Squamous-cell carcinoma due to mesh infection after umbilical hernia operation: third case of the literature

Introduction Polypropylene (PP) meshes are safe synthetic products used for hernia repairs and associated with minimal complication. Chronic inflammation is thought to play a pathophysiological role in the development of cancer. Case presentation: We present a 67-year-old female case of squamous cell-cancer (SCC) that developed due to mesh after umbilical hernia operation. The mass in the anterior abdominal wall was totally resected. Pathology was reported as T2N0, moderately differentiated acantholytic type SCC. No recurrence or complication was detected in the fourth-month follow-up. Conclusion Cancer development after mesh is very rare and our case is the third case in the literature. Cancer development should be kept in mind in patients presenting with ulcerated masses if do not regress with infection treatment after mesh application.

How To Prevent Inguinodynia - After Tension-Free Inguinal Hernia Repair – Our Experience

Inguinodynia is persistence of pain for more than 3 months after inguinal hernia operation. Chronic pain may be associated with hyperesthesia or hypoesthesia. This pain may be mild, moderate or severe. Inguinodynia may even effect quality of life. Pain may resolve on its own or after conservative treatment. Sometimes it persists and conservative methods fail then various other modalities of treatment are considered including re-exploration and neurectomy. We performed all 396 inguinal hernia repair by a modified Lichtenstein tension-free procedure. In our series of 396 cases inguinodynia happened only in 3 cases, a real low incidence. Some researchers have reported the incidence of inguinodynia as high as 19 percent 1 year after operation. No case required re-exploration, removal of mesh or neurectomy in our series. Keywords Chronic pain, Inguinal hernia, Inguinodynia, inguinal hernia repair

Comparison of the healing effect of occlusive hydrocolloid dressing and conventional gauze dressing concerning hernia operations in children

The purpose is using the occlusive hydrocolloid dressing (OHD) and gauze dressing (GD) to compare incidence of infection of wound and cost-effectiveness of dressing after hernia operation in children. Eighty children was undergo hernia surgery, wounds were dressing by OHD or GD. Hydrocolloid dressing was remain till suture was removed, and GD changed every day after operation. Calculations of cost dressing mean dressing alterations frequency and cost for each dressing in every treatment cluster. There are no variances amongst the two clusters concerning the incidence of wound infection. OHD was less costly and complex than GD, and GD necessary to be altered each day (p = 0.001). In conclusion, OHD is less costly to use, and less complex than GD because GD wanted to be altered more times during the period of healing.

Value of Transthoracic Echocardiography in the Prediction of Post-spinal Anesthesia Hypotension

INTRODUCTION: Spinal Anesthesia (SA) can lead to hypotension due to sympathic denervation, which causes a reduction in venous return to the heart as a result of peripheral vasodilation and redistribution of intravascular blood. Transthoracic Echocardiography (TTE) is a noninvasive and easy-to-use method to visualize cardiac reserve and functions. We aimed to evaluate whether parameters attained via transthoracic echocardiography are predictive of development of post-SA hypotension. METHODS: Forty-two patients between the ages of 18 and 80, who would undergo inguinal hernia operation under SA, with ASA physical status I-II and had no clinically recognized cardiovascular disease, were included in the study. TTE was performed for each patient 30 minutes before the operation, and measurements were recorded along with the intraoperative hemodynamic parameters. RESULTS: There was a statistically significant difference between the medians of left ventricle end-diastolic diameter (LVEDD) (cm) according to the status of post-SA hypotension (p=0.003).Accordingly, median LVEDD of patients who did not develop hypotension was significantly larger compared with that of those who had hypotension. Similarly, a statistically significant difference emerged between the medians of right ventricular (RV) tricuspid annular plane systolic excursion (TAPSE) (cm) showing RV global function according to the status of post-SA hypotension (p=0.001). Accordingly, patients who did not have hypotension had a larger RV-TAPSE median compared with that of those who had hypotension. The difference between the medians of RV isovolumetric relaxation time (RV-IVRT), which is one of the indicators of RV diastolic functions was again statistically significant according to the status of post-SA hypotension (p=0.025). DISCUSSION AND CONCLUSION: TAPSE, RV-IVRT and LVEDD measured via preoperative TTE, can be significant parameters to predict the development of post-SA hypotension.

Erector Spinae Plane Block for Different Laparoscopic Abdominal Surgeries: Case Series

The ultrasound guided erector spinae plane (ESP) block is a recent block described for various surgeries for postoperative analgesia. ESP block has effect on both visceral and somatic pain; therefore, its use in laparoscopic cholecystectomy and other abdominal surgeries can be advantageous. We describe successful ESP block application in three different cases for postoperative pain. Two patient were operated on using endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy and one patient was operated on using laparoscopic cholecystectomy together with the inguinal hernia operation.