Can ventral TAPP achieve favorable outcomes in minimally invasive ventral hernia repair? A systematic review and meta-analysis.

PURPOSE: The concept of the transabdominal preperitoneal (TAPP) was transferred from the inguinal hernia repair to be adopted in minimally invasive ventral hernia repair (VHR) and since then it has been gaining popularity. However, there are minimal data supporting the ventral TAPP (vTAPP) technique which may lead to reticence in the adoption of this approach. The aim of this meta-analysis was to evaluate the outcomes of patients who received minimally invasive vTAPP for VHR. STUDY DESIGN: A systematic search was performed of PubMed, Science Direct, Google Scholar and Cochrane Library until July 2022. We selected studies that compared the vTAPP technique with any of other minimally invasive techniques. A meta-analysis was done for the outcomes of perioperative characteristics and postoperative parameters. RESULTS: A total of 9 studies (1429 patients) were identified. vTAPP was associated with considerable benefit when compared to IPOM. vTAPP was less painful (MD = - 1.01; 95% CI [- 1.39, - 0.64], p < 0.00001), of reduced average cost (MD = - 457.10; 95% CI [- 457.27, - 456.92], p < 0.00001) and decreased SSI (OR = 0.29; 95% [0.09, 0.96], p = 0.04). On the other hand, the vTAPP approach consumed less operative time (MD: - 31.01, 95% CI [- 33.50, - 28.51]), p < 0.00001) and shorter hospital stay than the e-TEP approach. CONCLUSION: vTAPP appears to be safe and effective procedure for VHR, superior or similar to other minimally invasive techniques for perioperative characteristics and short-term outcomes.

[Ileocecal ameboma: a case diagnosed by pathology and molecular biology]. / Amoebome iléocaecal: un cas diagnostique par l'anatomie pathologique et la biologie moléculaire.

Colonic ameboma is a rare benign inflammatory tumor due to the infection by Entamoeba histolytica and poses frequently the problem of colon cancer. We report a case of a 52 year-old patient who presented a cecal amoeboma revealed by a painful mass in the right iliac fossa. Radiologic and endoscopic examinations depicted a parietal thickening of the right colon and the cecum. A presumptive diagnosis of colon cancer was firstly discussed. Confirmation of ameboma was made on pathological examination, PCR and serology.

[Functional outcome after resection followed by a coloanal anastomosis for cancer of the rectum]. / Resultats fonctionnels des resections avec anastomose colo-anale dans les cancers du rectum.

The aim of the study was to asseses the operative, functional results of total proctectomy with coloanal anastomosis (CAA). Between 1990 and 2002, 24 patients (14 males and 10 females ) with a mean age of 50,6 years were operated on for cancer of the rectum and they underwent a total proctectomy with CAA. There was one operative death. 3 patients developed non specific complications. 4 patients experienced a supra anastomosis stenosis and underwent a new straight CAA Functional outcome were evaluated by a scoring system fonction and were considered good in 87 and 84% at 1 and 2 years respectively. Low anterior resection combined with CAA provides good treatment for mid-rectal cancers and for some distal rectal cancers. It had a good functional outcome. However Both procedures and selection of patients who underwent radiotherapy must be carefully performed.

Management of liver hydatid cysts with a large biliocystic fistula: multicenter retrospective study. Tunisian Surgical Association.

The large biliocystic fistula (> 5 mm) encountered with hydatic cyst of the liver produces clinical manifestations only when it allows the hydatic cyst content to pass into the common bile duct. Various therapeutic problems occur. The aim of this study was to evaluate the results of the therapeutic methods used by 14 Tunisian centers to treat this specific aspect of the hydatic cyst of the liver associated with a large biliocystic fistula. This study concerned a period of 5 years between January 1988 and December 1992, and it included 244 cases associated with hydatic content in the common bile duct (158 cases) and with cholelithiasis and choledocholithiasis (2 cases); 127 patients underwent an emergency operation (52%). The surgical procedures performed consisted in radical procedures (24 cases, 9.8%) and conservative procedures (220 cases, 90.2%). The latter included 52 cases of internal transfistulary drainage, 140 unroofing procedures associated in 20 cases with the fistula, in 93 cases with suture of the fistula, and in 27 cases with direct fistulization. In the 28 remaining cases, through the choledoctomy evacuation of the parasite was performed. The common bile duct was approached in 180 cases (73.7%). The postoperative course was uneventful in 57% of the cases and complicated in 38.5% others. The mortality rate was 4.5%. In conclusion, the presence (or not) of hydatic material in the common bile duct did not seem to be a determinant of the surgical procedure choice and did not influence the results. The only difficulty with treatment was the large biliocystic fistula itself. The internal transfistulary drainage on one part, and the unroofing procedure associated with suturing healthy fistula tissue and to omentoplasty or capitonnage of the remaining cavity on the other part, were easily performed and constituted efficient methods. Radical methods constituted operations that had excellent results, but they were feasible in only 10% of the cases.

[Colon cancer. Study of 153 cases and comparison with a series of 140 historic cases]. / Le cancer du colon. Etude de 153 cas et comparaison avec une serie historique de 140 cas.

The authors study the epidemiological, diagnostic and therapeutic features of 153 consecutive cases of colon cancers collected between 1985 and 1998. They compare the results with those of a previous study performed in the same hospital service (140 cases between 1966 and 1984). It is a series of 79 men and 74 women (sex ratio = 1.07). The mean age was 56.6 +/- 14 years old with 13.7% of the patients who were less than 40 years old. The operability and the resectability were respectively 98.7% and 83.7% with a global operative mortality of 7.9%. According to the Dukes classification, they were 2 A stages, 73 B stages, 32 C stages and 45 D stages. Starting from 1993, 53% of the C stages an 48% of the B stages had an adjuvant chemotherapy. The comparison between our present results and those of our previous series does not show any modification in what regards the mean age, the cancer frequency in young people, the complicated forms proportion and time needed for the diagnosis by comparison to the beginning of symptomatology. The colic cancer prognostic improvement is attained through an earlier diagnosis, making it possible to reduce the developed forms and the complicated forms proportion, the consequence of which is the operative mortality decrease and the log-range survival increase.