Laparoscopic versus open repair of inguinal hernia: a prospective randomised trial

Inguinal hernia repair is one of the most common elective operations performed in general surgery, but the most effective surgical technique is unknown. The aim of this study is to compare laparoscopic repair with open repair of inguinal hernias. 40 patients with inguinal hernias from Misr University for Science and Technology hospital were randomly assigned to open repair with mesh fixation [n=20] and laparoscopic repair with mesh fixation [n=20]. Both groups were compared regarding operative time, intra-operative complications, and duration of hospital stay and as regards postoperative complications in the first week after surgery. The mean operative time for laparoscopic inguinal hernia repair was much longer than that for open repair [p<0.001] but hospital stay was much shorter for the laparoscopic group than for the open group [p<0.001]. Intra-operative complications were more common in the laparoscopic than in the open group but still not statistically significant. Postoperative complications in the first week after surgery were more common in the open group than in the laparoscopic group especially the local wound complications and especially in the recurrent cases. Laparoscopic inguinal hernia repair is an accepted method of repair especially for recurrent cases

Recurrent laryngeal nerve exploration in thyroid gland surgery: a prospective randomized trial

To determine whether intra-operative identification of the Recurrent Laryngeal Nerve reduces the incidence of permanent recurrent laryngeal nerve paralysis [RLNP] and its influence on temporary RLNR. In Misr University for Science and Technology Hospital during the period from September2000 to September 2002. Prospective blind randomized clinical study. Fifty consecutive patients undergoing thyroid surgery; were randomized to two groups 25 patients each. In group [A], recurrent laryngeal nerve was explored routinely while in group [B] no nerve exploration was done. Indirect laryngoscopy was done for vocal cords examination preoperatively and was repeated at one week, one month, and six months after the operation. Permanent recurrent laryngeal nerve palsy was defined as clinical dysphonia lasting for 6 months with proven immobile vocal cords on indirect laryngoscopy. In group [A] two patients had temporary symptomatic recurrent laryngeal nerve palsy [8%], both improved during the 6 months follow up period Incidence of permanent RLNP was therefore 0%. In group [B] also two patients bad symptomatic RLNP [8%] one continued to have symptomatic recurrent laryngeal nerve palsy at the 6 month postoperative examination i.e. permanent RLNP. Indirect Iaryngoscopy should be performed routinely for patient undergoing thyroid surgery prior to surgery and revised at least during ex-tubation. Whenever extracapsular thyroid surgery is performed, RLN exploration should be done