In 60% of patients (n = 18), a primary abdominal closure (PAC) was achieved, in 40% (n = 12) a staged closure (SAC) was necessary. Patients with PAC had undergone less pretransplant operations and required less posttransplant relaparotomies. They were mainly ITX recipients or more abdominal domain because of a

longer intestinal remnant. A literature review revealed different strategies to overcome a failed primary closure. They focus on graft reduction or an enlargement of the abdominal domain. The latter includes temporary coverage with prosthetic materials for SAC. Definite abdominal closure is achieved by skin only closure, or by using acellular dermal matrix, rotational flaps, rectus muscle fascia or abdominal wall grafts.

Summary

Abdominal wall reconstruction after ITX/MVTX is commonly

demanded and can be conducted by different strategies. The technique should be easy to use in a timely manner and should Ulixertinib solubility dmso prevent abdominal infections, intestinal fistulation, incisional hernias, and wound Erastin in vitro dehiscence.”
“Aims

The objective of our review is to provide a critical appraisal of the literature on the anatomy, structure and roles of cardinal ligaments (CL) in pelvic organ support, in conjunction with the currently evolving evidence based mainly on imaging and biomechanical modeling studies. We aim to contribute to the understanding of the pathophysiology of pelvic organ prolapse (POP) and stimulate new insights in research and development of novel surgical approaches for POP.

Methods

PubMed, Embase, Scopus-Elsevier, and Cochrane Databases were

searched in English and German. Studies from 1870 to 2012 were identified. The keywords used were “”cardinal ligament,”" “”transverse cervical ligament,”" “”Mackenrodt ligament,”" “”parametrium,”" and “”paracervix.”" Cross check and Google search of the reference Idasanutlin cell line lists were used for missing articles.

Results

We identified 35 related articles. Located at the base of the broad ligament, the CL is a supportive structure that attaches the cervix and upper vagina to the pelvic wall. The ligament contains the uterine vessels and hypogastric plexus. It conducts most of the pelvic loading forces. On MRI, it appears as a web-like structure around the axis of the internal iliac vessels. Their clinical importance is based on the apical supportive role and lymphatic-rich structure, involved in dissemination of cervical cancer.

Conclusions

The structure and role of the CL have been long studied, but remained unclear. Recent studies on imaging and biomechanics have improved our understanding and provide new insights which may enable the development of new techniques in prolapse surgery. Neurourol. Urodynam. 33:380-386, 2014. (c) 2013 Wiley Periodicals, Inc.”
“Purpose of review

Intestinal transplantation (ITx) represents a major immunological challenge as the bidirectional exchange of donor’s and recipient’s immune cells delivers a graft highly chimeric and immunogenic.