Zhenling Ji

Comparison of laparoscopic versus open procedure in the treatment of recurrent inguinal hernia: a meta-analysis of the results

BACKGROUND The aim of this meta-analysis was to compare the effectiveness and complications of the laparoscopic procedure and open techniques in the treatment of recurrent inguinal hernias. METHODS The electronic databases MEDLINE, Embase, PubMed, and Cochrane Library were used to search for randomized controlled trials and comparative trials about laparoscopic and open procedures on recurrent inguinal hernia repair from January 1999 to September 2012. RESULTS A total of 1,311 patients enrolled into 6 randomized controlled trials and 5 comparative studies were included in this meta-analysis. Our pooled data showed that the laparoscopic procedure was associated with a lower incidence of wound infection and a shorter sick leave. However, there were no differences in other complication rates or the operation time between the 2 methods. CONCLUSIONS The laparoscopic technique in the treatment of recurrent inguinal hernia was associated with less wound infection rates and a faster recovery to normal activity, whereas other complication rates, including the re-recurrence rate, were comparable between these 2 methods. Laparoscopic and open procedures could be performed with equal operation time.

The Comparison of Self-gripping Mesh and Sutured Mesh in Open Inguinal Hernia Repair: The Results of Meta-analysis.

Objective:The aim of this study was to compare the postoperative chronic pain and other postoperative complications after the use of the self-gripping Progrip meshes and the application of conventional suture-fixed Lichtenstein procedure. Background:Chronic pain after inguinal hernia repair is a complex problem. Many efforts have been put to reduce the postoperative chronic pain after open inguinal hernia repair, and the results are conflicting. Methods:A systematic literature review was undertaken to identify studies comparing the outcomes of open inguinal hernia repair with self-gripping Progrip meshes and the conventional Lichtenstein technique. Results:The present meta-analysis pooled the effects of outcomes of total 1353 patients enrolled into 5 randomized controlled trials and 2 prospective comparative studies. Statistically, there was no difference in the incidence of chronic pain [odds ratio = 0.74, 95% confidence interval (CI) (0.51–1.08)]. And there was no statistical difference in the incidence of acute postoperative pain [odds ratio = 1.32, 95% CI (0.68–2.55)], hematoma or seroma [odds ratio = 0.89, 95% CI (0. 56–1.41)], wound infection [risk difference = −0.01, 95% CI (−0.02 to 0.01)], and recurrence [risk difference = 0.00, 95% CI (−0.01 to 0.01)]. The self-gripping mesh group was associated with a shorter operating time (1–9 minutes). Conclusions:When the self-gripping mesh compared with the conventional suture fixed Lichtenstein technique, while there was a difference in operative time, there were no differences in pain (chronic or acute) or other complications.

Comparison of mesh-plug and Lichtenstein for inguinal hernia repair: a meta-analysis of randomized controlled trials.

Background and purposeMesh-plug and Lichtenstein techniques are among the most common used inguinal hernia repair procedures. The aim of this meta-analysis was to compare the recurrence and other postoperative complications between mesh-plug technique and Lichtenstein operation in inguinal hernia repair.MethodsThe electronic databases Embase, Pubmed, Springer and Cochrane Library were used to search for randomized controlled trials about mesh-plug and Lichtenstein repair techniques till Oct 2011. Two independent reviewers assessed the trials for eligibility and quality. And all related data matching our standards were abstracted for meta-analysis by RevMan 5.0.1. The evaluation criteria included recurrence, pain, hematoma, seroma, infection, paresthesia, testicular problem, urinary retention, operating time and recovery to daily activity.ResultsA total of 2,912 patients enrolled into 8 randomized controlled trials were included in this meta-analysis. All these RCTs compared mesh-plug and Lichtenstein procedures, and our pooled data showed similar results according to all the compared postoperative complications and return to daily activity.ConclusionMesh-plug versus Lichtenstein procedures for inguinal hernia repair was comparable in most of the analyzed outcomes.

Comparison of open preperitoneal and Lichtenstein repair for inguinal hernia repair: a meta-analysis of randomized controlled trials

BACKGROUND The aim of this article was to compare the outcomes of the open preperitoneal approaches and the Lichtenstein technique in the repair of inguinal hernias. METHODS A systematic literature review was undertaken to identify studies comparing the outcomes of open preperitoneal and Lichtenstein techniques in the repair of inguinal hernias. RESULTS The present meta-analysis pooled the effects of outcomes of a total of 2,860 patients enrolled into 10 randomized controlled trials and 2 comparative studies. The preperitoneal technique was associated with a lesser incidence of recurrence (odds ratio = .51; 95% confidence interval, .28-.92). However, statistically there was no difference in the incidence of chronic pain, hematoma, wound infection, testicular problem, urinary problem, numbness, inguinal parenthesis, and operative time. CONCLUSIONS The open preperitoneal approach is a feasible alternative for the standard Lichtenstein procedure with similar complication rates and potentially less postoperative recurrence.

Therapeutic value of sesame oil in the treatment of adhesive small bowel obstruction.

BACKGROUND The optimal treatment of partial adhesive small bowel obstruction (SBO) is still controversial. The purpose of this study was to determine the effects of oral administration of sesame oil to the standard of conservative treatment in this disease. METHODS Sixty-four cases of partial adhesive SBO were retrospectively allocated into either the control group or the intervention group (with sesame oil added), and clinical results were compared. RESULTS Of the 64 patients, 33 were in the control group and 31 in the intervention group. Significantly fewer patients required surgical intervention in the intervention group than in the control group (4/31 vs 16/33, P = .0029). Less SBO resolution time (24 hour vs 30 hour, P = .0019) and a shorter hospital stay (6 days vs 10 days, P = .0235) were observed in the interventional group. CONCLUSIONS Our study showed that sesame oil was a safe and effective adjunct to the standard treatment of partial adhesive SBO.

Overexpression of ADAM9 Promotes Colon Cancer Cells Invasion.

ABSTRACT Introduction: ADAM9 is a membrane-anchored metalloprotease that is markedly upregulated in several human carcinomas. We previously showed that ADAM9 staining was increased in colon cancer tissues. In the present work, we investigated the expression pattern of ADAM9 in colon cell lines, and the effects of overexpression ADAM9 on colon cancer proliferation and invasion. Materials and Methods: ADAM9 mRNA expression was determined in colon cancer tissues by RT-PCR assay, meanwhile, ADAM9 DNA and protein levels were measured in colon cancer cell lines by PCR and western blot, respectively. ADAM9 transfection was carried out in HT-29 colon cancer cells, and cell growth was measured by MTT assay, cell invasion ability was assessed by Matrigel assay. Results: ADAM9 mRNA was upregulated in colon cancer tissues, ADAM9 DNA and protein was overexpressed in Lovo cell lines, while the ADAM9 expression levels in HT-29, HCT-8, and Ls174t cells were below the levels of detection. Enhanced ADAM9 expression by ADAM9 transfection in HT-29 cells promoted cell invasion without increasing cell proliferation. Conclusions: These results suggest that ADAM9 contributes to cell invasion and progression in colon cancer.

Limited efficacy of early enteral nutrition in patients after total gastrectomy.

ABSTRACT Background: Evaluable data documenting the efficacy of early enteral nutrition (EEN) in patients after total gastrectomy are still limited. Aims: This study aimed to evaluate the clinical efficacy of EEN through a nasojejunal tube on the recovery of patients after total gastrectomy compared with that of patients receiving only total parenteral nutrition (TPN). Materials and Methods: One hundred and sixteen patients who underwent total gastrectomy were divided into the EEN and TPN groups. The clinical recovery and postoperative complications of these two groups were compared. Results: There were 62 patients in the EEN group and 54 in the TPN group. The postoperative length of hospital stay, time of flatus passage, and time to start a semisolid diet were similar in the two groups. In the TPN group, however, patients started a liquid diet earlier. No difference in any postoperative complications or perioperative death were found between the EEN and TPN groups. Conclusion: Since there was no significant difference regarding either the postoperative recovery course or complications, the routine placement of a nasojejunal tube for EEN is unnecessary in elective total gastrectomy.

Topic: Mesh and Prosthesis.

Introduction: The type of mesh used in complex ventral hernia repairs (VHR) remains controversial. Although mesh has been used to improve outcome, no specific mesh type has been shown to have superior characteristics in clean/contaminated and contaminated fields. Review ofthe literature shows that biologic mesh in clean/contaminated and contaminated fields demonstrate recurrence rates from 12 28% with follow up of 24 months and wound related events reported from 18 66%. Recent evidence suggests overuse of biologic mesh in these situations and more evidence is suggestive of infection resistance with light weight large pore polypropylene mesh. We aimed to evaluate our experience in patients with light weight large pore polypropylene mesh in clean versus clean/contaminated and contaminated fields.