[Pre-peritoneal inguinal hernioplasty using Rhodergon's prosthesis. Study of a series of 282 hernia operations]. / Hernioplastie inguinale pré-péritonéale par prothèse de Rhodergon. Etude d'une série de 282 hernies.

282 acquired inguinal hernias in 183 adult patients were treated between 1974 and 1986 by means of a pre-peritoneal prosthesis. Posterior herniorrhaphy with reconstruction of the internal inguinal ring was associated with this procedure from 1981 onwards. 75% of the patients were reviewed with a mean follow-up of 58 months. Analysis of the results demonstrated a significant correlation between recurrences and the use of a single midline prosthesis for bilateral hernias and parietalisation of the spermatic cord and between septic complications and the use of a silicone-coated velvet prothesis, which subsequently had to be abandoned. Age, sex, obesity, type of hernia and a history of herniorrhaphy did not have any influence on the results. In group of 150 hernias treated with a single, lateralised Rhodergon prosthesis with a transprosthetic cord and reconstruction of the internal inguinal ring, the recurrence rate was 1.3% (2 cases) and the deep infection rate was 0.6% (1 case). Apart from early recurrences due to technical errors, the long-term efficacy of this technique appears to be permanent.

Management of colorectal cancer in patients with cirrhosis and a LeVeen shunt.

Two cirrhotic patients with a LeVeen shunt presented with a large bowel cancer. In one patient, the shunt was removed and the venous catheter was ligated prior to the performance of a colon resection. The postoperative course was uneventful. A new valve was inserted and connected to the venous catheter two months later. The second patient had a carcinoma of the rectum. In order to prevent ascites and to ease the colorectal resection he had preliminary construction of a portacaval shunt. Six weeks later, he underwent an anterior resection of the rectum. The postoperative course was uneventful except for a self limiting episode of febrile subacute intestinal obstruction. These two cases demonstrate that it is possible to resect colorectal cancer in patients with cirrhosis, ascites and a peritoneovenous shunt provided measures are taken to avoid specific complications due to the presence of the shunt, ascites or portal hypertension.