Hung Lau

BackgroundEndoscopic totally extraperitoneal inguinal hernioplasty (TEP) is an accepted technique for the repair of recurrent and bilateral inguinal hernia, but its role in the management of unilateral primary inguinal hernia remains controversial. The current randomized trial was undertaken to compare the postoperative and 1-year outcomes of day-case TEP and open Lichtenstein hernioplasty for unilateral primary inguinal hernia in males.MethodsFrom January 2002 to January 2004, a total ...

Background: Chronic groin pain after open inguinal hernia repair is a common long-term morbidity, but its incidence after endoscopic totally extraperitoneal inguinal hernioplasty (TEP) has not been studied in detail. The objective of this study was to evaluate the prevalence and severity of chronic groin pain after TEP. Methods: Between June 1999 and September 2001, 313 consecutive patients who underwent TEP at our institution were recruited. To evaluate the incidence and severity of ...

BACKGROUND: Carotid stenosis is a recognized complication of external irradiation to the head and neck for malignancy. This study aim to investigate the pattern and prevalence of radiation induced carotid disease, and to identify risk factors associated with significant stenosis.

METHODS: In a comparative cross-sectional study, carotid arteries color flow duplex scan was performed on 240 patients who had received external irradiation to the head and neck area, with a mean interval of 72 ...

OBJECTIVE: To compare the clinical outcome of simultaneous bilateral endoscopic totally extraperitoneal inguinal hernioplasty (TEP) using fibrin sealant (FS) and mechanical stapling for prosthetic mesh fixation.

SUMMARY BACKGROUND DATA: Similar efficacy of FS and mechanical stapling for mesh fixation has been demonstrated in a swine model, but no clinical trial has been conducted to compare the outcomes of TEP using these 2 fixation devices. FS adheres the prosthetic mesh without causing ...

BACKGROUND: The prevalence of extracranial carotid stenosis in the Chinese population is not known. This study aims to investigate and compare carotid disease in several groups of high-risk patients.

METHOD: Routine screening carotid duplex scans were performed on high-risk Chinese patients without cerebrovascular symptoms. These consisted of 249 patients with peripheral vascular disease, 207 patients with coronary artery disease, and 45 patients with abdominal aortic aneurysm. In ...

BACKGROUND: Intrahepatic recurrence continues to be the main cause of late death among hepatocellular carcinoma patients after hepatic resection. The aims of the current study were to identify the prognostic factors affecting long term survival and to evaluate the clinical value of pTNM classification as a prognostic factor for these patients. The identification of significant prognostic factors plays an important role in the selection of patients for postoperative adjuvant therapy and ...

BackgroundLaparoscopic repair of perforated peptic ulcer has been gaining popularity in recent years, but few data exist to support the superiority of the laparoscopic approach over open repair. The objective of the current study was to compare the safety and efficacy of open and laparoscopic repair of perforated peptic ulcer in an evidence-based approach using meta-analytical techniques.MethodsA search of electronic databases, including MEDLINE and EMBASE, was conducted to identify ...

Background: Pain is the most common complaint after inguinal hernia surgery. The present study was undertaken to evaluate the significance of various perioperative clinical factors on the severity of postoperative pain following endoscopic totally extraperitoneal (TEP) inguinal hernioplasty.Methods: Between November 1999 and December 2002, 509 patients who underwent unilateral (n = 389) and bilateral (n = 120) TEP were recruited for this study. There were 491 men and 18 women. Severity ...

OBJECTIVES: Although endoscopic totally extraperitoneal inguinal hernioplasty (TEP) confers superior early outcomes compared to those of open repair, the requirement of general anesthesia has been held as an argument against the application of TEP by opponents of laparoscopic surgery. To date, the literature on TEP performed under spinal anesthesia remains scarce. The present study reports our early experience performing TEP under spinal anesthesia in selected patients who were medically ...

BACKGROUND: Postoperative hepatic failure is the leading cause of hospital mortality following hepatectomy for hepatocellular carcinoma (HCC). This prospective study was performed to identify the best test for assessment of the adequacy of hepatic functional reserve in patients with HCC before hepatectomy.

METHODS: Between April 1989 and June 1993, 127 patients with HCC underwent hepatectomy. Each patient was evaluated before operation with the indocyanine green (ICG) clearance test, the ...

Background: There is no consensus on the best technique for the repair of umbilical hernia in adults. The role of laparoscopic hernioplasty of umbilical hernia remains controversial. This study was undertaken to compare the outcomes of open and laparoscopic onlay patch repair of umbilical hernia in adults. Methods: From January 1996 to December 2002, 102 patients underwent elective repair of umbilical hernia. Operative techniques included Mayo repair (n = 43), laparoscopic onlay Gore-Tex ...

BACKGROUND: During endoscopic totally extraperitoneal inguinal hernioplasty (TEP), complete reduction of the hernia sac is not always feasible because a sac extends into the scrotum or is adhesed. In such circumstances, ligation of the hernia sac appears to be a sound alternative to reduction. The present study was undertaken to evaluate the safety of sac ligation and the clinical results for patients who underwent ligation of an indirect hernia sac during TEP.

PATIENTS AND METHODS: From ...

BACKGROUND: There has been no consensus on the best catheterization strategy for the management of postoperative urinary retention. A prospective randomized trial was undertaken to establish the best practice guidelines for the management of postoperative urinary retention. The authors also evaluated the contemporary incidence of urinary retention following different categories of general surgery and examined risk factors associated with its occurrence.

METHODS: All patients who ...

Background: Because it mimics a postoperative recurrence of hernia, seroma has been a concern to patients. There has been no consensus on the management of this condition after endoscopic totally extraperitoneal inguinal hernioplasty (TEP). The objectives of the present study were to evaluate the incidence and treatment of seroma after TEP. Risk factors for the development of seroma were also examined. Methods: A total of 450 consecutive patients who underwent TEP between June 1999 and ...

BackgroundEarly laparoscopic cholecystectomy has been advocated for the management of acute cholecystitis, but little evidence exists to support the superiority of this approach over delayed-interval operation. The current systematic review was undertaken to compare the outcomes and efficacy between early and delayed-interval laparoscopic cholecystectomy for acute cholecystitis in an evidence-based approach using metaanalytical techniques.MethodsA search of electronic databases, ...