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Research Article
Ultrasound-Guided Quadratus Lumborum Block Versus Local Infiltration Anesthesia for Inguinal Herniorrhaphy:
A Randomized Controlled Trial
Yong Liu*
Issue:
Volume 14, Issue 2, April 2026
Pages:
21-29
Received:
18 February 2026
Accepted:
27 February 2026
Published:
10 March 2026
Abstract: Background: Quadratus lumborum block (QLB) has been reported as an innovative analgesic procedure for enhanced recovery after inguinal herniorrhaphy. However, it has never been compared with local infiltration anesthesia (LIA) as the sole anesthetic technique in inguinal herniorrhaphy. This study aimed to compare the anesthetic efficacy of QLB and LIA for inguinal herniorrhaphy. Methods: A total of 70 patients undergoing elective inguinal herniorrhaphy were randomly assigned to receive either QLB or LIA. The primary outcome was the area under the curve (AUC) of the pain numeric rating scale (NRS) during surgery. Secondary outcomes included anesthesia efficacy, consumption of additional local anesthetics for rescue analgesia, level of intraoperative traction reaction, postoperative pain scores at rest and during movement, and adverse side effects. Results: The QLB group had a significantly higher AUC for intraoperative NRS scores than the LIA group (15.7 ± 3.1 vs 13.1 ± 3.6, 95% CI for the difference: 1.23 to 4.17, P=0.002) and required a greater volume of rescue local anesthetics (11.0 ± 7.6 mL vs. 5.7 ± 6.4 mL, 95% CI for the difference: 1.05 to 9.55, P=0.02). However, the QLB group had lower scores for visceral traction reaction [median 2.0 (interquartile range, IQR 2.0 to 2.3) vs. 2.0 (IQR 2.0 to 3.0), 95% CI for the median difference: -0.82 to -0.05, P=0.026] and lower resting NRS pain scores at 12 h postoperatively. Conclusions: Both QLB and LIA can provide sufficient analgesia for inguinal herniorrhaphy without the need for conversion to other anesthetic methods. LIA is more effective in controlling intraoperative pain and reducing the consumption of rescue local anesthetics, while QLB is associated with milder peritoneal traction reaction and better postoperative analgesia at 12 h after surgery. The combination of LIA and QLB is hypothesized to be a more optimal anesthetic choice for inguinal herniorrhaphy, which requires further prospective clinical research to verify this assumption.
Abstract: Background: Quadratus lumborum block (QLB) has been reported as an innovative analgesic procedure for enhanced recovery after inguinal herniorrhaphy. However, it has never been compared with local infiltration anesthesia (LIA) as the sole anesthetic technique in inguinal herniorrhaphy. This study aimed to compare the anesthetic efficacy of QLB and ...
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Case Report
Rare Presentation of a Primary Mesenteric Cystadenocarcinoma: Surgical Management
Rajib Kumar Majumdar,
Yadavalli Sri Venkata Raviteja*
Issue:
Volume 14, Issue 2, April 2026
Pages:
30-34
Received:
23 January 2026
Accepted:
5 March 2026
Published:
17 March 2026
Abstract: Primary cystadenocarcinoma of the mesentery is an extremely rare malignant cystic epithelial tumor and represents the malignant spectrum of mesenteric mucinous cystic neoplasms. Due to its rarity, fewer than 25 cases have been reported in the literature, and the clinical characteristics, diagnostic features, and optimal management strategies remain poorly defined. Patients usually present with nonspecific symptoms related to mass effect, including abdominal pain, abdominal distension, nausea, vomiting, constipation, or a palpable abdominal mass, often mimicking ovarian or gastrointestinal tumors. Preoperative diagnosis is particularly challenging because radiological findings are not pathognomonic and tumor markers have limited diagnostic value. We report a rare case of primary mesenteric cystadenocarcinoma in a 20-year-old female who presented with progressive abdominal distension, abdominal pain, nausea, vomiting, constipation, and exertional shortness of breath. Clinical examination revealed a large abdominal mass. Contrast-enhanced positron emission tomography–computed tomography demonstrated a large lobulated abdominopelvic mass with internal septations and heterogeneous enhancement, producing significant mass effect including bilateral ureteric dilatation and hydronephrosis. However, the exact origin of the lesion could not be determined preoperatively. Exploratory laparotomy revealed a large cystic mass arising from the mesentery with dense adhesions to the colon. Complete surgical excision was performed without rupture. Histopathological examination confirmed papillary mucinous cystadenocarcinoma of mesenteric origin. This case highlights the diagnostic difficulty associated with mesenteric cystic malignancies and emphasizes that complete surgical excision remains essential for definitive diagnosis and management.
Abstract: Primary cystadenocarcinoma of the mesentery is an extremely rare malignant cystic epithelial tumor and represents the malignant spectrum of mesenteric mucinous cystic neoplasms. Due to its rarity, fewer than 25 cases have been reported in the literature, and the clinical characteristics, diagnostic features, and optimal management strategies remain...
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Research Article
Complications of Colon Surgery: Frequency and Management in the General Surgery Department of Chu Ignace Deen
Kondano Saa Yawo*,
Konate Adama,
Diallo Mamadou Malipha,
Soumaoro Labile Togba,
Condé Nantenin,
Fofana Houssein,
Toure Aboubcar
Issue:
Volume 14, Issue 2, April 2026
Pages:
35-38
Received:
26 January 2026
Accepted:
5 March 2026
Published:
26 March 2026
DOI:
10.11648/j.js.20261402.13
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Abstract: Introduction: The aim was to evaluate the management of postoperative complications of colonic surgery at the Ignace DEEN University Hospital (CHU) in Conakry. Materials and Methods: A two-year retrospective descriptive study (January 2023 to December 2024) conducted in the general surgery department of Ignace Deen University Hospital. All records of patients admitted and operated on in our department who presented with complications from colon surgery and those referred for colon complications after surgery in other facilities meeting our criteria were included in the study. Incomplete records were excluded. The variables analysed were sociodemographic, therapeutic and evolutionary characteristics. Results: The study examined 56 cases of patients with complications from colon surgery, representing 18.48% of the department's total activity. The average age was 35 years, with extremes of 20 and 90 years. We noted a predominance of the male sex (66.07%) with a sex ratio (M/F) of 1.94. Pelvic colon volvulus was the most common initial pathology (64.28%), followed by dolichocolon (32.14%). The initial surgical procedure consisted of a left hemicolectomy with immediate restoration of colorectal digestive continuity in 47 cases (83.93%), followed by the Hartmann procedure in 7 cases (12.50%) and right hemicolectomy with immediate restoration of digestive continuity in 2 cases (3.93%). The average time to the occurrence of complications was 21 days, with extremes of 3 and 19 days. Surgical site infection was the most frequent (46.43%), followed by digestive fistula (19.64%), postoperative peritonitis (16.07%). Staphylococcus aureus was the most frequently encountered germ (41.66%). Non-surgical treatment was carried out in more than half of our patients (58.93%), and re-laparotomy was necessary in 23 patients (41.07%). Postoperative outcomes were uncomplicated in 83.93%. The average length of stay was 30 days, with a range of 6 to 102 days. Conclusion: Postoperative complications of colonic surgery are frequent and serious. Early diagnosis and appropriate management help reduce morbidity and mortality.
Abstract: Introduction: The aim was to evaluate the management of postoperative complications of colonic surgery at the Ignace DEEN University Hospital (CHU) in Conakry. Materials and Methods: A two-year retrospective descriptive study (January 2023 to December 2024) conducted in the general surgery department of Ignace Deen University Hospital. All records ...
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