RESUMO
BACKGROUND AND AIMS: The aim of this prospective single-center study was to evaluate the outcome of inguinal hernia repair. MATERIALS AND METHODS: A total of 485 inguinal hernias (452 patients and 33 patients with bilateral hernias) were operated between January 2004 and December 2010. Mean age was 56 years, and 93% were male. Patient demographics and operative data were collected, and the operating surgeon assessed the technical difficulty of the operation. Five years after surgery, a questionnaire evaluated recurrence and chronic discomfort according to the Cunningham scale. 372 responded (82%), and mean follow-up was 5.5 years. RESULTS: There were 390 repairs for a primary and 62 for a recurrent hernia. Totally extraperitoneal (TEP) operation was most frequently performed (56%), transabdominal preperitoneal (TAPP) operation in 31%, and Lichtenstein and Shouldice in 12% and 2%, respectively. At 5-year follow-up, the primary outcome of chronic discomfort was 19.5%. The independent positive predictors were young age and operation for a recurrent hernia (OR: 3.7), with TEP operation reducing the risk of chronic discomfort (OR: 0.5). The secondary outcome was the recurrence rate of 2.5%. Risk factors were strenuous work (OR: 13.7), technically difficult repairs (OR: 7.2), and chronic discomfort (OR: 6.7). CONCLUSIONS: Every fifth patient had chronic discomfort in long-term follow-up. The recurrence rate was 2.5%, and a technically difficult procedure was a risk factor.
RESUMO
AIM: Cholecystectomy is a common procedure in general surgery. The aim of this study was to retrospectivly assess the results of cholecystectomies performed in Akranes Hospital (AH), a small hospital in Iceland. MATERIAL AND METHODS: This retrospective study included all patients that underwent a cholecystectomy in AH from 1 January 2003 to 31 December 2010. Patient records were reviewed from AH, as well as from Landspitali University Hospital and Domus Medica. RESULTS: 378 operations were performed. 74% of the patients were women and the mean age was 49.6 years. The majority of operations were elective (87%) and the median operative time was 46 minutes (range: 17-240). The median length of stay was 2 days (range: 1-31). Intra-operative cholangiography (IOC) was performed in 93 of 378 patients (25%). Endoscopic retrograde cholangiopancreatography, ERCP, was performed consecutively in 22 of those 93 patients (23%). The conversion rate to open surgery was 0.5%. The rate of serious complications was 2.4% of which four (1.1%) patients had a deep infection and 5 (1.3%) had a bile leakage postoperatively. Patients with cholecystitis had an increased risk of serious complications (p=0.007). Reoperation was performed on three patients who had bile leakage. No patient had a serious bile duct injury and mortality was 0%. 254 (67%) patients had 4 week control postoperatively where 13 patients (5%) had mild gastrointestinal symptoms. CONCLUSION: The results of cholecystectomies in AH are very good and comparable to the results of national and international studies. Key words: laparoscopic cholecystectomy, intra-operative cholangiography, choledocholithiasis, endoscopic retrograde cholangiopancreatography, complications. Correspondence: Marta Ros Berndsen, mrberndsen3@gmail.com.
