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Published on: September 11, 2021
Subxiphoid incisional hernias after median sternotomy
J E Losanoff1, M D Basson, S Laker
1Surgical Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA. jelosanoff@yahoo.com
Summary
Subxiphoid hernias after median sternotomy are challenging to repair. Techniques like modified sternotomy and mesh repair can reduce recurrence, but long-term outcomes require further study.
Area of Science:
- Surgical Oncology
- Abdominal Wall Reconstruction
- Hernia Repair
Background:
- Subxiphoid incisional hernias present significant repair challenges and high recurrence rates.
- Limited literature exists on the etiology, pathology, treatment, and outcomes of these hernias.
- This review aims to consolidate existing knowledge on subxiphoid hernias.
Purpose of the Study:
- To analyze published literature on subxiphoid hernias.
- To enhance understanding of the etiology, pathology, treatment, and outcomes.
- To identify potential strategies for reducing hernia incidence and improving repair success.
Main Methods:
- Comprehensive literature search of Medline and Current Contents databases.
- Inclusion of bibliographies from relevant articles.
- Review of seven retrospective studies totaling 113 patients with subxiphoid hernias.
Main Results:
- Seven retrospective studies involving 113 patients with post-median sternotomy subxiphoid hernias were identified.
- A modified median sternotomy technique to prevent hernias was described.
- A review article on subxiphoid ventral repair techniques was also included.
Conclusions:
- Optimizing sternotomy closure and reinforcing the abdominal wall can potentially reduce subxiphoid hernia incidence.
- Open-mesh or laparoscopic prosthetic repair are effective treatments for existing defects.
- Further long-term outcome analyses are needed to fully evaluate treatment efficacy.
