The Role of Fibrin Glue Polypropylene Mesh Fixation in Open Inguinal Hernia Repair

THE AIM: of this study was to compare two methods of polypropylene mesh fixation for inguinal hernia repair according to Lichtenstein using fibrin glue and suture fixation. MATERIAL AND METHODS: The study included 60 patients with unilateral inguinal hernia, divided into two groups of 30 patients – Suture fixation and fibrin glue fixation. ALL PATIENTS WERE ANALYZED ACCORDING TO: age, gender, body mass index (BMI), indication for surgery–the type, localization and size of the hernia, preoperative level of pain and the type of surgery. Overall postoperative complications and the patient’s ability to return to regular activities were followed for 3 months. RESULTS AND DISCUSSION: Statistically significant difference in the duration of surgery, pain intensity and complications (p<0.05) were verified between method A, the group of patients whose inguinal hernia was repaired using polypropylene mesh–fibrin glue and method B, where inguinal hernia was repaired with polypropylene mesh using suture fixation. Given the clinical research, this systematic review of existing results on the comparative effectiveness, will help in making important medical decisions about options for surgical treatment of inguinal hernia. CONCLUSIONS: The results of this study may impact decision making process for recommendations of methods of treatment by professional associations, making appropriate decisions on hospital procurement of materials, as well as coverage of health funds and insurance

IMPACT OF CENTRAL VENOUS PRESSURE AND DIURESIS ON RENAL GRAFT FUNCTION

Introduction: Renal graft function in the immediate posttransplant period is directly associated with patients hemodynamic condition during graft revascularization and early postoperative period. Our aim was to evaluate correlation between average daily value of central venous pressure (CVP) and renal perfusion, in first seven posttransplant days.Patients and methods: We recruited 74 patients, who underwent renal transplantation. We evaluated the influence of CVP and 24 h urine output on renal graft function. In order to assess the renal graft function, following parameters were evaluated: glomerular filtration rate (GFR), creatinine clearance, 24-hour urine output, and from the serum levels of K+, Na++, urea and creatinine.Results: Statistically significant positive correlation between mean values of CVP and 24 h urine output was found on the first (r=0.5422; p=0.0001) but not on the third postoperative day (r=0.1116; p=0.344). Statistically significant inverse correlation between mean values of creatinine and diuresis was found on the first (r=-0.2824; p=0.015) and third (r=-0.2976; p=0.01) postoperative day but on the seventh postoperative day a positive statistically significant correlation between these parameters was registered (r=0.4114; p=0.0001). There is a statistically significant difference between GFR and urine output on the first (r=0.2771; p= 0.017) and seventh day (r=0.4114; p=0.0001). We have not found any significant correlation between mean values of creatinine clearance and diuresis on the first posttransplant day (r=0.1760; p=0.134), but when same parameters were examined on the seventh day a positive statistical significance was found (r=0.4248; p=0.0001).Conclusion: Renal graft survival in early postoperative period is largely influenced by recipient hemodynamic condition. This study proved that 24-hour urine output directly depended on CVP level; it also proved existence of statistically significant correlation between mean values of diuresis, creatinine clearance, GFR and serum creatinine.</jats:p