Michele Frazzetta

Tension-free hernia repair is associated with an increase in inflammatory response markers against the mesh ☆

BACKGROUND The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH). METHODS Thirty patients male with unilateral inguinal hernia without complications or recurrence were included in this study. Randomly, patients underwent LH or BH. Peripheral venous bloods samples were collected 24 hours prior to surgery and then 6, 24, 48 and 168 hours postoperatively. RESULTS We present evidences that LH patients showed a higher increased serum level of fibrinogen, C-reactive protein, alpha-1-antitrypsin, and interleukin-6 than BH patients. Postoperative visual analogue scales for pain were reduced on mobilization for patients undergoing LH compared with BH. Neutrophils were significantly increased only in LH compared with baseline. Ceruloplasmin, transferrin, and albumin levels were unmodified after BH or LH. CONCLUSIONS In conclusion our data show that although LH induces less pain and more rapid postoperative recovery, it is associated with an higher inflammatory response compared with BH, likely due to polypropylene mesh.

Treatment of esophageal cancer in inoperable elderly patients: our experience.

The esophagus carcinoma has an incidence rate of 3–4 new cases per 100,000 inhabitants, per year, with a male/female ratio of 3:1 and with a low incidence between the VI–VII decade of life. In Italy, the incidence rate equals 2,000 new cases/year with a mortality rate of 3–5/100,000 inhabitants.