Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.

Background: Hemoglobinopathies are common genetic disorders affecting the synthesis of one of the globin chains of hemoglobin molecule. Laparoscopic cholecystectomy is the standard procedure for treatment of patients with normal hemoglobin and symptomatic gall stones, but doubt is still to date regarding safety of this procedure in patients with hemoglobinopathy. Aims: 1. To assess the safety of laparoscopic cholecystectomy for hemoglobinopathic patients, 2. To describe the perioperative events that might happen before, during or after this procedure. Patients and Methods: This is a record-based comparative study conducted over a period of seven years, involved 62 hemoglobinopathic patients and 148 patients with normal hemoglobin variant. All underwent laparoscopic cholecystectomy and comparison done regarding perioperative events. Results: The overall complication rate was 56.5% in hemoglobinopathic patients and 21.6% in the other group and the difference was statistically significant (P-value ˂0.001). Vaso-occlusive crisis occurred in 9 patients (14.5%), respiratory complications (atelectasis and bronchitis) in (9.7%), acute chest syndrome in (4.8%) and hemolysis in (4.8%). Conclusions: 1. Laparoscopic cholecystectomy is safe in well prepared hemoglobinopathic patients but it is associated with significantly higher rate of disease related complications, namely acute chest syndrome, hemolysis and vaso-occlusive crises.2-Hemoglobinopathic patients require special pre, intra and post-operative care which should be offered by the surgeon, the physician and the anesthetist

A retrospective review of 80 consecutive patients with different types of intestinal stomas was carried out to analyze the indications, complications and the complication rate with respect to stoma type. The most common type of stoma was found to be end sigmoid colostomy (35%) followed by transverse loop colostomy (22.5%). The most common indication for stoma construction was colorectal cancer (37.5%) followed by Hirschsprung's disease and imperforate anus (12.5% for each). A total of 64 complications were reported in 49patients for a corrected complication rate of (61.25%). Peristomal skin excoriation was the most frequently recognized complication in this study (45.3%), followed by prolapse (23.4%) which was almost exclusive to infants and children. Transverse loop colostomy was associated with the highest complication rate (72.2%) followed by end sigmoid colostomy (64.28%). End ileostomy was associated with the lowest complication rate (33.3%) of all types of stoma. Emergency stomas and stomas in children were found to be associated with higher complication rates. The morbidity of stoma seems to be related to insufficient preoperative planning, technical errors of stoma construction and poor stoma care and management.

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