Experimental comparison of meshes for rectal prolapse surgery.

AIM: The aim of this experimental study is to investigate the foreign body tissue created by the meshes that are used for rectopexy. METHOD: Sixty rats were divided equally into 5 groups. Four mesh types (Surgipro, Ivalon, Gore-Tex and Vypro) were implanted into the retroperitoneal area except for the sham group. After a 5-week follow-up period, all animals were sacrificed. Specimens were evaluated macroscopically by using scoring systems and biochemically by determining tissue hydroxyproline and nitric oxide levels. RESULTS: The most evident foreign body reaction was observed in the Ivalon group, which showed higher 'macroscopic adhesion' scores (p < 0.005), although there were no significant differences in tissue hydroxyproline and nitric oxide levels between the groups (p > 0.05). CONCLUSION: In rectal prolapse surgery, selecting the ideal mesh type is unclear, depending on evidence-based results. In the present study, we could not prove which mesh was definitely superior to the other, macroscopically, histologically and biochemically. The findings of this experimental rat model suggest that implantation of all 4 types of meshes are suitable for posterior rectopexy.

Perforation of the stomach due to chest tube complication in a patient with iatrogenic diaphragmatic rupture.

Diagnosis of diaphragmatic injury is difficult. A case of iatrogenic diaphragmatic rupture is reported in which perforation of a herniated stomach occurred following left lobectomy and partial resection of the diaphragm for lung cancer. On the second postoperative day, bile-stained fluid coming out from the chest tube revealed gastrointestinal leakage. This rare complication of chest tube insertion, early diagnosis and treatment are emphasized.