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Aim The aim was to examine laparoscopic transabdominal preperitoneal patch repair (TAPP) repair of bilateral inguinal hernia using one big mesh instead of using one mesh for each side as usual. Patients and methods A prospective cohort trial was carried out on 40 patients with bilateral inguinal hernia. Laparoscopic TAPP repair using a single large mesh with fixation, and the preoperative and postoperative (PO) course of each patient was followed up for 24 months. Results Operative time ranged from 70 to 110min. Blood loss in the operation ranged from 10 to 50ml, with a mean value of 21.79±8.23ml. Bleeding occurred in two patients (5%) with hospital stay ranged from 1 to 3 days. Regarding PO complications, port infection occurred in one (2.5%) patients, hematoma occurred in only one (2.5%) patient, orchitis occurred in three (7.5%) patients, and groin pain occurred in three (7.5%) patients. None of the patients had recurrence, and the time to return of normal activities ranged from 4 to 9 days. Conclusion The use of a single large mesh during laparoscopic TAPP repair for bilateral inguinal hernias is a method that is possible, safe, and cost-effective with low rates of PO morbidities with a low recurrence rate. [ABSTRACT FROM AUTHOR]

Objective The primary objective of this study was to compare between liver resection (LR) and radiofrequency ablation (RFA) in the management of early hepatocellular carcinoma (HCC). We are trying to provide an update that can be valuable in clinical practice for determining the most suitable first-line management option for early HCC. Patients and methods The study included 80 patients with early HCC according to the Barcelona Clinic Liver Cancer staging system. Patients were divided into two groups: group A included 40 (50%) patients treated through LR, whereas group B included 40 (50%) patients managed through percutaneous RFA. In this study, we used the alternation method as an allocation process in this study. Procedures in both groups were done according to conventional principles. Percutaneous RFA technique was done under the guidance of ultrasonography (US) in complete aseptic conditions. Collected data included procedure time, intraoperative bleeding, postoperative complications, pain score, ICU, and the total hospital stay days. After procedures, patients were monitored every three months throughout the follow-up period. Results A total of 80 patients with early HCC underwent treatment with LR (N=40) and with RFA (N=40). There is a significant difference between both groups regarding the mean time of the procedure: 145±19.8 versus 40.6±7.8 min for LR and RFA, respectively. Rates of recurrence significantly (P<0.05) correlated with age and tumor size in both groups. No significant difference was observed in rates of recurrence or the time of recurrence (P>0.05) between LR and RFA groups. However, the recurrence percentage was slightly higher among patients treated by RFA compared with LR group. Conclusion Our prospective comparative study offers evidence that RFA provides a novel treatment for early HCC, and it shows survival and tumor relapse rates comparable to LR. [ABSTRACT FROM AUTHOR]

Objective The aim of the study is to evaluate the efficiency and safety of mesh repair in emergent complicated midline incisional hernias as well as the impact on the early postoperative (PO) morbidity and mortality to implement the best patient management procedure. Patients and methods The study includes 60 patients with emergent midline incisional hernias. Patients were divided according to the type of closure of hernia defect into two groups, group A (30 patients) was managed with a prosthetic mesh repair and group B (30 patients) was managed by primary suture repair. We used the alternation method as an allocation process. Patients in both groups were monitored during operations and along the PO period. The data collected include the patients’ condition at presentation, coexisting disease, operative data and PO complications, length of hospital stay, surgical site infection (SSI) and recurrence rates. Results A total of 60 patients underwent operations for emergent midline incisional hernias with (N=30) and without (N=30) the use of mesh repair. There is no significant difference between mesh and nonmesh groups about the mean operative time (P>0.05). Besides, there was no significant difference between both groups concerning the total hospital stay days. The SSI rate in the mesh repair group was 10%, while it was 6.7% in the primary suture repair group. The SSI rate was high among diabetic patients and those with chronic liver illness. The follow-up period ranged between 25 and 48 months with a significant difference between both groups regarding the recurrence rate (P<0.05). Conclusion Our prospective study offers an evidence that with adequate antiseptic precautions, it is possible and safe to use a nonabsorbable mesh in the repair of emergent abdominal wall midline incisional hernias with a significant decline in the recurrence rate. [ABSTRACT FROM AUTHOR]

Objective The objective is to check the efficacy and safety of two operative techniques designed for treating morbidly obese patients: laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Patients and methods The study includes 72 morbidly obese patients, who were divided into two groups: group A, 40 (55.5%) patients treated using LSG, whereas group B, 32 (44.5%) patients managed by LRYGB. Operations were completed according to the rules of laparoscopic surgery. Collected operative data included operative time, intraoperative complications, postoperative (PO) complications, ICU, and hospital stay. All patients were monitored throughout the first 2 PO years at 3rd, 6th, 12th, and 24th PO months. Results There is a significant difference between both groups regarding operative time. The rates of early PO complications were higher in LRYGB than LSG group. Both groups showed a significantweight loss at the first 12months postoperatively. ThemeanBMI dropped from 39.5±3.03 to 33.10±3.56 kg/m² among LSG patients compared with 40.18±3.18 to 30.23±2.64 kg among LRYGB patients. However, at the end of the second PO year, no difference in patients' weight, BMI, The percentage of excess weight loss (%EWL), or EBMIL was noticed in both groups. At the end of the first PO year, a dramatic improvement in both groups was seen about frequency and severity of associated comorbidities except for gastroesophageal reflux disease. At the end of the secondPOyear, all comorbidities showed prominent remissionamong patients of LSG group. Patients of LRYGB showed complete resolution of type 2 diabetes mellitus, obstructive sleep apnea, and depression. Conclusion Both LSG and LRYGB are safe bariatric surgical procedures that deliver convenient outcomes in weight loss and resolution of most obesity-associated comorbidities. [ABSTRACT FROM AUTHOR]