To evaluate the clinical efficacy of pedicled myocutaneous flap transfer for pelvic floor reconstruction in the prevention and management of empty pelvis syndrome (EPS) following total pelvic exenteration (TPE).

This retrospective study used a descriptive case-series design. Clinical data were collected from 10 patients who underwent TPE combined with pelvic floor reconstruction using pedicled myocutaneous flaps at the Department of General Surgery, Jiangyin People's Hospital, between December 2023 and July 2026. The primary outcome was the occurrence of EPS-related symptoms following pelvic floor reconstruction. Secondary outcomes included flap survival, pelvic floor wound healing, perioperative complications, and, in patients undergoing staged procedures, the duration of preoperative negative-pressure wound therapy and control of wound infection.

All 10 myocutaneous flaps survived. The median postoperative follow-up was 9.0 months (interquartile range, 1.8 to 22.5 months), during which one patient died of tumor recurrence. No EPS-related symptoms were observed during follow-up, and satisfactory filling of the pelvic dead space was achieved. Primary healing of the pelvic floor surgical wounds was achieved in 3 patients, while delayed healing occurred in 7 patients. Of these 7 patients, 2 developed purulent wound infections that resolved with dressing changes. At the donor sites, primary wound healing was achieved in 8 patients, while delayed healing occurred in 2 patients. No donor-site abscesses or hematomas were observed. Among the 2 patients who underwent vertical rectus abdominis flap transfer, neither developed an abdominal wall hernia, although 1 experienced delayed healing of the abdominal incision.

Pedicled myocutaneous flap transfer appears to be a feasible and potentially safe option for pelvic floor reconstruction following TPE. This technique can provide satisfactory filling of the pelvic dead space and may help prevent EPS. However, further studies are needed to confirm its effectiveness in reducing the risk of EPS.

To systematically describe the clinical implementation of four-stage progressive pelvic floor reconstruction following extended pelvic exenteration (EPE), including baseline characteristics, intraoperative parameters, postoperative recovery, and the distribution of complications related to empty pelvis syndrome (EPS). A total of 389 cases from a single center were included, so as to provide comprehensive overview and evidence for standardized pelvic floor reconstruction.

This retrospective descriptive study extracted data from a prospective Chinese pelvic exenteration database. A total of 389 consecutive pelvic tumor patients receiving EPE with en bloc pelvic floor resection at the Second Affiliated Hospital of Naval Medical University from November 2021 to January 2026 were included. Reconstruction was categorized into four stages according to pelvic floor repair, pelvic cavity obliteration, wound management and gastrointestinal reconstruction for radiated patients. Demographics, preoperative baseline, intraoperative indicators, postoperative recovery and complication data were collected. Given its descriptive nature, no intergroup hypothesis tests between four stages were performed.

The four-stage technique was implemented in a stepwise manner: biological mesh reconstruction→greater omental packing→staged negative-pressure wound therapy→prophylactic ileocecal resection for high-risk patients receiving radiotherapy. The median operative duration across the four stages ranged from 520 to 560 min, median blood loss ranged from 740 to 880 ml, and R₀ resection rate ranged from 80.0% to 86.2%. Perineal wound management evolved from primary closure to open staged negative-pressure therapy. The median time to first postoperative flatus across the four stages was 60 to 72 hours, drainage tube indwelling duration was 50 to 80 days, hospital stay was 38 to 75 days, and time to complete healing of the empty pelvis was 62 to 82 days. The proportion of complications with Clavien-Dindo grade<Ⅲ ranged from 52.8% to 68.0%. Perioperative mortality was only observed in the first two stages. In Stage 4 (n=36), no enterocutaneous fistula, perineoenteric fistula, pelvic hemorrhage or flap-related complications were observed (0/36). This finding remains to be validated due to limited sample size; deep pelvic collection, bowel obstruction and severe urological complications still existed.

The four-stage progressive strategy achieves layered optimization of pelvic floor repair, wound management and individualized intervention for radiotherapy-high-risk patients. Reduced severe EPS-associated complications were noted, which is conducive to improving perioperative safety and wound healing quality, and offering clinical reference for precise EPS prevention and enhancedrecovery.

To evaluate the feasibility and efficacy of preperitoneal mesh reinforcement combined with the Lap-re-Do Sugarbaker or Keyhole technique for parastomal hernia repair and stoma reconstruction.

This was a retrospective descriptive study. A retrospective analysis was conducted on the clinical data of 8 patients who underwent tension-free parastomal hernia repair with preperitoneal mesh placement and Lap-re-Do Sugarbaker/Keyhole at West China Hospital, Sichuan University between July 2020 and July 2022. All enrolled patients had concurrent conditions including intra-abdominal contamination, poor stoma construction, and intra-abdominal adhesions. Patient demographics, operative details, and length of hospital stay were analyzed, and postoperative complications were recorded during follow-up.

All patients successfully completed the planned procedure. Operative time ranged from 162 to 620 minutes, with a mean of (454.63±113.38) minutes; Median hernia sac size (length×width) was 8.38 (5.00, 10.00) cm×7.63 (4.00, 8.50) cm; Hernial ring diameter: 7-15 cm (mean 9.50±2.88 cm); Postoperative hospitalization: 7-41 days (mean 18.25±9.06 days). During the 2-year follow-up, no parastomal hernia recurrence was observed. One patient (1/8) required readmission for localized wound infection, which resolved after 20 days of negative-pressure wound therapy and anti-infection treatments.

With strict inclusion criteria, for high-risk patients undergoing tension-free parastomal hernia repair with concomitant abdominal cavity contamination, poor stoma quality, or intra-abdominal adhesions, mesh placement in the preperitoneal space is safe and effective. It can reinforce abdominal wall strength, and may potentially reduce the occurrence of postoperative complications such as infection and intra-abdominal adhesions.

To evaluate the clinical efficacy of totally endoscopic sublay (TES) and intraperitoneal onlay mesh (IPOM) for midline ventral hernia.

A retrospective analysis was conducted on the clinical data of patients diagnosed with midline ventral hernia who underwent either TES (25 cases) or IPOM (26 cases) at Guangzhou Huadu District People's Hospital from November 2018 to May 2025. Operative time, intraoperative blood loss, postoperative pain, hospital stay, complication rates, recurrence rates, total hospitalization costs, and surgical material expenses were compared between the two groups.

The TES group demonstrated significantly lower total hospitalization costs [20 657.06 (19 267.34, 22 103.42) yuan vs 38 853.24 (37 657.86, 45 291.49) yuan, P<0.001] and surgical material expenses [8943.24 (7929.24, 9976.84) yuan vs 27 776.17 (26 270.58, 29 915.35) yuan, P<0.001] compared to the IPOM group. However, there were no significant differences in intraoperative blood loss, postoperative pain, hospital stay, complication rates, operation time or recurrence rates between the two groups (P>0.05).

TES is equally effective as IPOM for midline ventral hernia repair. It has lower total treatment costs and surgical material expenses, making it one of the preferable surgical option for treating midline ventral hernias.

To analyze the preoperative detection of hiatal hernia (HH) and related factors in patients undergoing anti-reflux surgery, and to compare the report-based detection proportions of barium esophagography, upper gastrointestinal endoscopy, and thoracoabdominal computed tomography (CT) among patients with intraoperatively confirmed HH.

This single-center retrospective study included 94 patients who underwent fundoplication with HH repair for gastroesophageal reflux disease (GERD) at Sir Run Run Shaw Hospital Affiliated to Nanjing Medical University, between December 2023 and April 2026. All patients underwent preoperative barium esophagography, upper gastrointestinal endoscopy, and thoracoabdominal CT. Judgment was determined from the original formal clinical reports. HH reported by at least one examination was defined as the preoperative detection group, whereas no HH reported by any examination was defined as the preoperative non-detection group. Firth penalized logistic regression was used to identify factors independently associated with preoperative detection, and Cochran's Q test was used to compare the paired detection proportions of the three examinations. Because only reference-standard-positive surgical cases were included in this study, the detection proportion only reflects the case detection situation within this specific surgical population. Specificity, positive and negative predictive values, and overall diagnostic accuracy could not be estimated.

Among the 94 patients, 31 cases (33.0%) were detected before the operation, while 63 cases (67.0%) were not detected before the operation. The preoperative detection group had a higher median age than the non-detection group [69.0 (58.5, 82.0) years vs 59.0 (55.0, 71.5) years, P=0.026], and a larger hiatal defect area [15.00 (6.00, 16.50) cm² vs 6.00 (4.50, 11.25) cm², P<0.001]. Detection proportion differed significantly between type I and type Ⅱ-Ⅳ HH (P<0.001). Multivariable Firth penalized logistic regression showed higher odds of detection for type Ⅱ-Ⅳ HH than type I HH (OR=8.410, 95% CI: 1.991-48.859; P=0.003). Each 1-cm² increase in hiatal defect area was associated with an 8.4% increase in the odds of detection (OR=1.084, 95% CI: 1.002-1.178; P=0.045). Age, sex, and body mass index were not independently associated with preoperative detection (all P>0.05). Barium esophagography, upper gastrointestinal endoscopy, and thoracoabdominal CT detected HH in 19 (20.2%), 16 (17.0%), and 25 (26.6%) patients, respectively. The overall paired comparison did not reach the statistical significance threshold (Cochran's Q=5.727, P=0.057).

Among the patients who underwent anti-reflux surgery with intraoperatively confirmed HH, HH type and hiatal defect area were independently associated with preoperative detection. Type Ⅰ HH and a smaller hiatal defect area are less likely to be detected before the operation. The overall comparison of the three examinations did not reach the statistical significance threshold.

To compare the clinical efficacy, safety, and postoperative pain associated with laparoscopic transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair in adults with inguinal hernia, and to explore the potential mechanisms underlying differences in postoperative pain between the two procedures.

The clinical data of 180 adult patients with inguinal hernia treated at the Department of General Surgery, Anqing Municipal Hospital, between January 2022 and December 2024 were retrospectively analyzed. Patients were divided into a TAPP group and a TEP group according to the surgical procedure performed, with 90 patients in each group. Operative time, postoperative length of hospital stay, visual analog scale (VAS) pain scores at 24 hours after surgery, postoperative complications, and hernia recurrence rates during follow-up were compared between the two groups.

The operative time was significantly longer in the TAPP group than in the TEP group [(81.22±16.96) min vs. (62.33±14.72) min; t=7.84, P<0.001]. The VAS pain score at 24 hours postoperatively was significantly higher in the TAPP group than in the TEP group [(2.90±0.75) vs. (2.24±0.56); t=6.45, P<0.001]. No statistically significant differences were observed between the two groups in postoperative length of hospital stay, incidence of postoperative complications, or hernia recurrence rate during follow-up (all P>0.05).

TAPP and TEP repair have comparable overall clinical efficacy and safety in the treatment of adult inguinal hernia. Compared with TAPP, TEP is associated with a shorter operative time and less early postoperative pain. These differences may be related to peritoneal cavity entry, peritoneal incision and closure, and nerve irritation in the preperitoneal space.

To analyze the efficacy of laparoscopic totally extra-peritoneal hernia repair (TEP) versus trans-abdominal preperitoneal hernia repair (TAPP) in young adults with unilateral inguinal hernia.

A total of 135 young adults with unilateral inguinal hernia admitted to Haian People's Hospital from April 2021 to April 2024 were selected. According to the surgical approach, they were divided into TAPP group (63 cases) and TEP group (72 cases). Surgical conditions, postoperative mobility and chronic pain, quality of life, complications, and long-term prognosis of the two groups were compared.

The operative time (59.19±8.74) min, intraoperative blood loss (19.36±4.83) ml, time to first flatus (7.47±1.29) hours, time to stand up at bedside (7.59±1.33) s, time to achieve 90° hip and knee flexion (1.21±0.26) s, time to walk 10 meters (12.54±1.67) s, visual analogue scale (VAS) score at postoperative day 1 (3.11±0.41) points, VAS score at postoperative day 2 (2.54±0.37) points in the TEP group were lower than those in the TAPP group (62.38±9.63) min, (21.28±3.47) ml, (8.13±1.86) hours, (8.26±1.64) s, (1.34±0.39) s, (13.17±1.82) s, (3.29±0.56) points, (2.71±0.42) points, with statistically significant differences (P<0.05). The physical function score (95.47±2.19) points and physiological role score (95.06±2.04) points in the TEP group were higher than those in the TAPP group (94.26±3.52) points, (94.12±3.17) points, with statistically significant differences (P<0.05). There were no statistically significant differences in terms of complication rates and hernia recurrence rates (P>0.05).

Compared to TAPP, TEP in young adults with unilateral inguinal hernia can promote postoperative recovery, alleviate pain, and improve quality of life. Both surgical techniques are safe.

To investigate the clinical characteristics, diagnosis, and treatment of incarcerated obturator hernia in elderly patients.

The clinical data of 37 patients with incarcerated obturator hernia who were admitted to Anqing Medical Center of Anhui Medical University for emergency treatment between October 2013 and October 2022 were retrospectively analyzed. The diagnostic and therapeutic procedures and clinical manifestations were analyzed.

All 37 patients were elderly women from rural areas of Anqing and were admitted to the emergency department with symptoms of intestinal obstruction. The diagnosis was confirmed by emergency preoperative computed tomography (CT) in all patients. Four patients declined further treatment, while the remaining 33 underwent emergency exploratory laparotomy and suture repair of the obturator hernia. Of these, 32 patients recovered well and were discharged after recovery, with a mean hospital stay of 12.3 days. One patient died on the second postoperative day due to refractory septic shock and multiple organ failure. During follow-up, one patient experienced recurrence two years after surgery, and another required reoperation for metachronous incarceration of an obturator hernia.

Abdominal and pelvic CT is an effective imaging modality for diagnosing incarcerated obturator hernia. Emergency surgical intervention is essential for patients with incarcerated obturator hernia. A transabdominal approach is recommended, and suture repair of the obturator canal is a simple, feasible, safe, and reliable surgical technique suitable for use in primary hospitals. The contralateral side should be carefully explored during surgery, and prophylactic suture repair is recommended for high-risk patients, provided that it does not increase surgical risk.

To evaluate the association of preoperative inflammatory markers and CT findings with bowel ischemic necrosis in adults with incarcerated inguinal hernia and to describe the selection of surgical procedure and short-term outcomes according to different timing of intervention.

This was a single-center retrospective cohort study. Clinical data of 57 adults patients with incarcerated inguinal hernia admitted to Chuxiong Yi Autonomous Prefecture People's Hospital between November 2022 and February 2025 were retrospectively analyzed. Patients were divided as emergency surgery group (n=34) or scheduled surgery group (n=23) according to the initial intervention. The scheduled group comprised 15 patients after successful manual reduction and 8 after short observation; all underwent surgery during the same admission, with an observed interval of 1-4 days. Inflammatory markers (white blood cell count, C-reactive protein, neutrophil-to-lymphocyte ratio), CT findings, operative approach, bowel resection, mesh repair, and complications of the two groups were recorded.

The scheduled group was younger than the emergency group [(58.1±16.9) versus (67.1±13.2) years, t=2.254, P=0.028] and had a lower proportion of elevated inflammatory markers [4.3% (1/23) versus 58.8% (20/34), P<0.001]. All seven patients with irreversible bowel ischemic necrosis had elevated inflammatory markers and at least one CT sign related to ischemia; all underwent bowel resection in the emergency group. No clinically diagnosed case of delayed bowel necrosis was documented in the scheduled group based on medical records, operative findings, and follow-up. Laparoscopic procedures were performed more frequently in the scheduled group. A total of five patients in the two groups developed postoperative complications, all of which resolved after conservative management.

In this cohort, every case of bowel necrosis was accompanied by elevated inflammatory markers and CT findings related to ischemia. Scheduled surgery during the same admission after manual reduction may be feasible in carefully selected low-risk patients; the observed 1-4 days interval should not be interpreted as a validated optimal time window.

To compare the clinical efficacy of totally transumbilical single-port laparoscopic surgery and surgery through a small transverse abdominal skin-crease incision in children with inguinal hernia, and to evaluate differences in treatment outcomes between the two surgical approaches across different age groups.

This prospective randomized controlled trial included 120 children with inguinal hernia who underwent surgical treatment at the First Affiliated Hospital of Xinjiang Medical University between January 2023 and January 2025. The children were randomly assigned, using a simple random number method, to either the control group (surgery through a small transverse abdominal skin-crease incision) or the study group (totally transumbilical single-port laparoscopic surgery), with 60 children in each group. Perioperative outcomes, including incision length, operative time, intraoperative blood loss, time to first postoperative flatus, and length of hospital stay, were compared between the two groups. Pain intensity was assessed using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Pediatric quality-of-life scores and postoperative complications were also evaluated. In addition, the children were stratified into two age groups (3–6 years and 7–12 years), and treatment outcomes were compared between the two surgical approaches within each age stratum.

All perioperative outcomes were significantly more favorable in the study group than in the control group (all P<0.05). The pooled effect size for the perioperative outcomes indicated a large between-group difference (Hedges' g=2.44). Compared with preoperative values, postoperative pain scores decreased, while physical and emotional functioning scores increased in both groups. These improvements were significantly greater in the study group than in the control group (all P<0.05). All postoperative between-group effect sizes were large (Hedges' g>0.8). The overall incidence of postoperative complications was significantly lower in the study group than in the control group [odds ratio (OR)=0.183, P=0.004]. Intraoperative exploration identified occult contralateral inguinal hernias in eight children in the study group. In both age strata, the study group demonstrated significantly more favorable perioperative outcomes, lower pain scores, and higher pediatric quality-of-life scores than the control group (all P<0.05). Among children aged 7–12 years, the difference in complication rates between the two groups was not statistically significant. However, among children aged 3–6 years, the complication rate remained significantly lower in the study group than in the control group (P<0.05).

Both totally transumbilical single-port laparoscopic surgery and surgery through a small transverse abdominal skin-crease incision achieve reliable efficacy for pediatric inguinal hernia. The laparoscopic approach allows intraoperative detection of occult contralateral inguinal hernias, causes less surgical trauma, and facilitates faster postoperative recovery. Younger children may derive greater benefits from this approach in terms of reducing postoperative complications.

To evaluate the effect of biofeedback combined with magnetoelectric stimulation plus visceral manipulation on postpartum pelvic organ prolapse (POP).

This is a retrospective non-randomized controlled study. We retrospectively analyzed 161 women with postpartum POP who completed treatment within 3 months at Ma'anshan Maternal and Child Health Hospital from December 2024 to July 2025. Patients were divided into two groups according to surgical method. Seventy-three women received biofeedback plus magnetoelectric stimulation (control group) and 88 received the same regimen plus visceral manipulation (experimental group). After 1∶1 propensity score matching, 134 women were included, with 67 cases in each group. The primary outcome was the mean value of the slow-twitch phase on pelvic floor surface electromyography and the POP-Q Aa point; the remaining measures were exploratory. The changes in pelvic floor electromyography and the changes at each POP-Q indicator point were compared between the two groups.

After propensity score matching and baseline adjustment, the between-group difference in slow-twitch mean amplitude was 1.45 μV (95% CI -0.97 to 3.86, P=0.240). The between-group difference at the Aa point was -0.52 cm (95% CI -0.75 to -0.29, P<0.001). Among exploratory outcomes, fast-twitch relaxation time difference was -0.22 s (95% CI -0.41 to -0.03, P=0.022), and there were statistically significant inter-group differences in some POP-Q indicator points (Ba, C, PB, TVL, Bp, etc.). No serious adverse events were observed.

No serious adverse events were observed with biofeedback combined with magnetoelectric stimulation plus visceral manipulation for postpartum POP. The combined regimen may be superior to simple biofeedback plus magnetoelectric stimulation alone at the Aa point. There was no clear between-group advantage for the slow-twitch mean amplitude. The clinical value of this method needs to be further verified by prospective studies.

To compare perioperative outcomes, postoperative pain, and safety between cold dissection with dissecting forceps and thermal dissection with an electrosurgical hook for hernia sac management during laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.

This single-center retrospective study included 170 male patients with unilateral indirect inguinal hernias who underwent TAPP repair at Mengcheng County First People's Hospital between January 2024 and May 2025. Patients were divided into two groups according to the chronological implementation of different preperitoneal dissection techniques. The control group (n=85), treated during the initial period, underwent thermal dissection with an electrosurgical hook, whereas the observation group (n=85), treated after technical optimization, underwent cold dissection with dissecting forceps. Perioperative parameters, visual analog scale (VAS) pain scores at 12, 24, and 48 hours postoperatively, and the incidence of complications within 14 days after surgery were compared between the two groups. Propensity score matching (PSM) and multivariable regression analysis were used to control for potential confounding factors. Patients were followed up for 3 months to assess short-term outcomes.

No statistically significant differences were observed between the two groups in age, disease duration, body mass index, hernia sac size, or severity of adhesions (all P>0.05). The operative time and hernia sac dissection time were significantly shorter in the observation group than in the control group, whereas intraoperative blood loss and postoperative inguinal fluid collection volume were significantly greater in the observation group (all P<0.001). There was no statistically significant difference in the length of hospital stay between the two groups (P>0.05). No statistically significant differences were observed in VAS pain scores at any postoperative assessment time point between the two groups (all P>0.05). The overall incidence of complications within 14 days after surgery was significantly lower in the observation group than in the control group (5.9% vs. 15.3%, P=0.046). Severe thermal injury-related complications occurred in the control group. No patients were lost to follow-up during the 3-month follow-up period, and no hernia recurrence or delayed severe complications were observed.

Cold dissection with dissecting forceps during TAPP repair can shorten operative time and reduce the risk of perioperative complications, although it may be accompanied by transient postoperative inguinal fluid collections. Thermal dissection with an electrosurgical hook provides direct hemostasis but carries a risk of thermal injury. The two techniques should be selected individually or used in combination according to the characteristics of the hernia sac.

To measure the dimensions of the esophageal hiatus in patients with type I hiatal hernia (HH) using multidetector computed tomography (MDCT) with multiplanar reconstruction (MPR) and to investigate their correlations with body mass index (BMI).

Clinical and imaging data from 106 patients with surgically confirmed type I HH at the Affiliated Hospital of Xuzhou Medical University between January 2022 and June 2025 were retrospectively collected and analyzed. The hiatal surface area (HSA), anteroposterior diameter (AP), and transverse diameter (TD) of the esophageal hiatus were measured using MDCT with MPR. According to BMI, the patients were divided into three groups: normal-weight, overweight, and obese groups. The correlations between BMI and HSA, AP, and TD were evaluated.

Comparisons among the three groups showed statistically significant differences in HSA (F=4.54, P=0.013, partial η²=0.08), AP (F=4.43, P=0.014, partial η²=0.08), and TD (F=9.85, P<0.001, partial η²=0.16), indicating medium to large effect sizes for BMI grouping on these esophageal hiatal measurements. No statistically significant differences were observed among the three groups in sex, age, height, systolic blood pressure, diastolic blood pressure, or fasting blood glucose (P>0.05, partial η²<0.04). After adjustment for age, sex, blood pressure, fasting blood glucose, and other factors, multiple linear regression analysis showed that each 1 kg/m² increase in BMI was associated with an increase of 0.46 cm² in HSA, 0.08 cm in AP, and 0.07 cm in TD (all P<0.001). BMI was positively correlated with HSA, AP, and TD.

MDCT with MPR can accurately measure various parameters of the esophageal hiatus. The findings suggest that BMI may be an independent risk factor for type I HH, with higher BMI associated with larger HSA, AP, and TD measurements of the esophageal hiatus.

To investigate the factors associated with readiness for hospital discharge among patients undergoing transabdominal preperitoneal (TAPP) inguinal hernia repair.

A retrospective cross-sectional study was conducted involving 110 patients who underwent TAPP inguinal hernia repair at Rugao People's Hospital between June 2024 and June 2025. Data on patient demographics, disease- and surgery-related characteristics, and postoperative recovery were collected. Readiness for hospital discharge was assessed using the Chinese version of the Readiness for Hospital Discharge Scale (RHDS). RHDS scores were compared among patients with different clinical and demographic characteristics, and independent factors associated with discharge readiness were identified.

The mean RHDS score among the 110 patients was (89.23±20.28). Univariate analysis showed that patients aged >70 years, those residing in rural areas, unmarried patients, self-paying patients, those whose primary caregivers were non-family members or who had no primary caregiver, those living alone, those who underwent open surgery, those with direct or combined inguinal hernias, those with chronic comorbidities, those experiencing postoperative local edema or urinary retention, those with a postoperative visual analog scale (VAS) pain score ≥4, and those reporting a perceived decline in self-care ability had significantly lower RHDS scores (all P<0.05). Multivariable analysis identified age >70 years (β=−18.502, 95% CI −24.425 to −12.613), rural residence (β=−6.054, 95% CI −10.534 to −1.642), unmarried status (β=−12.106, 95% CI −18.449 to −5.821), and moderate-to-severe postoperative pain (β=−15.204, 95% CI −23.815 to −6.601) as independent factors associated with lower RHDS scores.

Readiness for hospital discharge after TAPP inguinal hernia repair is associated with multiple factors, particularly advanced age, rural residence, unmarried status, and moderate-to-severe postoperative pain. Greater attention should be given to patients with these characteristics, with an emphasis on optimizing perioperative pain management and providing individualized discharge education to improve discharge readiness.

To compare the efficacy and safety of single-incision laparoscopic totally extra-peritoneal hernia repair (SIL-TEP) and conventional three-port laparoscopic totally extra-peritoneal hernia repair (CL-TEP).

PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database and VIP Journal Database were searched from the establishment of the databases to July 2024, for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing SIL-TEP with CL-TEP. Two reviewers independently performed literature screening, data extraction and quality assessment according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 and Stata 18.0 MP.

A total of 28 studies were included, comprising 10 RCTs and 18 CCTs, involving 2939 patients (1542 in the SIL-TEP group and 1397 in the CL-TEP group). There were no statistically significant differences in age or body mass index between the two groups (P>0.05). The SIL-TEP group had a longer operation time for unilateral hernias (MD=6.22, 95% CI 2.07-10.37; P=0.003); and a longer operation time for bilateral hernias after excluding two studies contributing to heterogeneity (MD=7.88, 95% CI 4.08-11.69; P<0.0001), but the difference was not statistically significant when all studies were included (P=0.08). The SIL-TEP group also had a higher incision satisfaction score (SMD=0.21, 95% CI 0.03-0.39; P=0.02), a lower pain score at 24 h after surgery (SMD=-0.59, 95% CI -0.93--0.26; P=0.0005), and a lower incidence of postoperative subcutaneous emphysema (RR=0.20, 95% CI 0.04-0.99; P=0.05; reported in only two studies). There were no significant differences in intraoperative blood loss, postoperative hospital stays, time to return to normal activities or the incidence of postoperative complications between the two groups (all P>0.05).

Compared with CL-TEP, SIL-TEP has comparable safety and feasibility, with less postoperative pain, better incision cosmesis, and the incidence of subcutaneous emphysema may be lower. However, it requires a longer operation time for unilateral hernias, and operation time may also be prolonged for bilateral hernias. SIL-TEP may be chosen for patients with uncomplicated hernias who have high demands regarding cosmesis and pain relief. It should be chosen with caution when the operation time needs to be controlled, such as in elderly patients or those with complex hernias.

Inguinal hernia is one of the most common conditions encountered in general surgery. Laparoscopic inguinal hernia repair (LIHR) has become a widely used surgical approach owing to its minimally invasive nature and rapid postoperative recovery. The clinical use of biological meshes in LIHR has increased, and these meshes have shown potential advantages in reducing postoperative complications, particularly among younger patients. This review summarizes recent advances in the clinical application of biological meshes in LIHR, evaluates their safety, efficacy, and potential benefits, and discusses their limitations and possible directions for improvement. Studies suggest that biological meshes may promote tissue regeneration and healing, reduce the long-term retention of implanted foreign material, and lower the risks of postoperative complications such as mesh infection and chronic pain. With continuing advances in laparoscopic surgical techniques and biological mesh technology, the use of biological meshes in LIHR may become safer and more effective, providing clinicians with additional treatment options.

Abdominal wall hernias are among the most common conditions encountered in general surgery, but their pathophysiological mechanisms remain incompletely understood. The conventional theory that attributes hernia formation primarily to fascial weakness has certain limitations. Sarcopenia is an age-associated syndrome characterized by loss of skeletal muscle mass and impaired muscle strength and physical function. Increasing evidence suggests that sarcopenia is associated with the occurrence, progression, and prognosis of abdominal wall hernias. This review comprehensively summarizes recent research on the associations between sarcopenia and various types of abdominal wall hernias, including umbilical trocar-site hernias, complex abdominal wall hernias, inguinal hernias, parastomal hernias, and incisional hernias. It also discusses the impact of sarcopenia on surgical outcomes following abdominal wall hernia repair and potential intervention and treatment strategies. The aim is to provide a reference for future clinical and basic research on sarcopenia-associated abdominal wall hernias.

This study retrospectively analyzed the clinical data of a 47-year-old woman with a giant presacral teratoma complicated by chronic infection and multiple cutaneous sinus tracts, to evaluate the feasibility and safety of transsacrococcygeal resection combined with single-stage pelvic floor reconstruction using a biologic mesh. Following a preoperative multidisciplinary discussion to assess the surgical approach, the tumor and associated infected sinus tracts were resected en bloc via a transsacrococcygeal approach. During the same operation, pelvic floor reconstruction was performed using a porcine small intestinal submucosa (SIS) biologic mesh to wrap and support the bulging posterior rectal wall. The tumor was completely excised, and histopathological examination confirmed a mature teratoma. The incision healed by primary intention, with no seroma, mesh infection, or delayed wound healing. At the 6-month postoperative follow-up, no recurrent infection or perineal hernia was observed, and the Wexner constipation score was 1. This case suggests that, in selected patients with giant presacral teratomas complicated by chronic infection and cutaneous sinus tracts, the transsacrococcygeal approach may enable complete tumor resection and infection control, while single-stage pelvic floor reconstruction using an SIS biologic mesh may be feasible and safe in the short term.

This report describes a rare case of chronic traumatic diaphragmatic hernia with displacement of multiple organs in an adult and reviews its clinical features, diagnostic approaches, and laparoscopic management strategies. The diagnostic and therapeutic course of this case is retrospectively analyzed, and key considerations in the diagnosis and treatment of this condition are summarized to improve clinical recognition and management.