Prophylactic subfascial non-absorbable mesh reinforcement of midline closure in high-risk patients can be used safely and effectively to provide extrinsic strength of the wound without relying too much on the defective development of its own intrinsic strength and to prevent subsequent incisional hernia. There was no risk in the use of the mesh regarding local and systemic complication. However, the final statement should await the outcomes of the long-term follow up of the studied cases.
Using prophylactic preperitoneal Prolene mesh during wound closure in open bariatric surgery is safe and effective in preventing incisional hernia development.
Our study favors the rhomboid flap for recurrent sacrococcygeal pilonidal sinus, especially for complex sinuses, and found it suitable for cases where simpler operations have failed. It allows early return to full activity, does not necessitate prolonged postoperative care, and has very low recurrence and complications rates which may outweigh the disadvantages related to an unfavorable cosmetic appearance.
Obesity is a major health problem which heightens the risk of several chronic illnesses including cancer development particularly colon cancer. The underlying pathophysiology of obesity associated colon cancer remains to be elucidated. The purpose of this current study was to determine fatty acid synthase (FASN) activity/expression, oxidized low-density lipoprotein (ox-LDL) level and redox status under the context of anthropometric measurements and lipid profile to find their potential role as interacting biomarkers relating obesity to colon cancer initiation and progression via nuclear factor kappa-B (NF-κB) signaling. This study was conducted upon Egyptian individuals; 30 obese subjects with colon cancer, 11 nonobese and 11 obese subjects without colon cancer. FASN gene expression, NF-κB immunoreactivity, and serum ox-LDL level were estimated by real-time PCR, immunohistochemistry and immunoassay, respectively. FASN activity, glycemic status, obesity, and oxidative stress indices were also assessed. It was found that FASN expression and activity were statistically increased in obese with colon cancer (P=0.021 and 0.018, respectively), with statistically significant increase in patients with advanced grading. Moreover, NF-κB immunoreactivity and serum ox-LDL level were significantly increased in obese colon cancer patients with significantly higher levels in those with advanced grading (all P<0.05). Dyslipidemia, insulin resistance, and oxidative stress indices were worsened in obese patients with colon cancer. These results revealed that FASN and ox-LDL as well as oxidative stress may increase the risk of obesity related colon cancer, particularly via NF-κB signaling and could be used as potential predictive and prognostic biomarkers for obesity complicated with colon cancer.
The preperitoneal mesh placement during the repair of paraumbilical hernias is superior to the preaponeurotic placement, because it is associated with fewer complications, less pain and a shorter time of return to normal daily activities.
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