How I do it: using a hammock mesh in the reconstruction of inguinal ligament during a wide en-bloc resection of a groin mesenchymal tumor

PURPOSE

In case of soft tissue sarcomas (STS), an en-bloc resection with safe margins is recommended. To ensure safe removal without tumor rupture, STS of the groin area, retroperitoneal or pelvic mesenchymal tumors may require incision or resection of the inguinal ligament. Solid reconstruction is mandatory to prevent early and late postoperative femoral hernias. We present here a new technique of inguinal ligament reconstruction.

METHODS

Between September 2020 and September 2022, patients undergoing incision and/or resection of inguinal ligaments during a wide en-bloc resection of STS of the groin area in the Department of General Surgery in Strasbourg were included. All patients had an inguinal ligament reconstruction with biosynthetic slowly resorbable mesh shaped as a hammock, pre- or intraperitoneally, associated or not with loco-regional pedicled muscular flaps.

RESULTS

A total of 7 hammock mesh reconstructions were performed. One or several flaps were necessary in 57% of cases (4 patients): either for inguinal ligament reconstruction only (n = 1), for recovering of femoral vessels (n = 1), and for both ligament reconstruction and defect covering (n = 2). The major morbidity rate was 14.3% (n = 1), related to a thigh surgical site infection due to sartorius flap infarction. After a median follow-up of 17.8 months (range 7-31), there was neither early nor late occurrence of post-operative femoral hernia.

CONCLUSIONS

This is a new surgical tool for inguinal ligament reconstruction with the implementation of a biosynthetic slowly resorbable mesh shaped as a hammock, which should be compared to other techniques.

Prevalence of chronic diseases among United Arab Emirates University students: cross-sectional study

Background

Chronic disease burden is increasing globally. In Arab Gulf Countries, the burden has increased exponentially over the past five decades due to rapid economic growth and urbanization. In the United Arab Emirates (UAE), chronic diseases are the leading cause of mortality and economic burden, hence, there is need to explore their patterns for targeted interventions. Studies among university students in Europe and the United States show chronic diseases prevalence ranging from 16.5% to 30.0%, respectively. To our knowledge, this is the first study in the Gulf region to assess multiple chronic diseases among university students. Our study describes the prevalence and patterns of multiple chronic diseases among UAE University (UAEU) students.

Methods

We conducted a descriptive cross-sectional study among UAEU students ≥18years from July to October 2021. Online questionnaire was used to collect data. Self-reported chronic diseases were described and compared between male and female students using chi-square and t tests. Other students’ characteristics were also explored. All analyses were conducted using STATA statistical software.

Results

902 students participated in the study with mean age of 21.9±5.2yrs. 79.8% were females. 80.7% were undergraduates. The prevalence of self-reported chronic diseases was 23.0%. Obesity, Diabetes and Asthma/Allergies were the commonest (12.5%, 4.2% & 3.2%, respectively). 34.8% of the students were either overweight or obese. Overall chronic disease prevalence was similar between males and females [27.5% vs 21.8%, 0.104] though it was significantly higher among postgraduates, students who are older, married and have family history of diabetes. 4.7% of the students reported 2 or more chronic diseases.

Conclusions

Our study showed that more than 1 in 5 of the students reported at least one chronic disease. This shows the need for proactive chronic disease screening and prevention programs to meet the health needs of the students.

Key messages

• Prevalence of chronic diseases (Diabetes, Prediabetes, Obesity, Hypertension, Asthma/Allergies, Lipid disorders, Thyroid disorders, GI disorders, and CVDs) was high among the university students.

• Universities should commit to researching students’ health and creating targeted health policies and interventions, as chronic diseases have direct and indirect negative impact on students’ education.