Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
Add more filters










Database
Language
Publication year range
2.
Hernia ; 20(3): 349-56, 2016 06.
Article in English | MEDLINE | ID: mdl-27048266

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate whether a relation exists between surgical expertise and incidence of chronic postoperative inguinal pain (CPIP) after inguinal hernia repair using the Lichtenstein procedure . BACKGROUND: CPIP after inguinal hernia repair remains a major clinical problem despite many efforts to address this problem. Recently, case volume and specialisation have been found correlated to significant improvement of outcomes in other fields of surgery; to date these important factors have not been reviewed extensively enough in the context of inguinal hernia surgery. METHODS: A systematic literature review was performed to identify randomised controlled trials reporting on the incidence of CPIP after the Lichtenstein procedure and including the expertise of the surgeon. Surgical expertise was subdivided into expert and non-expert. RESULTS: In a total of 16 studies 3086 Lichtenstein procedures were included. In the expert group the incidence of CPIP varied between 6.9 and 11.7 % versus an incidence of 18.1 and 39.4 % in the non-expert group. Due to the heterogeneity between groups no statistical significance could be demonstrated. CONCLUSION: The results of this evaluation suggest that an association between surgical expertise and CPIP is highly likely warranting further analysis in a prospectively designed study.


Subject(s)
Hernia, Inguinal/surgery , Herniorrhaphy/adverse effects , Herniorrhaphy/standards , Pain, Postoperative/etiology , Chronic Pain/etiology , Clinical Competence , Herniorrhaphy/methods , Herniorrhaphy/statistics & numerical data , Humans , Incidence , Surgical Mesh/adverse effects
3.
Br J Surg ; 90(3): 320-4, 2003 Mar.
Article in English | MEDLINE | ID: mdl-12594667

ABSTRACT

BACKGROUND: Duodenum-preserving resection of the head of the pancreas (DPRHP) according to Beger has been developed as an alternative to pylorus-preserving resection of the pancreatic head for painful chronic pancreatitis. METHODS: Between 1988 and 2000, 36 consecutive DPRHPs were performed. The group was divided into patients with (group 1; n = 23) and without (group 2; n = 13) significant enlargement of the pancreatic head. Pain was the indication for surgery in all patients. RESULTS: Complications occurred in 12 patients, necessitating reoperation in 11. Initial overall results were favourable; significant improvement or complete relief of pain was reported in 27 of 35 patients. Long-term results were obtained in 27 of 30 patients; the overall success rate was 16 of 27, 13 of 16 patients with distinct enlargement of the pancreatic head and 3 of the 11 with minimal or no enlargement (P = 0.018). CONCLUSION: DPRHP can be performed with good early results. This effect is sustained in patients with distinct localized disease of the pancreatic head. In those without, the long-term results are disappointing.


Subject(s)
Pancreas/pathology , Pancreatitis/pathology , Adult , Cholangiopancreatography, Endoscopic Retrograde/methods , Chronic Disease , Cohort Studies , Female , Humans , Male , Middle Aged , Pain, Intractable/etiology , Pain, Intractable/surgery , Pancreas/diagnostic imaging , Pancreas/surgery , Pancreatitis/diagnostic imaging , Pancreatitis/surgery , Prognosis , Survivors , Tomography, X-Ray Computed/methods
SELECTION OF CITATIONS
SEARCH DETAIL
...