Background : The objective of this study is to compare the outcomes of Lichtenstein repair and no mesh Desarda repair for inguinal hernia. Methods : This is a prospective randomized trial of 1382 patients having 1461 hernias operated from January 2002 to December 2011.704 patients were operated using Lichtensteinrepairand 678 using Desardarepair. The variables like age, sex, type of hernia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results : There were no significant differences regarding age, sex, type of hernia, and pain in both the groups. The operation time was 48 minutes in Desarda group and 39 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.5 % in Desarda group and 0.4% in Lichtenstein group. There were 8 cases of infection to the polypropylene mesh in the Lichtenstein group, 3 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7.5%) as compared to Desarda group (3.4%). The mean time to return to normal routine non-strenuous work in the Desarda group was 8.26 days v 12.58 days in the Lichtenstein group. The mean hospital stay was 29 hrs. in Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions : Desarda repair scores significantly over the Lichtenstein repair. Morbidity due to complications and re-explorations for sepsis were significantly higher in mesh group. Period of return to normal work was also less in the Desarda group. No mesh Desarda repair is a better choice as compared with the Lichtenstein mesh repair. Key words : Lichtenstein, Desarda, Inguinal, Hernia, Repair, Randomized, Trial.

/pdf/a-randomized-trial-comparing-lichtenstein-repair-and-no-mesh-4xw0uu2imc.pdf

A Randomized Trial Comparing Lichtenstein Repair and No Mesh Desarda Repair for Inguinal Hernia: A Study of 1382 Patients

Clinical significance of mesenteric panniculitis-like abnormalities on abdominal computerized tomography in patients with malignant neoplasms

Clinical significance of mesenteric panniculitis-like abnormalities on abdominal computerized tomography in patients with malignant neoplasms.

Background
The role of positron emission tomography (PET) of the mesentery as a diagnostic modality in cases of mesenteric panniculitis is unclear.

Mesenteric panniculitis presenting with acute non-occlusive colonic ischemia

Mesenteric panniculitis is an underdiagnosed inflammatory condition of unknown etiology that involves the mesenteric adipose tissue. Clinical symptoms are not specific (fever, abdominal pain, or nausea), so diagnosis is not simple. We report a case of 48-year-old man with abdominal pain and fever not responsive to antipyretics and antibiotics for 2 months, who underwent an F-FDG PET/CT after a nondiagnostic CT scan. PET/CT has proven to be a useful method for the diagnosis of mesenteric panniculitis in this patient, showing a uniformly high uptake of FDG in the mesenteric adipose tissue of the mesocolon, mesoappendix, mesosigmoid, and mesorectum.

Mesenteric Panniculitis Demonstrated on 18F-FDG PET/CT.

Mesenteric panniculitis is a chronic inflammatory process involving the adipose tissue of the mesentery. The etiology is unknown, and it is rare in children. We report a 5 year old girl who presented with abdominal symptoms and was misdiagnosed as appendicular mass. The correct diagnosis was established after surgical resection.

/pdf/mesenteric-panniculitis-in-a-child-misdiagnosed-as-4sxgfgo0yr.pdf

Mesenteric panniculitis in a child misdiagnosed as appendicular mass: a case report and review of literature

Mesenteric panniculitis (also known as sclerosing mesenteritis) is a chronic inflammatory disease of the mesenteric connective tissue. It is known to have a wide spectrum of clinical and radiological presentations. In general, biopsy is recommended for diagnosis; however, a recent study proposed that a negative positron emission tomography- computerized tomography (PET-CT) scan is accurate in differentiating benign and neoplastic mesenteric processes [Br J Radiol 2006;79:37–43]. The following case report questions the accuracy of PET-CT in this setting and confirms the requirement for biopsy to rule out the presence of mesenteric lymphoma.

/pdf/normal-positron-emission-tomography-computerized-tomogram-in-4eno1s3057.pdf

Normal Positron Emission Tomography-Computerized Tomogram in a Patient with Apparent Mesenteric Panniculitis: Biopsy Is Still the Answer.

Mp39-15 implementation of an opioid free pain pathway in minimally invasive urological oncologic surgeries

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Normal Positron Emission Tomography-Computerized Tomogram in a Patient with Apparent Mesenteric Panniculitis: Biopsy Is Still the Answer.

Mp39-15 implementation of an opioid free pain pathway in minimally invasive urological oncologic surgeries