Fahrettin Yildiz

Comparison of Modified Darn Repair and Lichtenstein Repair of Primary Inguinal Hernias

OBJECTIVE This study was designed to compare the results of the Modified Darn Repair through Lichtenstein procedure in inguinal hernias. MATERIALS AND METHODS The study involved 322 patients with inguinal hernia, operated in General Surgery Departments of Gulhane Military Medical Academy and Sirnak Military Hospital between 1998 and 2004. The durations of operation time, hospitalization, and time to return to daily activities and postoperative complication and recurrence rates were evaluated. Lichtenstein procedure was applied on 170 patients (Group 1), and modified darn repair was applied on 152 patients (Group 2). RESULTS The average follow-up period was 56 months. For the Lichtenstein procedure, the average duration of operation was 56 min; the average time to return to routine activities was 20 days. The number of patients with postoperative complications was 20 (11.7%), and the number of patients with recurrence was 1 (0.6%). For modified darn repair, the average duration of operation was 48 min; the time to return to daily activities was 20 days. The number of patients with postoperative complication was three (1.9%), and no recurrences were noted. The hospitalization time of the groups was similar. DISCUSSION Modified darn repair is a reliable method for inguinal hernia repair with short hospitalization time, low rate of postoperative complications, and recurrence.

Correlation Of Biochemical Markers With Histopathological Findings In Experimental Strangulated Hernia

Objectives: This study was planned to evaluate whether possible changes in the hematological parameters and the biochemical markers can be used to detect obstruction-induced (strangulated) intestinal ischemia. Materials and Methods: Forty rats divided into five groups underwent the following procedures: Group 1 rats were treated with only laparotomy (sham-operated controls). To the strangulated hernia groups surgical induction of strangulated intestinal obstruction was performed. Tissue and blood samples were taken at 30 minutes (group 2), 2nd hour (group 3), 4th hour (group 4) and 6th hour (group 5) respectively, and then LDH, CPK, ALP, AST, ALT, D-dimer levels and blood cells counts were measured and histopathological examination was done. Results: Focal mucosal necrosis accompanied was confirmed by histological findings in the strangulated intestinal ischemia group after second hour. Serum D-dimer, ALT, ALP, CPK levels and neutrophil count became elevated at second hour, which was statistically significant. Conclusion: In patients with hernia, after reduction of the intestinal hernia, raised levels of serum D-dimer, ALT, ALP, CPK levels and neutrophil count may indicate the presence of a bowel ischemia. However, more comprehensive clinical studies are required to evaluate the potential survival benefit by using the laboratory tests as a marker and/or a useful diagnostic tool of the need for laparotomy.