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    Comparing laparoscopic totally extraperitoneal inguinal hernia repair with and without mesh fixation
    (Edizioni Luigi Pozzi, 2022) Akturk, Remzi; Serinsoz, Serdar
    AIM: To compare totally extraperitoneal (TEP) repair in uncomplicated primary inguinal hernia patients with and without mesh fixation using tack in terms of peri- and post-operative complications, recurrence, return to work, and hospital stay. MATERIAL AND METHODS: We retrospectively analyzed the medical records of patients who underwent TEP repair of uncomplicated primary inguinal hernia (American Society of Anesthesiologists score at our institute from January 2008 to December 2017. RESULTS: In total, 354 patients were included in this study. There was no statistical difference in the body mass index (BMI) and duration of operation between patients with and without fixation. The mean number of days to return to work was significantly (p=0.000) higher in patients with use mesh fixation (9.06+1.749) compared to patients without mesh fixation (7.31+2.097). There was no difference between the two groups in terms of post-operative complications, except for seroma of the inguinal region, subcutaneous emphysema, and post-operative pain (p<0.05). The mean number of days of hospital stay was significantly (p=0.002) higher in patients with mesh fixation (1.11+0.329) compared to patients without mesh fixation (1.02+0.149). Evaluation of peri- and post-operative complications in BMI groups showed that obese patients and other groups had no significant difference (p>0.05). CONCLUSIONS: Non-mesh fixation laparoscopic TEP repair is safe and feasible for primary and relapsed inguinal hernias. Patients experienced less chronic pain, shorter hospital stay, and shorter time to return to work. Furthermore, it might be safe in obese patients but requires additional study to confirm.
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    The role of mesalazine co-treatment in the prevention of recurrence in subjects with subclinical inflammatory bowel disease and perianal fistula who are scheduled for surgical intervention
    (Edizioni Luigi Pozzi, 2022) Akturk, Remzi; Serinsoz, Serdar
    AIM: To investigate the impact of mesalazine co-treatment in addition to the surgical intervention on recurrence rate in subjects with subclinical inflammatory bowel disease (SIBD) who present with perianal fistula (PAF). MATERIALS AND METHODS: All consecutive patients who had undergone surgery for PAF in our institutes were included in this retrospective analysis. Ileal tissue samples were obtained during colonoscopy for pathological evaluation. Patients with active chronic ileitis, structural distortion, erosion, ulceration, cryptitis, crypt abscess, fibrosis, and Paneth cell hyperplasia were defined as SIBD. Patients were divided into two groups according to the presence or absence of SIBD on pathological evaluation of ileal tissue samples (Group 1: SIBD +; Group 2: SIBD -). Rectal 5-aminosalicylic acid (mesalazine) of 2 gr once daily was administered to half of the subjects in each group for 8 weeks. The difference in 6 months recurrence rates of subjects receiving or not receiving mesalazine was the primary outcome measure. RESULTS: The overall recurrence rate of subjects not receiving mesalazine was significantly higher than that of the subjects receiving mesalazine (9.7% vs. 4.4%, p = 0.020). Recurrence rate of the subjects with SIBD who received mesalazineco-treatment was significantly lower than those without mesalazine (1.6% vs. 12.6%, p=0.002). However, recurrence rate of the subjects without SIBD who received and not received mesalazine co-treatment was similar (6.8% vs. 7.8%, p=0.764). CONCLUSION: Mesalazine co-treatment in addition to the surgical intervention was associated with lower 6 months recurrence rate compared to surgical intervention alone in patients with SIBD and PAF.