Laparoscopic Inguinal Hernia Repair in a Developing Nation: Short‑term Outcomes in 103 Consecutive Procedures

Background: There are no published data on the outcomes of inguinal hernia repair from the Anglophone Caribbean. To the best of our knowledge, this is the first report of a series of laparoscopic inguinal hernia repairs from the region.Materials and Methods: Data was extracted from a prospectively maintained database of consecutive trans abdominal pre‑peritoneal (TAPP) repairs done between June 1, 2005 and May 30, 2012. Perioperative data collected included patient demographics, hernia type, operative technique, duration of surgery, intra‑operative details, morbidity, analgesia requirements, and duration of hospitalization. A telephone survey was also performed to identify late recurrences and complications. Descriptive statistics were generated using Statistical Package for Social Sciences (SPSS) Ver 12.0. Results: There were 103 consecutive TAPP procedures in 88 patients at an average age of 35.4 years ± 12.9 (standard deviation; SD) and average body mass index (BMI) of 28.9 Kg/m2 ± 2.23 (SD). The indications were bilateral (30), recurrent unilateral (24), and primary unilateral (49) inguinal hernias. The mean duration of operation was 68.5 minutes (SD ± 10.4; Range: 55-95; Median 65; Mode 65) minutes for unilateral TAPP and 89 minutes (SD ± 7.61; Range: 80‑105; Median 90; Mode 90) for bilateral repairs. Post‑operatively, 65/70 patients required ≤1 dose of parenteral opioid analgesia and 74 (84.1%) patients discontinued oral analgesia within 48 hours of operation. Complications were recorded in six (5.8%) cases and a recurrence in one (0.97%) case after a mean follow‑up period of 3.2 years (SD ± 1.8; Range: 0.5-7).Conclusion: Laparoscopic inguinal hernia repair is a safe and effective operation in this setting.Key words: Hernia, laparoscopic, recurrence, TAP

Duodenal Fibrosarcoma Mimicking Franz Tumour Complicated by Post-resection Chylous Ascites: A Case Report

This case report presents a young woman who underwent a Whipples resection for a large pan-creatoduodenal tumour. Pathology and immunohistochemical analysis of the tumour suggest duodenal fibrosarcoma. The patient’s postoperative management was complicated by chylous ascites. A brief literature review is given to highlight this unusual case. Keywords: Duodenal fibrosarcoma, chylous ascites, Whiples resection "Fibrosarcoma Duodenal con Apariencia de Tumor de Franz Complicado por Ascitis Quilosa Post-resección: Reporte de un Caso" RESUMEN Este reporte presenta el caso de una mujer joven a la cual se le practicó una resección de Whipples a causa de un tumor pancreato-duodenal grande. La patología y el análisis imunohistoquímico del tumor sugieren la existencia de un fibrosarcoma duodenal. El tratamiento postoperatorio del paciente estuvo complicado por una ascitis quilosa. Se ofrece una breve revisión de la literatura para resaltar este caso inusual. Palabras claves: Fibrosarcoma duodenal, ascitis quilosa, resección de Whipple