Laparoscopic surgery has recently become commonplace in the general surgeon's armamentarium of surgical approaches to many problems. This has been seen most notably with laparoscopic cholecystectomies. Herein is reported a case of an incidental benign stromal tumor of the stomach being resected laparoscopically.
Over a 2-year period 157 inguinal hernias in 151 patients were consecutively entered in this descriptive, observational study to determine any difference in outcome between a laparoscopic inguinal hernia repair versus an open inguinal hernia repair in a community hospital setting. The laparoscopic transabdominal preperitoneal technique was utilized in 50 cases. A conventional open repair was used in 107 cases. There were statistically significant differences when the laparoscopic and open groups were compared for the number of days until driving a car (p < 0.01), the number of days until getting in and out of bed comfortably (p = 0.01), the number of days until working on a limited basis (p = 0.01), and the number of days until working on a full-time basis (p < 0.05), although these differences may be due to confounding factors in this nonrandomized study. The average length of operating time was 72.2 min laparoscopic versus 51.6 min open (p < 0.001). We have shown that laparoscopic inguinal hernia repairs may have benefits over conventional hernia repairs. This may make its use more widespread than it has already become.
Stereotactic core needle biopsies (SCNBs) are accurate and relatively convenient for the patient; however, the long-term follow-up of benign results has not been reported. All patients between 1993 and 1998 undergoing SCNB at a community-based hospital were entered into a registry. Follow-up was obtained by a retrospective analysis of the charts. Biopsies were performed on 865 lesions. One hundred thirty-one (15%) were malignant, 42 (5%) were suspicious for malignancy, 687 (79%) were benign, and five (1%) were lobular carcinoma in situ. Of the 42 patients with suspicious findings 38 underwent biopsy. Ten were malignant and 28 benign. Of the 687 patients with benign pathology, 377 had follow-up available with a mean length of 1.7 years. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SCNB for benign lesions in our study are all 100 per cent. Eight lesions were worrisome and await final analysis. Of 687 patients with benign lesions 310 were lost to follow-up. This study suggests that patients with a benign diagnosis should be returned to routine mammography. These data also extend the reported follow-up to 1.7 years and establish an acceptable level of accuracy for SCNB. The lost patients remind us that follow-up is essential despite a benign diagnosis.
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