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Erschienen in: European Surgery 1/2022

20.07.2021 | case report

Ventral hernia repair under neuraxial anesthesia

verfasst von: Paolo Germanò, MD, Stefano Siboni, MD, Pamela Milito, MD, Gaetano Mautone, MD, Marco Resta, MD, Luigi Bonavina, MD

Erschienen in: European Surgery | Ausgabe 1/2022

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Summary

Background

Acute strangulated ventral hernia is associated with operative morbidity and mortality. General anesthesia may increase the operative risk, especially in morbidly obese and COVID-19-positive individuals.

Methods

A 67-year-old woman with body mass index (BMI) 51 kg/m2, hospitalized for SARS-CoV-2-related interstitial pneumonia and renal failure, presented with acute abdominal pain, nausea, vomiting, and abdominal tenderness secondary to giant ventral hernia strangulation.

Results

Due to the suspicion of vascular bowel compromise at contrast-enhanced CT scan, urgent open surgical repair surgery was performed under spinal anesthesia and Venturi mask support. There was no need for an intensive care unit (ICU) stay. Postoperative course was uneventful, and the patient was transferred to a rehabilitation center on postoperative day 10.

Conclusion

Although some anesthetists and surgeons may be reluctant to use regional anesthesia for both emergent and elective ventral hernia repair, this may represent an excellent option in obese patients with a high respiratory risk.
Literatur
1.
Zurück zum Zitat Flemming S, Hankir M, Ernestus R, Seyfried F, Germer C, Meybohm P, et al. Surgery in times of COVID-19—recommendations for hospital and patient management. Langenbecks Arch Surg. 2020;405(3):359–64.CrossRef Flemming S, Hankir M, Ernestus R, Seyfried F, Germer C, Meybohm P, et al. Surgery in times of COVID-19—recommendations for hospital and patient management. Langenbecks Arch Surg. 2020;405(3):359–64.CrossRef
2.
Zurück zum Zitat De Simone B, Chouillard E, Di Saverio S, Pagani L, Sartelli M, Biffl W, et al. Emergency surgery during the COVID-19 pandemic: what you need to know for practice. Ann R Coll Surg Engl. 2020;102(5):323–32.CrossRef De Simone B, Chouillard E, Di Saverio S, Pagani L, Sartelli M, Biffl W, et al. Emergency surgery during the COVID-19 pandemic: what you need to know for practice. Ann R Coll Surg Engl. 2020;102(5):323–32.CrossRef
3.
Zurück zum Zitat Presl J, Varga M, Mittermair C, Mitterwallner S, Weitsendorfer M, Gabersek A, et al. Impact of the COVID-19 pandemic lockdown on the utilization of acute surgical care in the State of Salzburg, Austria: retrospective, multicenter analysis. Eur Surg. 2021;53:48–54.CrossRef Presl J, Varga M, Mittermair C, Mitterwallner S, Weitsendorfer M, Gabersek A, et al. Impact of the COVID-19 pandemic lockdown on the utilization of acute surgical care in the State of Salzburg, Austria: retrospective, multicenter analysis. Eur Surg. 2021;53:48–54.CrossRef
4.
Zurück zum Zitat Fink JB, Ehrmann S, Li J, Dailey P, McKiernan P, Darquenne C, et al. Reducing aerosol-related risk of transmission in the era of COVID-19: an interim guidance endorsed by the international society of aerosols in medicine. J Aerosol Med Pulm Drug Deliv. 2020;33(6):300–4.CrossRef Fink JB, Ehrmann S, Li J, Dailey P, McKiernan P, Darquenne C, et al. Reducing aerosol-related risk of transmission in the era of COVID-19: an interim guidance endorsed by the international society of aerosols in medicine. J Aerosol Med Pulm Drug Deliv. 2020;33(6):300–4.CrossRef
5.
Zurück zum Zitat Asti E, Sironi A, Lovece A, Bonitta G, Bonavina L. Open versus laparoscopic management of Incisional abdominal hernia: cohort study comparing quality of life outcomes. J Laparoendosc Adv Surg Tech A. 2016;26:249–55.CrossRef Asti E, Sironi A, Lovece A, Bonitta G, Bonavina L. Open versus laparoscopic management of Incisional abdominal hernia: cohort study comparing quality of life outcomes. J Laparoendosc Adv Surg Tech A. 2016;26:249–55.CrossRef
6.
Zurück zum Zitat Samel S, Hakky SM, Tukanova K, Huf S, Markar S, Purkayastha S. Hybrid approach to ventral wall hernia repair: a single-institution cohort study. Eur Surg. 2021;53:60–5.CrossRef Samel S, Hakky SM, Tukanova K, Huf S, Markar S, Purkayastha S. Hybrid approach to ventral wall hernia repair: a single-institution cohort study. Eur Surg. 2021;53:60–5.CrossRef
7.
Zurück zum Zitat Huckaby LV, Dadashzadeh ER, Handzel R, Kacin A, Rosengart MR, van der Windt DJ. Improved understanding of acute incisional hernia incarceration: implications for addressing the excess mortality of emergent repair. J Am Coll Surg. 2020;231:536–46.CrossRef Huckaby LV, Dadashzadeh ER, Handzel R, Kacin A, Rosengart MR, van der Windt DJ. Improved understanding of acute incisional hernia incarceration: implications for addressing the excess mortality of emergent repair. J Am Coll Surg. 2020;231:536–46.CrossRef
8.
Zurück zum Zitat Romanzi A, Boleso N, Di Palma G, La Regina D, Mongelli F, Milanesi M, et al. Awake major abdominal surgeries in the COVID-19 era. Pain Res Manag. 2021;2021:8763429.CrossRef Romanzi A, Boleso N, Di Palma G, La Regina D, Mongelli F, Milanesi M, et al. Awake major abdominal surgeries in the COVID-19 era. Pain Res Manag. 2021;2021:8763429.CrossRef
9.
Zurück zum Zitat Wongyingsinn M, Kohmongkoludom P, Trakarnsanga A, Horthongkham N. Postoperative clinical outcomes and inflammatory markers after inguinal hernia repair using local, spinal, or general anesthesia: a randomized controlled trial. PLoS ONE. 2020;15(11):e242925.CrossRef Wongyingsinn M, Kohmongkoludom P, Trakarnsanga A, Horthongkham N. Postoperative clinical outcomes and inflammatory markers after inguinal hernia repair using local, spinal, or general anesthesia: a randomized controlled trial. PLoS ONE. 2020;15(11):e242925.CrossRef
11.
13.
Zurück zum Zitat Hajifathalian K, Kumar S, Newberry C, Shah S, Fortune B, Krisko T, et al. Obesity is associated with worse outcomes in COVID-19: analysis of early data from New York City. Obesity. 2020;28(9):1606–12.CrossRef Hajifathalian K, Kumar S, Newberry C, Shah S, Fortune B, Krisko T, et al. Obesity is associated with worse outcomes in COVID-19: analysis of early data from New York City. Obesity. 2020;28(9):1606–12.CrossRef
14.
Zurück zum Zitat COVIDSurg Collaborative, GlobalSurg Collaborative. Timing of surgery following SARS-CoV‑2 infection: an international prospective cohort study. Anaesthesia. 2021;76(6):748–58.CrossRef COVIDSurg Collaborative, GlobalSurg Collaborative. Timing of surgery following SARS-CoV‑2 infection: an international prospective cohort study. Anaesthesia. 2021;76(6):748–58.CrossRef
15.
Zurück zum Zitat Birindelli A, Sartelli M, Di Saverio S, Coccolini F, Ansaloni L, van Ramshorst GH, et al. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg. 2017;12:37.CrossRef Birindelli A, Sartelli M, Di Saverio S, Coccolini F, Ansaloni L, van Ramshorst GH, et al. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg. 2017;12:37.CrossRef
16.
Zurück zum Zitat Henderson Harold K, Webster M. Anesthesia for emergent abdominal surgery in a patient with a tricuspid valvectomy. A A Pract. 2018;10(7):185–7.CrossRef Henderson Harold K, Webster M. Anesthesia for emergent abdominal surgery in a patient with a tricuspid valvectomy. A A Pract. 2018;10(7):185–7.CrossRef
17.
Zurück zum Zitat Janež J, Preskar J, Avguštin M, Štor Z. Surgical repair of a large ventral hernia under spinal anaesthesia: a case report. Ann Med Surg. 2019;40:31–3.CrossRef Janež J, Preskar J, Avguštin M, Štor Z. Surgical repair of a large ventral hernia under spinal anaesthesia: a case report. Ann Med Surg. 2019;40:31–3.CrossRef
18.
Zurück zum Zitat Symeonidis D, Baloyiannis I, Georgopoulou S, Koukoulis G, Athanasiou E, Tzovaras G. Laparoscopic ventral hernia repair in obese patients under spinal anesthesia. Int J Surg. 2013;11:926–9.CrossRef Symeonidis D, Baloyiannis I, Georgopoulou S, Koukoulis G, Athanasiou E, Tzovaras G. Laparoscopic ventral hernia repair in obese patients under spinal anesthesia. Int J Surg. 2013;11:926–9.CrossRef
19.
Zurück zum Zitat Sultan S, Rana S, Hafeez A, Tariq U, Firdous R. Comparison of general and spinal anesthesia in patients undergoing open abdominal hernia repair in terms of postoperative pain. Annals of Punjab Medical College. 2018;12(1):70–3. Sultan S, Rana S, Hafeez A, Tariq U, Firdous R. Comparison of general and spinal anesthesia in patients undergoing open abdominal hernia repair in terms of postoperative pain. Annals of Punjab Medical College. 2018;12(1):70–3.
Metadaten
Titel
Ventral hernia repair under neuraxial anesthesia
verfasst von
Paolo Germanò, MD
Stefano Siboni, MD
Pamela Milito, MD
Gaetano Mautone, MD
Marco Resta, MD
Luigi Bonavina, MD
Publikationsdatum
20.07.2021
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 1/2022
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-021-00731-x

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