Rafał Solecki

Practical Approach to Inguinal Hernia Treatment -Guidelines of the Association of Polish Surgeons

Department of General, Oncological and Gastroenterological Surgery, University Hospital, Collegium Medicum Jagiellonian University in Cracow1 Kierownik: prof. dr hab. J. kulig Department of Anatomy, Collegium Medicum Jagiellonian University in Cracow2 Kierownik: prof. dr hab. J. Walocha 2nd Department of General Surgery, University Hospital, Collegium Medicum Jagiellonian University in Cracow3 Kierownik: prof. dr hab. A. budzyński Department of General and Vascular Surgery, Ceynowa Hospital in Wejherowo4 Kierownik: dr n. med m. Witzling 2nd Department of General, Gastroenterological and Digestive Tract Surgery, Medical University in Lublin5 Kierownik: prof. dr hab. g. Wallner

Polish guidelines for treatment of patients with parastomal hernia

Department of General and Vascular Surgery, Hospital in Wejherowo1 Department of Cardiac and Vascular Surgery, Medical University in Gdańsk2 Department of General, Oncological and Gastroenterological Surgery, Jagiellonian University in Cracow3 Department of General and Colorectal Surgery, Medical University in Łódź4 Department of General, Gastrointestinal and Oncological Surgery of the Alimentary Tract, Medical University in Lublin5 Department of Radiology, Medical University in Gdańsk6 Department of General and Minimaly Invasive Surgery, Hospital of the Order of the Brothers Hospitallers of St John of God in Cracow7 Department of General and Colorectal Surgery, Bielański Hospital in Warsaw8 Department of Oncological Surgery, Medical University in Gdańsk9 Department of General, Transplant and Liver Surgery, Warsaw Medical University10 Department of General, Oncological and Gastrointestinal Surgery, Medical Centre of Postgraduate Education11 Department of General, Oncological and Gastroenterological Surgery, Jagiellonian University in Cracow12 Department of General Surgery, Municipal Hospital in Siedlce13 POLSKI PRZEGLĄD CHIRURGICZNY 10.2478/pjs-2013-0027 2013, 85, 3, 152–180

Effectiveness of mesh hernioplasty in incarcerated inguinal hernias

Introduction The use of mesh is still controversial in patients undergoing emergency incarcerated hernia repair, mostly because of potential infectious complications. Aim The main aim of this study was to assess the efficacy of tension-free methods in treating incarcerated inguinal hernias (IIH), with and without intestine resection. The secondary aim was to establish an algorithm on how to proceed with incarcerated hernias. Material and methods A retrospective analysis of patients who underwent surgery due to an inguinal hernia at the First Department of General Surgery Jagiellonian University Medical College in Krakow, in the period 1999–2009. Operative methods included Lichtenstein, Robbins-Rutkow and Prolene Hernia System. The rate of postoperative complications was compared in patients who underwent elective and emergency surgery. Results The study group consisted of 567 patients (546 male) age 19–91 years. In this group 624 hernias were treated using the three tension-free techniques – 295 using the Lichtenstein method, 236 using PHS and 93 using the RR technique. Out of the 561 operations 89.9% were elective. No correlation (p > 0.05) was found between the type of surgery and such complications as postoperative pain duration and intensity, fever, micturation disorders, wound healing disorders, testicle hydrocoele, testicle atrophy, spermatic cord cyst, sexual dysfunction, wound dehiscence, wound suppuration, seroma, haematoma and hernia recurrence. Conclusions Mesh repairs can be safely performed while operating due to an IIH. The use of a synthetic implant, in emergency IIH repairs, does not increase the rate of local complications. Synchronous, partial resection of the small intestine, due to intestinal necrosis, is not a contraindication to use mesh.

Primary Adenocarcinoma of the Appendix – A Case Report

Abstract Primary adenocarcinoma of the vermiform appendix is a rare clinical condition. It usually presents as an acute abdominal process or as a mass in the right lower quadrant. The gross pathologic and microscopic characteristics of this disease are the same as for colon carcinoma and carry a serious prognosis. We report a case of a 64-year old male patient presenting symptoms of acute appendicitis. The patient underwent laparoscopic appendectomy that revealed a severely inflamed appendix. Histopathological examination has shown that it was a poorly differentiated, high grade adenocarcinoma invading the periappendicular fat. According to the histopathological findings, a right hemicolectomy was further advised and performed. Right hemicolectomy is the generally recommended method of treatment for invasive adenocarcinoma of the appendix.