read more.

Most urological interventions are now performed with minimally invasive surgery techniques such as laparoscopic surgery. Combining ERAS protocols with minimally invasive surgery techniques may be the best option to reduce hospital length-of-stay and post-operative complications. We designed this study to test the hypothesis that using low intra-abdominal pressures (IAP) during laparoscopy may reduce post-operative complications, especially those related to reduced intra-operative splanchnic perfusion or increased splanchnic congestion. We applied a complete neuromuscular blockade (NMB) to maintain an optimal space and surgical view. We compared 115 patients treated with standard IAP and moderate NMB with 148 patients treated with low IAP and complete NMB undergoing major urologic surgery. Low IAP in combination with complete NMB was associated with fewer total post-operative complications than standard IAP with moderate NMB (22.3% vs. 41.2%, p < 0.001), with a reduction in all medical post-operative complications (17 vs. 34, p < 0.001). The post-operative complications mostly reduced were acute kidney injury (15.5% vs. 30.4%, p = 0.004), anemia (6.8% vs. 16.5%, p = 0.049) and reoperation (2% vs. 7.8%, p = 0.035). The intra-operative management of laparoscopic interventions for major urologic surgeries with low IAP and complete NMB is feasible without hindering surgical conditions and might reduce most medical post-operative complications. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

Review

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11 pages, 282 KiB

Open AccessFeature PaperReview

Guidelines for the Treatment of Abdominal Abscesses in Acute Diverticulitis: An Umbrella Review

by Roberto Cirocchi, Francesca Duro, Stefano Avenia, Matteo Capitoli, Giovanni Domenico Tebala, Massimiliano Allegritti, Bruno Cirillo, Gioia Brachini, Paolo Sapienza, Gian Andrea Binda, Andrea Mingoli, Piergiorgio Fedeli and Riccardo Nascimbeni

J. Clin. Med. 2023, 12(17), 5522; https://doi.org/10.3390/jcm12175522 - 25 Aug 2023

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Abstract

Background: This systematic umbrella review aims to investigate and provide an analysis of guidelines regarding the treatment of diverticular abscesses. Material and methods: A systematic literature search was performed using the Cochrane Overviews of Reviews model and the ‘Clinical Practice Guidelines’; at the [...] Read more.

Background: This systematic umbrella review aims to investigate and provide an analysis of guidelines regarding the treatment of diverticular abscesses. Material and methods: A systematic literature search was performed using the Cochrane Overviews of Reviews model and the ‘Clinical Practice Guidelines’; at the end of initial search, only 12 guidelines were included in this analysis. The quality of the guidelines was assessed by adopting the “Appraisal of Guidelines for Research and Evaluation II” (AGREE II). The comparative analysis of these guidelines has highlighted the presence of some differences regarding the recommendations on the treatment of diverticular abscesses. In particular, there are some controversies about the diameter of abscess to be used in order to decide between medical treatment and percutaneous drainage. Different guidelines propose different abscess diameter cutoffs, such as 3 cm, 4–5 cm, or 4 cm, for distinguishing between small and large abscesses. Conclusions: Currently, different scientific societies recommend that diverticular abscesses with diameters larger than 3 cm should be considered for percutaneous drainage whereas abscesses with diameters smaller than 3 cm could be appropriately treated by medical therapy with antibiotics; only a few guidelines suggest the use of percutaneous drainage for abscesses with a diameter greater than 4 cm. The differences among guidelines are the consequence of the different selection of scientific evidence. In conclusion, our evaluation has revealed the importance of seeking new scientific evidence with higher quality to either confirm, reinforce or potentially weaken the existing recommendations from different societies. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

14 pages, 324 KiB

Open AccessReview

Postsurgical Adhesions: Is There Any Prophylactic Strategy Really Working?

by Irina-Maria Flutur, Dan Nicolae Păduraru, Alexandra Bolocan, Alexandru Cosmin Palcău, Daniel Ion and Octavian Andronic

J. Clin. Med. 2023, 12(12), 3931; https://doi.org/10.3390/jcm12123931 - 08 Jun 2023

Cited by 2 | Viewed by 1437

Abstract

Postoperative adhesions are a frequent complication encountered after surgical procedures, mainly after intraperitoneal interventions. To this day, the pathophysiological mechanism behind the process of adhesions formation is not completely known. There are many strategies proposed as prophylaxis methods, involving surgical techniques, drugs or [...] Read more.

Postoperative adhesions are a frequent complication encountered after surgical procedures, mainly after intraperitoneal interventions. To this day, the pathophysiological mechanism behind the process of adhesions formation is not completely known. There are many strategies proposed as prophylaxis methods, involving surgical techniques, drugs or materials that prevent adhesions and even state of the art technologies such as nanoparticles or gene therapy. The aim of our review is to present these innovative approaches and techniques for postoperative adhesions prevention. After a thorough scientific database query, we selected 84 articles published in the past 15 years that were relevant to our topic. Despite all the recent groundbreaking discoveries, we are at an early stage of understanding the complexity of the adhesion formation mechanism. Further investigations should be made in order to create an ideal product for safe clinical use for prevention. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

15 pages, 5488 KiB

Open AccessReview

Treatment and Prevention of Postoperative Leakage after Gastrectomy for Gastric Cancer

by Sang-Ho Jeong, Jin-Kwon Lee, Kyung Won Seo and Jae-Seok Min

J. Clin. Med. 2023, 12(12), 3880; https://doi.org/10.3390/jcm12123880 - 06 Jun 2023

Cited by 4 | Viewed by 3471

Abstract

Anastomotic leakage is one of the common causes of serious morbidity and death after gastrectomy. The use of surgical treatment for leakage decreased due to the development of nonsurgical management. However, if nonsurgical management fails to control the spread of intra-abdominal infection, emergency [...] Read more.

Anastomotic leakage is one of the common causes of serious morbidity and death after gastrectomy. The use of surgical treatment for leakage decreased due to the development of nonsurgical management. However, if nonsurgical management fails to control the spread of intra-abdominal infection, emergency surgical treatment is required. The authors wished to determine in which cases surgical treatment is needed for postoperative leakage and to identify treatment and prevention strategies. If a patient’s vital signs are stable, local abscesses can be cured by conservative treatment after percutaneous drain insertion; if there is no improvement in anastomotic leakage, endoscopic treatment such as clipping, vacuum, and stent placement can be performed. If a patient’s vital signs are unstable or patient shows diffuse peritonitis, surgical treatment should be performed. A surgical plan can be established according to leakage location. The duodenal stump may first require conservative treatment. It is recommended that surgical treatment be attempted first for anastomotic leakage of gastrojejunostomy site and gastric stump in remnant stomach. In conclusion, the need for surgical treatment is determined depending on vital signs and presence of diffuse peritonitis. During surgical treatment, a strategic approach is required according to the patient’s condition and the anatomical location of leakage. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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15 pages, 914 KiB

Open AccessReview

Management of Littre Hernia—Case Report and Systematic Review of Case Reports

by Marian Răcăreanu, Silviu Daniel Preda, Agnesa Preda, Victor Dan Eugen Strâmbu, Petru Adrian Radu, Tudor Constantin Bratiloveanu, Ștefan Pătrașcu, Daniela Marinescu, Konstantinos Sapalidis and Valeriu Șurlin

J. Clin. Med. 2023, 12(11), 3743; https://doi.org/10.3390/jcm12113743 - 29 May 2023

Cited by 1 | Viewed by 1515

Abstract

Littre hernia is a rare type of hernia in which a Meckel diverticulum is found in the hernia sac. Given the rare nature of this disease, little data on demographics and surgical management exists. In this article, we provide a case report of [...] Read more.

Littre hernia is a rare type of hernia in which a Meckel diverticulum is found in the hernia sac. Given the rare nature of this disease, little data on demographics and surgical management exists. In this article, we provide a case report of a strangulated inguinal Littre hernia and perform a systematic review of the literature. The PubMed database was searched on 5 March 2022, and all cases of Littre hernia in adults that had English abstracts or full-text were analyzed. Our primary objective was to evaluate the surgical management and outcomes of this particular type of hernia, and our secondary objectives were to assess demographic characteristics, presentation particularities, and recurrence rates. We identified 89 articles with 98 cases, including our own. Results show a high prevalence of complications described intraoperatively, with strangulation being present in up to 38.46% of patients. The laparoscopic approach was utilized in patients with femoral, inguinal, and umbilical hernias. The most commonly performed type of resection was MD resection, followed by bowel resection, while a minority of cases (5.48%) remained unresected. Mesh repair was more frequently performed in patients with MD resection. A mortality rate of 8.7% in patients who underwent bowel resection was found. A relatively high number of reports of ectopic tissue (21.21%), ulceration (12.12%), and tumors (9.09%) were found. The average follow-up was 19.5 ± 10.29 months, with no hernia recurrence. In conclusion, most cases are admitted in an emergency setting, and intestinal obstruction is frequently associated. A minimally invasive approach can be an option even for complicated hernias. MD resection or bowel resection is usually employed, depending on the extent of ischemic lesions. Patients undergoing bowel resection may be prone to worse outcomes. Full article

(This article belongs to the Special Issue Abdominal Surgery: Clinical Updates and Perspectives)

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