ABSTRACT
Background: Repair operation for recurrent inguinal hernia is a more exigent than the primary inguinal hernia. Open hernia repair associated with lower recurrence and fewer complications while the Laparoscopic repair associated with less pain postoperatively, early recovery time with subsequent earlier return to activity and better results regarding the wound.Methods: From November 2015 to March 2019, a total of 86 patients were randomized. 42 patients were recruited to total extra-peritoneal repair (TEP) group and 44 patients for Lichtenstein group. Overall, 86 were operated in general surgery department, Menoufia University hospitals.Results: The mean age of patients was 41.3±14.4, range from (25-55 years). One conversion occurred in the TEP group to Lichtenstein. Operative time was significantly low in TEP group (82.7 min) compared to Lichtenstein group (108 min). Hospital stay was significantly less in TEP group (1 day) compared to Lichtenstein group (1.8 days). Patients undergoing Lichtenstein repair have significant earlier oral intake than TEP group (3.7 vs. 6.6 hours). 12 cases developed seroma in Lichtenstein group with significant p value (0.001). This study showed less immediate and early VAS score in TEP group (2.3) versus high VAS score in Lichtenstein group (5.9) with highly significant p value (0.0001).Conclusions: TEP offer excellent results than LR for treatment of unilateral or bilateral recurrent inguinal hernia with lower morbidity and less incidence of post-operative pain with subsequent earlier return to normal activities.
ABSTRACT
Background: Bariatric surgery became the most popular choice in the management of obesity. Laparoscopic sleeve gastrostomy (LSG) and laparoscopic mini-gastric bypass (LMGB) has taken place in weight-loss and improvement in comorbidities.Methods: This was a retrospective cohort study with equal allocation included 112 super-obese patients with body mass index ≥50 kg/m2, which carried out in General Surgery department of Al-Azhar University Hospitals, between January 2016 and December 2018. 56 patients underwent LSG (Group A), and 56 patients underwent LMGB (Group B). Metabolic effect and weight loss outcomes were evaluated over one year.Results: Operative time was shorter in LSG than LMGB (64.3±33.32 min versus 70±37.24 min). There was a highly significant more weight loss in LSG than in LMGB at 6 and 12 months following the surgery. Also, improvement of type 2 diabetes mellitus, hypertension, hyperlipidemia, and quality of life occurred after 1 year in both surgeries.Conclusions: LSG and LMGB were better optimal procedures for super-obese patients with a comparable percent excess weight loss and improvement of associated comorbidities.