Experience in Day Surgery with prolene hernia system (PHS)

Aim: The aim of this study was to evaluate the outcomes of inguinal hernia repair with prolene hernia system (PHS) mesh under local anaesthesia with sedation as a day surgery procedure within a surgical training programme. Patients and Methods: 5450 patients with inguinal herniae were admitted for hernia repair between 1997 and 2005 in our day surgery unit. 1840 inguinal hernias were repaired with PHS during this time, 1002 patients were operated by residents (54,54 %) under staff supervision. Patients were followed-up at five years post-operatively and the outcome measures of pain and complications recorded. Trainees and staff surgeons were assessed by an evaluation of both knowledge and technique. Results: Local anaesthesia with sedation was used in 97.4 % (1793) of patients; regional anaesthesia in 45 (2.49 %): conversion from local to general anaes-thesia was required in two patients (0.2 %). Mean operation time was 40 min, including the anaesthesic preparation. Mean hospital stay for all patients was 6 hours. The evaluation of hernia repair with the PHS system was similar between the staff members and residents. Conclusion: Inguinal hernia repair using the PHS technique under local anaesthesia with sedation is feasible on a day case basis and is a suitable procedure for training in a residency programme (AU)

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Effect of melatonin on myocardial oxidative stress induced by experimental obstructive jaundice

Objective: melatonin has been demonstrated to have activeantioxidant properties in different tissues during experimentalcholestasis. The aim of this research was to study myocardial oxidativestress on obstructive jaundice, and to analyze the effect ofmelatonin on myocardial oxidative lesions.Material and methods: we achieved cholestasis by ligatureand sectioning of the main bile duct. Melatonin was administeredintraperitoneally (500 ìg/kg/day). We measured malondialdehyde(MDA), reduced glutathione (GSH), catalase (CAT), superoxidedismutase (SOD) and glutathione peroxydase (GPx) antioxidantenzyme levels in the heart tissue.Results: obstructive cholestasis increased MDA and decreasedGSH as well as all antioxidant enzymes. Melatonin administrationsignificantly decreased MDA values, and increased GSH and antioxidantenzymes on the icteric animal myocardium.Conclusions: melatonin treatment prevents oxidative stressin the cardiac tissue as induced by experimental cholestasis(AU)

Alteration of the renal regulatory hormonal pattern during experimental obstructive jaundice

Objective: the alteration of hormones regulating sodium andwater status is related to renal failure in obstructive jaundice (OJ).Experimental design: OJ was induced by common bile ductligation. Samples were obtained from the control (SO) and OJgroups at 24 and 72 hours, and at 7 days. Different parametersrelated to biliary obstruction, liver and renal injury, and vasoactivemediators such as renin, aldosterone, endothelin-1 (ET-1) andprostaglandin E2 (PGE2) were studied.Results: bile duct ligation caused an increase in total bilirubin(p < 0.001) and alkaline phosphatase (AP) (p < 0.001). The SOand OJ groups had the same values for diuresis, renin, and creatinineclearance at 24 h. However, animals with OJ had a lowersodium concentration in urine than SO animals (p < 0.01), as wellas an increase in aldosterone levels (p < 0.03). ANP levels weremoderately increased during OJ but did not reach statistical significancewhen compared to the SO group. In contrast, OJ animalsshowed a rise in serum ET-1 concentration (p < 0.001) and increasedPGE2 in urine (p < 0.001).Conclusions: biliary obstruction induced an increase in ET-1release and PGE2 urine excretion. These hormones might play arole during the renal complications associated with renal disturbancesthat occur during OJ(AU)