ABSTRACT
Background: Incisional hernia is a common complication after laparotomy. Up to now, there is no consensus on the ideal surgical approach of such hernia. The aim of the present study was to compare the surgical outcomes, feasibility and cost effectiveness of the open mesh repair and laparoscopic repair of incisional hernia.Methods: A randomized controlled study conducted between August 2015 and September 2019 in which 64 patients with incisional hernias were randomly selected for either open mesh repair (36 patients) or laparoscopic repair (28 patients).Results: Patients in both groups were similar in their characteristics. The mean operative time was significantly longer in laparoscopic repair than in open mesh repair (128.6±15 minutes versus 89.8±82 minutes, p<0.05). The peri-operative complications and intra-operative blood loss were comparable in the two groups. The use of the drain was significantly higher in open group than in laparoscopic repair group (44.4% versus 10.7%). The overall rate of postoperative complications was similar in both groups, (25% for each group). The rate of wound infection and the length of hospitalization were significantly less in laparoscopic repair group. The results of postoperative pain score, cosmetic outcomes and recurrence rate showed no significant differences between the two groups but patient's satisfaction was significantly higher in laparoscopic repair. p>0.05.Conclusion: Both laparoscopic and conventional open mesh repair of incisional hernia are equivalent and feasible and safe technique. Laparoscopic repair was superior to open mesh repair in term of surgical site infection, hospital stay and patient’s satisfaction only.
ABSTRACT
Pseudomyxoma peritonei (PMP) is a rare neoplastic illness with unique clinical and pathologic patterns. This disease characterized by being chronic, indolent, and relapsing. It is diagnostically challenging and very vague disease. It characterized by huge amounts of thick mucinous ascites with multiple omental and peritoneal implants that is gradually fill the abdominal and pelvic cavities. The most common clinical features are progressive abdominal distention with increase in the abdominal girth. Diagnosis of Pseudomyxoma peritonei (PMP) is usually difficult due to its vague symptoms especially in the early stages. Ultrasound examination is very useful and generally has pictures similar to that of CT scan images. Treatment of Pseudomyxoma peritonei (PMP) is cytoreductive (debulking) surgery to remove the mucin and the tumor implants in the peritoneal cavity. This is followed by intraoperative hyperthermic peritoneal chemotherapy (HIPEC). Recurrence of pseudomyxoma peritonei (PMP) patients is quite common as particularly when the disease is diagnosed and treated in the late stage.