[Recurrent inguinal hernias: surgery with transversalis fascia repair]. / Inguinalhernien-Rezidiv: Operation mit Transversalisplastik.

Some authors recommend different prosthetic repairs for treatment of recurrent groin hernia. In our institution groin hernias are treated by a modified Shouldice-repair, which considers the transversalis fascia layer only. In this prospective study 240 consecutive patients with 298 groin hernias were operated on. 46 patients were treated for 53 recurrent hernias. It was possible to carry out the operative procedure of transversalis plasty in all recurrent cases. 90% of these patients were followed-up by personal examination after a median of 26 months after operation (range 12-36 months). 89% of the patients with primary operation have been checked 15 months postoperatively. 2 patients (4.5%) of the recurrent hernias had a recurrence. This compares well with the 3.2% recurrence rate (7 patients) in the patients with primary hernias. The difference is not significant (p greater than 0.5). The only observed difference between recurrent and primary hernias was in the rate of testicular atrophy (6.8% for recurrent and 0% for primary hernias). According to our experience large prosthetic repairs are not necessary for the common case of recurrent groin hernia, but may be useful in specially selected situations.

[Early results of transversalis-plasty. A prospective randomized comparison of non-resorbable and resorbable sutures]. / Frühergebnisse nach Transversalisplastik. Ein prospektiv randomisierter Vergleich von nichtresorbierbarem und resorbierbarem Nahtmaterial.

In a prospective randomized trial we analyzed the perioperative management, complications, and the recurrence rate of inguinal hernia repair using either resorbable (polydioxanone, PDS) or non-absorbable (polyamide, Ethilon) suture material. From January 1988 to June 1989, 484 consecutive transversalis fascia repairs were performed in 425 adult patients with inguinal or femoral hernia. Local anaesthesia was used in 273 cases. At least one year postoperatively, 390 patients with 445 repairs had a clinical follow-up. The recurrence rate after 360 primary herniae was 3.3% (Ethilon 2.3%, PDS 4.3%) while 5.9% rerecurrences were found following operation for recurrent hernia (Ethilon 2.5%, PDS 8.9%). The differences in the recurrence rates following the use of polyamide or polydioxanone were not statistically significant. Complications occurred in 5.2%. The postoperative hospital stay averaged 3.8 days and work was resumed after a mean of 3.9 weeks.

[Plasma and tissue concentration of ceftriaxone following a one-time i.v. dose of 2 g]. / Die Plasma- und Gewebskonzentration von Ceftriaxon nach einmaliger Gabe von 2 g i.v.

The concentration of ceftriaxon found in plasma and in fatty, muscular and colonic tissue after a single intravenous dose of 2 g are reported. 20 patients undergoing elective surgery of the colon were divided into five groups of 4, and ceftriaxon was given 45 min, 3, 6, 12 and 24 h before surgery. Even after 24 h the plasma and tissue concentrations were above MIC 90 for most microorganisms sensitive to ceftriaxon.