We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block þ group, n ¼ 18) or without peripheral nerve block (Block À group, n ¼ 14). Preoperatively, TAP and RS block were performed through ultrasound guidance. We evaluated postoperative pain control and patient outcomes. The mean postoperative hospital stays were 1.56 days (Blockþ group) and 2.07 days (Block À group; range, 1-3 days in both groups; P ¼ 0.0038). A total of 11 patients and 1 patient underwent day surgery in the Block þ and Block À groups, respectively (P ¼ 0.0012). Good postoperative pain control was more commonly observed in the Block þ group than in the Block À group (P ¼ 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery.
Peritoneal recurrence of breast cancer 10 years or more after initial surgery is very rare. We present a case of peritoneal recurrence occurring 42 years after a left breast mastectomy. The patient presented with abdominal pain and vomiting, and an abdominal computed tomography scan revealed a well-defined, ovoid mass causing intestinal obstruction. Partial resection of the ileum was performed, and the pathological diagnosis of the resected tumor was poorly differentiated adenocarcinoma. In addition, a hard tumor was observed on the left chest wall that was also found to be a poorly differentiated adenocarcinoma. Both tumors were negative for progesterone receptor and human epidermal growth factor receptor 2, but positive for estrogen receptor. A late recurrence of breast cancer was diagnosed, the postoperative course of which was uneventful. This case illustrates that an extended follow-up is required for breast cancer patients to check for late recurrence.
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