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Inguinal hernia is a worldwide medical problem for its frequency. Elective surgery for inguinal hernia is a common and simple operation, but 5 to 10% of groin hernia requires emergency surgery for incarceration. The aim of our retrospective revision was to evaluate the feasibility of the tissue-based repair technique from Desarda into selected patients with incarcerated groin hernia. Between January 2016 and December 2018, 22 patients were admitted to our institution with a primary groin hernia incarcerated without occlusion signs of or strangulation. Fifteen patients underwent at Desarda's technique performed by the single surgeon experienced in abdominal wall. There were 3 women and 12 men with a mean age of 65.8 years (range 52 to 87 years). Overall morbidity occurred in 6 patients (40%). Length follow-up was set in 6 months. At the end of follow-up any reccurence or chronic pain was detected. The Desarda repair is a simple and straightforward procedure with no complexity involved in the tissue dissection and repair. In our retrospective evaluation feasibility of this treatment, it was possible in selected cases. Desarda's technique has the potential to enlarge the number of tissue-based methods available to groin hernia and also into the acute treatment. [ABSTRACT FROM AUTHOR]

Purposes: To evaluate the impact of percutaneous cholecystostomy (PC) on severe acute cholecystitis (AC). Methods: According to the ICD-9 classification, we retrospectively retrieved medical records of patients discharged with a diagnosis of AC from January 2007 to December 2016 at our hospital. Patients were then stratified according to the Tokyo 2013 (TG 13) AC severity criteria. Grade III AC was diagnosed according to the TG 13 criteria. Indications for PC were failure of optimal medical treatment within 48 h, worsening of clinical condition within early medical treatment, patients unfit for upfront surgery and patient's preference. Ascites was considered a contraindication to PC while coagulopathy was considered a minor contraindication. Primary end points were: clinical improvement, morbidity and related mortality. Secondary endpoints were AC recurrences and elective laparoscopic cholecystectomies (LS). Response was evaluated by clinical and blood test improvement. Morbidity was evaluated according to the Dindo–Clavien scale. Results: A total of 117 eligible patients were diagnosed as grade III AC. Of these, 29 (24.7%) underwent PC. The procedure was completed in all cases. Overall morbidity rate was 20.6%. Main complication was the drainage dislodgement due to involuntary patient's movement. Overall mortality was 17.2% but no causes of death were dependent upon the procedure. Clinical improvement was reported in 95.5% of surviving patients. Conclusion: This study confirms that PC is a valuable tool in the treatment of severe AC. Randomized trials are needed to clarify the criteria for patient selection and to optimize the timing for both cholecystostomy and cholecystectomy. [ABSTRACT FROM AUTHOR]