BackgroundThe Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to the European Hernia Society guidelines. Desarda’s technique, presented in 2001, is an original hernia repair method using an undetached strip of external oblique aponeurosis. This randomized trial compared outcomes after hernia repair with Desarda (D) and mesh-based Lichtenstein (L) techniques.MethodsA total of 208 male patients were randomly assigned to the D or L group (105 vs. 103, respectively). The primary outcomes measured were recurrence and chronic pain. Additionally, early and late complications, foreign body sensation, and return to everyday activity were examined in hospital and at 7, 30 days, and 6, 12, 24, and 36 months after surgery.ResultsDuring the follow-up, two recurrences were observed in each group (p = 1.000). Chronic pain was experienced by 4.8 and 2.9% of patients from groups D and L, respectively (p = 0.464). Foreign body sensation and return to activity were not different between the groups. There was significantly less seroma production in the D group (p = 0.004).ConclusionsThe results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 3-year follow-up. The technique may potentially increase the number of tissue-based methods available for treating groin hernias.
IntroductionWith an average incidence rate of 11%, chronic pain is considered the most serious complication of inguinal hernioplasty after surgical site infection. One of the proposed solutions to this problem is to use tissue adhesive for mesh fixation, which helps prevent nerve and tissue damage.AimThe goal of this study was to compare mesh fixation with the use of sutures vs. adhesive in Lichtenstein's inguinal hernia repair in a randomized, double-blind one-center study.Material and methodsThe study group consisted of 41 males with primary inguinal hernia undergoing Lichtenstein's repair (20 – adhesive; 21 – suture) and remaining in follow-up from July 2008 to November 2010. Randomization took place during the operation. The follow-up was performed by one surgeon (blinded) according to a pre-agreed schedule; the end-of-study unblinding was performed during the last follow-up visit, usually 16 months postoperatively.ResultsIn 1 patient from the “adhesive” group, a recurrence was observed one year after the initial repair. The early postoperative pain was less intense in this group. In later postoperative periods the method of mesh fixation had no influence on the pain experienced by the patient. Other complications were not correlated with the method of mesh fixation.ConclusionsIn this randomized, one-center double-blind clinical study of males with primary inguinal hernia it has been show during follow-up that the use of Glubran 2 cyanoacrylate adhesive for mesh implant fixation yields similar recurrence and chronic pain rates as the classical suture technique. In the early postoperative period, the pain reported by these patients was relatively weaker; patients undergoing adhesive mesh fixation experienced a quicker return to daily household activities.
BackgroundComplete resection is the only potential curative treatment of synchronous colorectal liver metastases. Although simultaneous liver and colon resections became an accepted procedure at specialized centres for selected patients, there is still little data about the long‐term results of simultaneous operative procedures compared with those of delayed operations. In this retrospective study, the long‐term survival rates of the patients who underwent simultaneous or delayed resections were presented.MethodsA retrospective analysis of liver resections in our institution between 1997 and 2012 was performed. Among 131 patients presented with synchronous colorectal liver metastases, 52 underwent simultaneous and 79 delayed resection. Patients with extrahepatic metastases were excluded, except for 10 patients with metastases limited to liver and lungs that were qualified as resectable.ResultsAge, sex and localization of the primary tumour were similar in the two groups. In the delayed resection group, the majority of colon resections were performed in different hospitals. The frequency of complications did not differ between the groups. The 1, 5 and 10 years survival rates were 77%, 43% and 20% in simultaneous and 86%, 37% and 19% in delayed resection group, respectively. No cancer related deaths occurred after more than 10 years of observation.ConclusionThe long‐term outcome of simultaneous resection of synchronous colorectal liver metastases is comparable to delayed resection.
The method based on two-dimensional stochastic process was used to examine the short-term postural sway under eyes-open and eyes-closed conditions. Obtained parameters, i.e., matrix of the fluctuation strength and friction coefficient, describe the stochastic activity of the muscles of the lower limbs as well as mechanisms compensating that activity. The standard force platform was used to measure the center of pressure displacements. In this investigation 17 control subjects and 22 morbid obese subjects were included. It is shown that the method is useful in the study of the postural control system of morbid obese subjects. The muscles responsible for postural control in these subjects have exhibited larger stochastic activity, than these muscles in non-obese subjects. However morbid obese as well as non-obese subjects compensate additionally enlarged level of muscles activity after closure of their eyes. The morbid obesity causes an increase of the muscles' force but does not cause the impairment of the postural control system.
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