Cholecystectomy and hernioplasty during the same laparoscopic procedure.

Cholelithiasis and inguinal or femoral hernia usually coexist in the same patient. The simultaneous laparoscopic approach to these diseases benefits the patients, who avoid two separate admissions to the hospital, two operations, and twice the cost, recuperation, and potential morbidity and mortality. The authors describe a technique that facilitates cholecystectomy and hernioplasty during the same laparoscopic approach, thus avoiding the use of two separate procedures. The results of this procedure in the first six patients were excellent.

Short-term antibiotic prophylaxis in elective colorectal surgery.

In the last 2 years, 50 patients who underwent elective colorectal surgery were prospectively studied about antibiotic prophylaxis. Two groups of 25 patients each were randomly selected. Both received: (a) a colic preparation: hypactic drugs and two enemas during the day before surgery and (b) metronidazole 0.5 g plus neomycin 1 g per 8 h orally for 1 day before surgery. Every group also received: group A, metronidazole 0.5 g plus amikacin 500 mg i.v. 2 h before surgery and the same doses per 8 or 12 h, respectively, for 2 days postoperatively; group B, ornidazole 1 g by intravenous infusion plus ceftriaxone 2 g i.v. 2 h before surgery and the same doses of the drugs per 24 h for 2 days postoperatively. Wound infection occurred in 1 case of group A versus 2 cases of group B (p greater than 0.25). Ornidazole plus ceftriaxone prophylactic antibiotic therapy is therefore as effective as a classic therapy (metronidazole plus amikacin) and constitutes an alternative choice for patients undergoing elective colorectal surgery, because the simple manner of its administration (once per 24 h) is resulting in cost saving due to gained nursing time.

Prevention of peritoneal adhesions in rats with trimetazidine.

The effect of trimetazidine (an antianginal drug that acts as a scavenger of oxygen radicals) in the prevention of peritoneal adhesions induced by complete vascular obstruction of an ileal segment for 30 minutes followed by reperfusion was investigated in rats. Group A (n = 20) acted as controls. Group B (n = 20) received trimetazidine intravenously in a dose of 2.5 mg/kg 30 minutes before the induction of ischaemia. Group C (n = 20) received the same dose of trimetazidine for 5 days before the experiment, twice a day intraperitoneally, and also intravenously 30 minutes before the induction of ischaemia. Group D (n = 20) received the same dose of trimetazidine intravenously immediately after reperfusion had started. Ten days later adhesions had developed in 90% of the animals of group A, 40% of those in group B (p less than 0.001), 5% of those in group C (p less than 0.001), and 60% of those in group D (p less than 0.05). The severity of adhesions was significantly less in the treated groups than in the control animals. Release of creatine phosphokinase during ischaemia and reperfusion significantly increase in groups A, B, and D. These results suggest that trimetazidine reduces the incidence and severity of peritoneal adhesion formation induced by ileal ischaemia and reperfusion, treatment before induction of ischaemia gave better results than treatment given afterwards.