Effects of suture tecnique on mesh shrinkage.

OBJECTIVE: Polypropylene meshes are one of the most frequently used patches in inguinal hernia repairs. This material was proved to be not completely inert, and may cause inflammatory responses like foreign body reactions. One of the physical results of these inflammatory reactions against the mesh is mesh shrinkage which is responsible for recurrence and pain. In this study, we aimed to investigate the effects of the suture technique on mesh shrinkage. METHODS: 36 animals were used for the study. Subjects were divided into 3 groups. In the first group the mesh (onlay) was not fixated by any means. In the second group, mesh was placed on the abdomen wall, after which the mesh was fixated with interrupted suturing. In the third group, continuous suturing was applied after the placement of the mesh. Mesh shrinkage was measured macroscopically, and the mesh site reaction was evaluated microscopically. At the end of the second month, 18 subjects were sacrificed again to conduct the same procedure. RESULTS AND CONCLUSION: When meshes are used for hernia repairs, shrinkage may be observed in meshes placed on fascia. In the first group without mesh fixation, mesh shrinkage was more significant in the second month compared to the first month. The amount of shrinkage of without fixation group was found to significantly differ during the second month from interrupted and continuous suture groups. Even though statistically not significant, fixation of the mesh with interrupted sutures seems to be more advantageous compared to fixation with continuous sutures.

The effects on diet, anastomotic type, and loxiglumide on gastric emptying following gastrojejunostomy.

PURPOSE: The effects on gastric emptying of feeding with a normal diet (ND), an early high-calorie and hyperosmolar diet (HCHOD) or normal diet plus intraperitoneal loxiglumide (LOX) were investigated in rats with antecolic (ACGJ) or retrocolic (RCGJ) gastrojejunostomy. METHODS: Sixty rats were separated into six groups of ten animals each (ACGJ+ND, RCGJ+ND, ACGJ+HCHOD, RCGJ+HCHOD, ACGJ+ND+LOX, and RCGJ+ND+LOX). On the seventh day, scintigraphic measurements of solid gastric emptying were made at 1, 30 and 60 min. RESULTS: According to the 60-min results, the RCGJ+ND group exhibited delayed emptying compared to the ACGJ+ND group (p=0.023). Gastric emptying of ACGJ+HCHOD rats was delayed compared with the other ACGJ groups (compared to ACGJ+ND: p=0.000, and ACGJ+ND+LOX: p=0.015). Gastric emptying was more effective in the RCGJ+ND+LOX group than the other RCGJ groups (compared to RCGJ+ND: p=0.003, and RCGJ+HCHOD: p=0.001). CONCLUSION: Antecolic gastrojejunostomy provided better gastric emptying. An early high-calorie and hyperosmolar enteral diet delayed gastric emptying in both types of anastomosis.