New trend in repair of large incisional hernias using explored peritoneal inversion reinforced by double fascial approximation flaps

One hundered large abdominal incisional hernias were treated following a new modified technique using peritoneal inversion reinforced by double fascial approximation of the anterior rectus sheath as two flaps without use mesh in 81% of cases. The average follow up was three years, Good clinical results without pain were found more than 97 per cent of the patients.Recurrence occurred only in three patients [3 percent]. The complications were wound infection in 2 cases and parietal necrosis in one case. These results are significant, justify the use of this new technique especially even in recurrent, large ones and concurrent case

Effective management in mesenteric vascular occlusion

In retrospective study we have reviewed all cases of mesenteric infarction treated at the Menia University Hospital between the year 1988 and 1991. Our standard mangement consisted of laparotomy and bowel resection and eventually revascularization, but did not include routine angiography. Twenty seven cases of mesenteric infarction documented by laparotomy were reviewed to assess the cause of the persistently high mortality.Thirteen patients [47%] were felt to have inoperable lesions and were treated by supportive care only while fourteen [53%] were subjected for bowel resection and or revascularization. Of these fourteen patients, six [44%] survived, five [33%] died of an early recurrence of infarction and three [23%] died from an unrelated cause. On the basis of recent clinical research we suggest that treatment should include routine angiography with selective perfusion of vasodilators through the superior mesenteric artery, pharmacological prevention of ischaemic and perfusion tissue damage before surgery and resection anastomoses followed by post-operative anticoagulation