Inguinal hernia is the commonest surgical operation. This is a large study from a district general hospital. The study spanned over 2 years with 2 further years of follow up. It is a retrospective analysis of eight hundred and seventy seven (877)inguinal hernia operations performed in a district general hospital. The following factors were looked at: type of repair, grade of surgeon performing the procedure and outcome of various repairs. The results showed that the most common technique was the Lichenstein's repair(58%). Recurrence rates were between 0.4%-30% depending on types of hernia repair.
IntroductionThe automated breast volume scanner (ABVS) is the fi rst of its kind and utilises a large, 17 cm × 15 cm high-frequency ultrasound probe which sweeps across the whole breast generating images that can be reformatted into multiple planes and a 3D volume. ABVS will change breast ultrasound practice by: introducing operator standardisation, reproducibility and repeatability of measurement and interpretation; changing who acquires the volume set and how breast ultrasounds are reported; and allowing accurate comparison of previous and current examinations for screening and assessing treatment change. Methods Patients presented to the symptomatic clinic for conventional 2D ultrasound assessment with a variety of conditions. An additional ABVS was performed. Results Cases were classifi ed into: benign -for example, cysts, fi broadenomas, diabetic mastopathy; and malignant. Conclusion We present a review of our initial experience and highlight its advantages over conventional ultrasound, which include: improved mapping of lesions enabling more accurate future assessment and follow-up, and improved assessment of distortion over conventional 2D ultrasound. Further research is required to explore other potential benefi ts. Introduction A study of symptomatic breast units geographically spread over Ireland collected image quality, compression and radiation dose data from 18 mammography units; so how do these optimisation parameters compare nationally and internationally? The mean glandular dose (MGD) diagnostic reference level was proposed for the all-digital breast screening service [1] but not for the symptomatic breast service. Methods The quantitative and qualitative data were analysed using SPSS. Recommendations of MGD diagnostic reference levels were made at various levels for fi lm-screen mammography (FSM) and full-fi eld digital mammography (FFDM) units to match those levels published in worldwide. O2 Symptomatic breast services inResults MGDs received by symptomatic breast patients within Ireland are higher than those received in the all-digital Irish Breast Screening service, although the diff erences for FFDM are not substantial; 55 to 65 mm breast: 1.75 mGy (screening) versus 2.4 mGy (symptomatic) at the 95th percentile. The four-view routine mammography MGDs obtained in symptomatic breast units in Ireland are, however, substantially diff erent from other screening units with mixed FSM/FFDM modalities: 4.5 mGy (UK); 4.98 mGy (USA) versus 5.96 mGy (FFDM, symptomatic) and 9.63 mGy (FSM, symptomatic). Various reasons are proposed for the diff erences. Conclusion MGD diagnostic reference levels achieved in the screening service may be lower due to the exacting requirements for radiographer training, nonsurgical alteration of patient breasts and equipment quality assurance levels. Greater training of radiographers performing mammography in the symptomatic breast services is required to standardise mammographic projections with regard to MGDs delivered. Reference O3Correlations between shear wave elastog...
Introduction: The aim was to compare the accuracy of standard supplementary views and GE digital breast tomosynthesis (DBT) for assessment of soft tissue mammographic abnormalities. Methods: Women recalled for further assessment of soft tissue abnormalities were recruited and received standard supplementary views (typically spot compression views) and two-view GE DBT. The added value of DBT in the assessment process was determined by analysing data collected prospectively by unblinded radiologists working up the cases. Following anonymisation of cases, there was also a retrospective multireader review. The readers first read bilateral standard two-view digital mammography (DM) together with the supplementary mammographic views and gave a combined score for suspicion of malignancy on a fivepoint scale. The same readers then read bilateral standard two-view DM together with two-view DBT. Pathology data were obtained. Differences were assessed using ROC analysis. Results: The study population was 342 lesions in 322 patients. Final diagnosis was malignant in 113 cases (33%) and benign/normal in 229 cases (67%). In the prospective analysis, the performance of two-view DM plus DBT was at least equivalent to the performance of two-view DM and standard mammographic supplementary views-area under the curve (AUC) was 0.946 and 0.922 respectively, which did not reach statistical significance. Similar results were obtained for the retrospective review-AUC was 0.900 (DBT) and 0.873 (supplementary views), which did not reach statistical significance. Conclusion: The accuracy of GE DBT in the assessment of screendetected soft tissue abnormalities is equivalent to the use of standard supplementary mammographic views.
Introduction: The aim was to compare the accuracy of standard supplementary views and GE digital breast tomosynthesis (DBT) for assessment of soft tissue mammographic abnormalities. Methods: Women recalled for further assessment of soft tissue abnormalities were recruited and received standard supplementary views (typically spot compression views) and two-view GE DBT. The added value of DBT in the assessment process was determined by analysing data collected prospectively by unblinded radiologists working up the cases. Following anonymisation of cases, there was also a retrospective multireader review. The readers first read bilateral standard two-view digital mammography (DM) together with the supplementary mammographic views and gave a combined score for suspicion of malignancy on a fivepoint scale. The same readers then read bilateral standard two-view DM together with two-view DBT. Pathology data were obtained. Differences were assessed using ROC analysis. Results: The study population was 342 lesions in 322 patients. Final diagnosis was malignant in 113 cases (33%) and benign/normal in 229 cases (67%). In the prospective analysis, the performance of two-view DM plus DBT was at least equivalent to the performance of two-view DM and standard mammographic supplementary views-area under the curve (AUC) was 0.946 and 0.922 respectively, which did not reach statistical significance. Similar results were obtained for the retrospective review-AUC was 0.900 (DBT) and 0.873 (supplementary views), which did not reach statistical significance. Conclusion: The accuracy of GE DBT in the assessment of screendetected soft tissue abnormalities is equivalent to the use of standard supplementary mammographic views.
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