Subject(s)
Appendectomy/methods , Appendicitis/surgery , Humans , Recurrence , Reoperation , Risk FactorsABSTRACT
BACKGROUND: The optimum method for inguinal hernia repair has not yet been determined. The recurrence rate for non-mesh methods varies between 0.2 and 33 per cent. The value of tension-free repair with prosthetic mesh remains to be confirmed. The aim of this study was to compare mesh and non-mesh suture repair of primary inguinal hernias with respect to clinical outcome, quality of life and cost in a multicentre randomized trial in general hospitals. METHODS: Between September 1993 and January 1996, all patients scheduled for repair of a unilateral primary inguinal hernia were randomized to non-mesh or mesh repair. The patients were followed up at 1 week and at 1, 6, 12, 18, 24 and 36 months. Clinical outcome, quality of life and costs were registered. RESULTS: Three hundred patients were randomized of whom 11 were excluded. Three-year recurrence rates differed significantly: 7 per cent for non-mesh repair (n = 143) and 1 per cent for mesh repair (n = 146) (P = 0.009). There were no differences in clinical variables, quality of life and costs. CONCLUSION: Mesh repair of primary inguinal hernia repair is superior to non-mesh repair with regard to hernia recurrence and is cost-effective. Postoperative complications, pain and quality of life did not differ between groups.
Subject(s)
Hernia, Inguinal/surgery , Surgical Mesh , Suture Techniques , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Health Care Costs , Hernia, Inguinal/economics , Humans , Length of Stay , Male , Middle Aged , Pain, Postoperative/etiology , Quality of Life , Recurrence , Risk Factors , Surgical Mesh/economics , Suture Techniques/economics , Treatment OutcomeSubject(s)
Ankle Injuries/diagnosis , Ankle Injuries/therapy , Acute Disease , Ankle Injuries/diagnostic imaging , Athletic Injuries/diagnosis , Athletic Injuries/therapy , Diagnosis, Differential , First Aid , Humans , Netherlands , Practice Guidelines as Topic , Radiography , Sprains and Strains/diagnosis , Sprains and Strains/therapy , Time FactorsABSTRACT
A total of 144 evaluable patients with breast cancer were enrolled in a multicenter, randomized, prospective study to establish the role of delayed shoulder exercises on wound drainage and shoulder function after axillary lymph node dissection. Patients in group 1 (n = 78) started active shoulder exercises 1 day postoperatively. Patients in group 2 (n = 66) started on the eight postoperative day, following 1 week of immobilization of the arm. Patients in group 2 had 14% less wound drainage volume than those in group 1 (600 +/- 436 mL versus 701 +/- 398 mL); this difference, however, was not significant. Also, no differences could be established between the two groups when duration and volume of wound drainage, number and volume of seroma aspirations, wound complication rates, and shoulder function were compared 6 months after surgery.
