ABSTRACT
BACKGROUND: Laparoscopic ventral and incisional hernia repair has been reported in a number of small trials to have equivalent or superior outcomes to open repair. METHODS: Randomized controlled trials comparing laparoscopic and open incisional or ventral hernia repair with mesh that included data on effectiveness and safety were included in a meta-analysis. RESULTS: Eight studies met the inclusion criteria. There was no difference between groups in hernia recurrence rates (relative risk 1.02 (95 per cent confidence interval (c.i.) 0.41 to 2.54)). Duration of surgery varied. Mean length of hospital stay was shorter after laparoscopic repair in six of the included studies; the longest mean stay was 5.7 days for laparoscopic and 10 days for open surgery. Laparoscopic hernia repair was associated with fewer wound infections (relative risk 0.22 (95 per cent c.i. 0.09 to 0.54)), and a trend toward fewer haemorrhagic complications and infections requiring mesh removal. CONCLUSION: Laparoscopic repair of ventral and incisional hernia is at least as effective, if not superior to, the open approach in a number of outcomes.
Subject(s)
Hernia, Ventral/surgery , Laparoscopy/methods , Postoperative Complications/etiology , Surgical Mesh , Humans , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
"This paper synthesizes available research regarding the residency patterns of refugees in the United States." Consideration is given to the impact of policy on residency patterns and to the effect of secondary migration on the geographic distribution of refugees. "The first section of the paper presents an historical background to this issue, tracing the evolution of U.S. policy and outcomes from 1945 to the start of the Indochinese resettlement program in 1975. The second part focusses upon the residency patterns of the 1975 Indochinese arrivals, and the third section deals with refugees who have arrived since 1979."
