Background: The aim of this study was to systematically analyze the randomized trials comparing fibrin glue mesh fixation with suture mesh fixation in open inguinal hernia repair. Methods: Information was collected from a literature search using PubMed, Springer, Cochrane Library database and reference lists. The methodological quality of included publications was evaluated. Statistical analysis was performed using Review Manager Version 5.2.5 software. Results: Nine articles were identified for inclusion: four randomized controlled trials (RCTs) and five prospective observational clinical studies. All the trials were considered to be of fair quality. The results showed that there was a lower incidence of chronic pain (RR 0.42, 95% CI 0.22-0.79, I2 11%; p < 0.01), and hematoma/seroma (RR 0.43, 95% CI 0.21-0.87, I2 0%; p < 0.05) in the fibrin glue mesh fixation group. However, the results of meta-analysis revealed that the incidence of recurrence or urinary problems between the two procedures were similar. Conclusions: During the 6-15 months follow-up, fibrin glue mesh fixation is a feasible alternative for mesh fixation with sutures in open inguinal hernia repair. However, the poor quality of the included trials limits the evidence; rigorously designed trials are warranted to confirm this conclusion.
HighlightsGiant oesophageal liposarcomas, a rare but important cause of oesophageal tumours.A review of the current literature focusing on resection techniques.Shift in the treatment paradigm in recent years to endoscopic resection techniques.Decision on type of resection technique depends on tumour characteristics and location.
Laparoscopic surgery is the modality of choice in the surgical treatment of colorectal malignancies. The reported incidence of trocar site hernias is 0.65–2.80% with conventional cutting-tip trocars, and this risk increases with the diameter of the trocar. Newer bladeless, blunt-tipped trocars effectively mitigate this risk, and routine fascial closure has been generally deemed unnecessary. We present two cases of trocar site hernias despite the use of bladeless trocars in laparoscopic colorectal surgery, challenging the conventional wisdom of leaving such fascial defects open.
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