Medial incisional ventral hernia repair with Adhesix® autoadhesive mesh: descriptive study.

Nowadays, the gold standard for the surgical treatment of abdominal wall defects is the use of a mesh. There is an extensive variety of meshes, self-adhesive ones being among the most novel technologies. The literature on the self-adhesive mesh Adhesix® (Cousin Biotech Laboratory, 59117 Wervicq South, France) in medial incisional ventral hernia is scarce. We performed a retrospective descriptive study with prospective data collection from 125 patients who underwent prosthetic repair of medial incisional ventral hernia-M1-M5 classification according to European Hernia Society (EHS)-with self-adhesive mesh Adhesix® between 2013 and 2021. Follow-up was performed 1 month and yearly after the surgery. Postoperative complications and hernia recurrences were recorded. Epidemiological results were average BMI 30.5 kg/m2 (SD 5), highlighting that overweight (41.6%) and obesity type 1 (25.6%) were the most represented groups. 34 patients (27.2%) had already undergone a previous abdominal wall surgery. The epigastric-umbilical (M2-M3 EHS classification, 22.4%) and umbilical (M3 EHS classification, 20%) hernias were the predominant groups. The elective surgery technique was Rives or Rives-Stoppa with an associated supraaponeurotic mesh if the closure of the anterior aponeurosis of the rectus sheath was not surgically closed (13 patients). The most frequent postoperative complication was seroma (26.4%). The recurrence rate was 7.2%. The average follow-up length was 2.6 years (SD 1.6 years). According to the results of this study and the literature available, we consider that the self-adhesive mesh Adhesix® is an appropriate alternative mesh option for the repair of medial incisional ventral hernias.

[Effect of preoperative radiotherapy in the detection of lymphatic metastasis of rectal cancer]. / Efecto de la radioterapia preoperatoria en la detección de las metástasis ganglionares del cáncer de recto.

The purpose of this study was to assess whether the understaging of rectal tumors seen after preoperative radiotherapy is due to the biological effect of the irradiation or reflect the difficulties of the pathologists in identifying lymph nodes from radiated specimens. To study this question a retrospective non randomized study was undertaken including 31 patients with rectal cancer and oncological resection, 16 after preoperative administration of 36 Gy and 15 without radiotherapy. Metastatic lymph nodes were found in 37% of patients of the radiated group and in 58% of no irradiated group, being de difference between them of 16% with a confidence interval from -15% to 40%. A mean of 13 and 18 lymph nodes were identified in the radiated and non radiated group respectively, being the difference between means of 5 with a confidence interval from -0.6 to 10. A 80% and 57% of the pathological reports in no radiated and radiated group respectively accomplished the criteria of reliability (> 13 lymph modes isolated), being the difference between proportions of 27% with a confidence interval from -3% to 57%. Based on the above stated results no conclusive answer can be addressed to the proposed question; both effects could participate in the downstaging. More studies including more patients are needed to give a reliable answer to the proposed question.