Surgical management of venous aneurysms.

BACKGROUND: Venous aneurysms (VA) are often underestimated as a dangerous vascular condition that can lead to fatal complications. We have adopted a more aggressive surgical approach to treatment of venous aneurysms that seems to be safe and effective, and report herein the results of this approach. METHODS: A retrospective analysis of patients presented with VA between January 2013, and January 2018. RESULTS: We identified 13 VA in 13 patients. The mean patient age was 21.6 years (range, 7-42 years). Six patients were male (46.2%) and seven were female (53.8%). All patients presented with swellings in different areas, mostly in the neck (nine patients [69.2%]). Two patients had a short saphenous vein aneurysm complicated with paresthesia (15.3%). All patients underwent surgical correction. Tangential excision was done for noncomplicated saccular aneurysms (six patients [46.2%]), whereas ligation and excision were done for fusiform aneurysms (five patients) and two saccular aneurysms presenting with thrombosis (53.8%). No signification complications were noted. CONCLUSIONS: Surgical treatment of venous aneurysms is safe and may help to avoid possible pulmonary embolism.

Randomized clinical trial of Desarda versus Lichtenstein repair for treatment of primary inguinal hernia.

BACKGROUND: The ideal operation to treat inguinal hernia is still far to define. We analyzed the outcomes of the Desarda tissue-based repair in comparison with the standard Lichtenstein procedure in treatment of primary inguinal hernia. METHODS: A total of 168 patients were randomly allocated into two groups to undergo one of two repairs: Desarda (group I) or Lichtenstein (group II) (85 vs. 83, respectively). The primary outcome measures were recurrence of inguinal hernia and chronic groin pain. Secondary outcome measures included operating time, postoperative pain scores, time to return to normal gait and to work, foreign body sensation in the groin, and postoperative complications. RESULTS: During 2-year follow up, one recurrence was detected in each group (P = 0.99). Chronic groin pain was experienced by 5.6% and 4.2% of patients from Desarda and Lichtenstein groups respectively (P = 0.68). There was no significant statistical difference in mean postoperative VAS scores for pain at the five time points between the two study groups. There was significantly shorter operating time and earlier return to normal gait in favor of Desarda repair. Foreign body sensation was not different between the two groups. CONCLUSION: Successful inguinal hernia treatment without mesh implantation can be achieved using Desarda repair, as it is effective as the standard Lichtenstein procedure. Shorter operating time, early return to normal gait and lower cost (no mesh) are potential benefits of Desarda repair. The suitability of Desarda repair for patients found to have thin, weak or divided external oblique aponeurosis intraoperatively needs further evaluation.