A Study of Abdominal Wall Hernias and Its Management

Introduction: Hernia is defined as the gap in the continuity of the fascia. The most common types of hernia are inguinal (innergroin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).Aim: The aim of the study was to study the various risk factors and complications of different types of hernias, clinicalpresentations, and their management.Materials and Methods: All cases of abdominal wall hernias presenting above 12 years of age were included in the study.Patients were assigned to undergo suture repair or mesh repair at the operating surgeon’s discretion. All patient-related datawere collected for analysis.Results: Among the 185 cases studied, 86 were incisional hernia (46.4%), 75 were umbilical hernia (40.5%), and 21 wereepigastric (11.3%), one Spigelian, and two lumbar hernia. Female preponderance was seen in incisional hernias with male tofemale ratio of 1:6.7. The swelling was the most common complaint in 55% followed by pain 31.6. Previous surgery or traumawas the single most important cause for ventral (Incisional) hernias. Simple suture repair and or Mayo’s repair was the choiceof repair in emergencies in all age groups.Conclusion: Size of the defect and presence of complications are the guiding factors for choosing the type of repair. Laparoscopicapproach for ventral hernia repair is definitely a method of choice with the advantages of good operative field visibility, lessenedduration of hospital stay, and minimal post-operative scar.

A Study on Secondary Neck Nodes from Squamous Cell Carcinoma

Introduction: Head and neck squamous cell carcinoma also carries a high rate of occult nodal metastasis. It is important todetect lymph node development in its early stages for improving the prognosis. The mechanisms by which malignant tumors,invade lymphatics, and metastasize to regional lymph nodes are complex and interrelated, the exact mechanisms have onlyrecently been the subject of intense interest and sophisticated experimentation.Aim: The aim of the study was to correlate the incidence of cervical node metastases by the site of primary in squamous cellcarcinoma of the head and neck region and to correlate individually the size of the tumor and its degree of histopathologicaldifferentiation.Materials and Methods: The present prospective study of 60 patients with proven squamous cell carcinoma at various sitesof head and neck was undertaken to study the possible tumor factors which influence the incidence and the pattern of regionalnodal metastases.Results: A progressive increase in the incidence of node metastases was observed with increasing tumor size 55.55%for lesions smaller than 2 cm, 75% for lesions between 2 and 4 cm, and 100% for lesions larger than 4 cm. A progressiveincrease in the incidence of node metastasis was observed with increasing histological undifferentiation of the tumor (4.3% forwell-differentiated primaries and 75% for moderately differentiated primaries).Conclusion: Large primaries (more than 4 cm) and those with higher histologic grade (moderate to poorly differentiated)especially when situated in the oropharynx or the oral tongue, have a greater propensity for developing regional nodal metastasiscompared to the rest.