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  1. Laparoscopic versus open inguinal herniorrhaphy : preliminary results of a randomized controlled trial. Discussion.

    Article, Communication - En anglais

    Central Surgical Association. Annual meeting. Cleveland OH USA, 1995/03/09.

    Background

    Benefits of laparoscopic herniorrhaphy (LH) over open hernia repair (OH) remain unproved.

    Methods

    Interim analysis of a prospective randomized controlled trial compared OH with LH where study outcomes were measured by third-party evaluators through patient interviews.

    Results

    Both groups were well matched for all baseline parameters, although LH patients anticipated a quicker postoperative recovery than OH (p=0.014).

    No significant difference was noted in operating time or surgeon operative satisfaction.

    The median duration of hospital stay was 1 day in both groups ; LH patients made use of significantly less postoperative narcotics than OH (p=0.02).

    No difference was observed in the durations of convalescence (LH, 9.6 ± 7.6 days ; OH, 10.9 ± 7.4 days).

    Greater improvements in quality of life were exhibited in LH patients than OH patients 1 month after operation (p=0.035), with one of the two measures used.

    A greater percentage of LH patients seemed « very satisfied with their operation » (p=0.07).

    Complication rates were similar, and a single recurrence, in a patient in the OH group, has been observed after a median follow-up of 14 months.

    Conclusions

    Direct cost measurements showed LH to be 40% more expensive than OH in the context of a Canadian-type health care system.

    To date, benefits in postoperative pain and possibly quality of life have been detected in the LH group. (SURGERY 1995 ; 118 : 703-10.).

    Mots-clés Pascal : Herniorraphie, Laparoscopie, Hernie, Inguinal, Coût, Essai thérapeutique contrôlé, Traitement, Homme, Canada, Amérique du Nord, Amérique, Chirurgie, Endoscopie, Abdomen pathologie, Chirurgie endoscopique

    Mots-clés Pascal anglais : Herniorrhaphy, Laparoscopy, Hernia, Inguinal, Costs, Controlled therapeutic trial, Treatment, Human, Canada, North America, America, Surgery, Endoscopy, Abdominal disease, Endoscopic surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0571104

    Code Inist : 002B13D03. Création : 01/03/1996.