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Scientific Surgery

Liem MSL, van Duyn EB, van der Graaf Y, morbidity (20·6 per cent versus 38·3 per cent) and shortened
van Vroonhoven TJMV on behalf of the COALA Trial postoperative stay in hospital (10·4 days versus 12·5 days).
Group. Recurrences after conventional anterior and
laparoscopic inguinal hernia repair: a randomized Libertiny G, Knight JS, Farouk R. Randomised trial of topical
comparison. Ann Surg 2003; 237: 136–141. 0·2% glyceryl trinitrate and lateral internal sphincterotomy
Some 994 patients were included and followed for five years. for the treatment of patients with chronic anal fissure: long
Laparoscopic repair had a lower recurrence rate and less chronic term follow-up. Eur J Surg 2002; 168: 418–421.
groin pain. Recurrence was particularly frequent after Bassini repair.
This study compared outcomes two years after 70 patients were
randomised. All those who had surgery had healed fissures, and only
Bringman S, Ramel S, Heikkinen T-J, Englund T, Westman B, one recurred. Some 19 of 35 fissures healed with GTN, and three
Anderberg B. Tension-free inguinal hernia repair: TEP recurred. Those whose fissures didn’t heal with GTN all had successful
surgery later.
versus mesh-plug versus Lichtenstein: a prospective
randomized controlled trial. Ann Surg 2003; 237: 142–147.
There were two recurrent hernias each in the mesh plug and Lygidakis NJ, Sgourakis G, Georgia D, Vlachos L, Raptis S.
laparoscopic groups after mean follow-up of 20 months in this trial Regional targeting chemoimmunotherapy in patients
that included 294 procedures. Totally extraperitoneal hernia repair was undergoing pancreatic resection in an advanced stage of their
associated with less postoperative pain and shorter sick leave. disease: a prospective randomized study. Ann Surg 2002; 236:
Sutherland LM, Burchard AK, Matsuda K, Sweeny JL, Some 128 patients were randomized into three groups after pancreatic
resection. The addition of locoregional chemotherapy through a superior
Bokey EL, Childs PA et al. A systematic review of stapled
mesenteric artery cannula, with, or without, systemic chemotherapy
hemorrhoidectomy. Arch Surg 2002; 137: 1395–1406.
improved five year survival over surgery alone (10, 18 and 0 per cent,
Seven studies were included. Stapled haemorrhoidectomy reduced the respectively).
incidence of bleeding at two weeks after surgery and length of hospital
stay. Other variables in favour of the stapled procedure had less robust
results. Hulscher JBF, van Sandick JW, de Boer AGEM,
Wijnhoven BPL, Tijssen JGP, Fockens P et al. Extended
transthoracic resection compared with limited transhiatal
Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM,
resection for adenocarcinoma of the esophagus. N Engl J Med
Shapiro MJ et al. on behalf of the EPO Critical Care Trials
2002; 347: 1662–1669.
Group. Efficacy of recombinant human erythropoietin in
Perioperative morbidity was lower after transhiatal surgery in this study
critically ill patients. A randomized controlled trial. JAMA that included 220 operations. After five years, however, there was a
2002; 288: 2884–2886. trend towards improved survival after extended transthoracic resection:
Some 1302 long stay patients in intensive care were included. 39 per cent versus 29 per cent, 95 per cent confidence interval for the
Erythropoietin did not affect mortality (14 versus 15 per cent after difference – 3 to 23 per cent.
placebo) or complication rates, but reduced the requirement for blood
transfusion: odds ratio 0·67, 95 per cent confidence intervals 0·54–0·83.
Singer MA, Nelson RL. Primary repair of penetrating colon
injuries: a systematic review. Dis Colon Rectum 2002; 45:
Thomas SH, Silen W, Cheema F, Reisner A, Aman S, 1579–1587.
Goldstein JN et al. Effects of morphine analgesia on Five randomized studies that compared primary repair with faecal
diagnostic accuracy in emergency department patients with diversion were analysed. Primary repair appeared to reduce the rate of
abdominal pain: a prospective, randomized trial. J Am Coll complications, although it did not affect overall survival.
Surg 2003; 196: 18–31.
Seventy-four patients with undiagnosed abdominal pain were ran- The trials listed here are added to the Scientific Surgery
domized to morphine or placebo. Morphine analgesia did not affect Archive which contains all randomized clinical trials in
diagnostic accuracy or clinical course.
Surgery that have been identified by searching the top
50 English language medical journal issues since January
Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, 1998. The Archive, which is fully searchable, can be
Gruarin P et al. Laparoscopic versus open colorectal surgery: found on the BJS website (www.bjs.co.uk) together with
a randomized trial on short-term outcome. Ann Surg 2002; other useful features for surgeons such as Instructions
236: 759–767. to Authors, EarlyView of accepted articles and on-line
The conversion rate was 5·1 per cent in this trial that included 269 pro- Correspondence.
cedures. Laparoscopic colectomy significantly reduced postoperative DOI: 10.1002/bjs.4329

Copyright  2003 British Journal of Surgery Society Ltd British Journal of Surgery 2003; 90: 891
Published by John Wiley & Sons Ltd