Synthetic Versus Biological Mesh in Laparoscopic and Open Ventral Hernia Repair (LAPSIS): Results of a Multinational, Randomized, Controlled, and Double-blind Trial.

Objective: The aim of this study was to investigate the approach (open or laparoscopic) and mesh type (synthetic or biological) in ventral hernias in a clean setting.Summary of Background Data: The level of evidence on the optimal surgical approach and type of mesh in ventral hernia repair is still low.

Methods: Patients with a ventral abdominal hernia (diameter 4-10 cm) were included in this double-blind randomized controlled trial across 17 hospitals in 10 European countries.

Lower incidence of hepatic metastases of colorectal cancer in patients with chronic liver diseases: meta-analysis.

Background/aims: The rarity of metastatic malignancy in injured liver has been noticed. This meta-analysis evaluates the difference in occurrence of metastatic colorectal cancer in healthy and chronically injured liver.

Methodology: Literature search of occurrence of metastatic colorectal cancer in chronically injured liver opposed to healthy liver was conducted.

Suture granuloma of the abdominal wall with intra-abdominal extension 12 years after open appendectomy.

Most complications after appendectomy occur within ten days; however, we report the unusual case of a suture granuloma 12 years after open appendectomy. The afebrile 75-year-old woman presented with a slightly painful palpable mass in the right lower abdomen. There was no nausea or vomiting and bowel movements were normal.

The current evidence on stapled versus hand-sewn anastomoses in the digestive tract.

The innovation process and developments in technology have given surgeons new products which can improve their performance and benefit our patients. Before the era of laparoscopic surgery one of the most important applications in surgical practice was the introduction of staplers. In this article, the evidence supporting the decision whether to use a mechanical device (stapler) or to make a hand-sewn anastomosis is presented.

[Fast track surgery--enhanced multimodal rehabilitation after surgery].

Despite constant improvements in surgical technique and perioperative care which led to significant reductions in mortality and morbidity after general surgery, complication rates after major abdominal surgery still reach 15-40%. The main cause of postoperative complications (not linked to surgical technique itself) is the perioperative stress reaction potentiated by pain, inadequate perioperative fluid management, immobilisation and hypothermia. Multimodal rehabilitation of surgical patients represents the practical application of advances in surgery, anaesthesiology and postoperative rehabilitation with the aim of reducing perioperative stressors and facilitating an early return of the patient to his/her preoperative functional status.

Patient-reported outcomes. How important are they?

Outcome after surgical treatment has been based predominantly on objective criteria (biomedical model) and has largely ignored, until recently, the expectations, personal feelings, satisfaction, and quality of life of patients (outcomes model). The importance of this derives from considerations that the viewpoints and priorities of patients may not be the same as those of their surgeons. Furthermore, there is often little correlation between symptom severity and disease severity.

Improving comprehension of informed consent.

Objective: To explore the way the doctor-patient communication process may be improved by adopting the patients' conversational style in the development of written materials for surgical patients.

Methods: Written information prepared by doctors, specialists in abdominal surgery, was tested for comprehension on patients undergoing cholecystectomy, using the standard Cloze test procedure. At the same time, the patients were asked to describe in their own words all they knew about their illness and the treatment.

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery.

Background: Measuring health-related quality of life (QoL) after surgery is essential for decision making by patients, surgeons, and payers. The aim of this consensus conference was twofold. First, it was to determine for which diseases endoscopic surgery results in better postoperative QoL than open surgery.

Extent of oncological resection in laparoscopic vs. open colorectal surgery: meta-analysis.

Background: Laparoscopy is not yet wide accepted in cancer colorectal surgery. This study investigated whether the extent of anatomical resection in laparoscopic colorectal surgery is equivalent to that in the open colorectal surgery.

Materials And Methods: We examined reports on the results of laparoscopic or open colorectal procedures published between 1990 and 1999 and selected 35 with data on lymph node count and distal margin clearance (total of 3935 patients).

[Partial laryngectomies].

After introduction of partial laryngectomies into the treatment of malignant larynx tumors, within a research project we analyzed symptoms, occurrence and the type of partial larynx resections for the two year period (October 1990 to September 1992). During this period of time 111 patients with malignant tumors were operated, while total laryngectomy was performed in 50 (45.0%).