Long-term follow-up of a randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia (Br J Surg 2007; 94: 506–510)

✍ Scribed by T. Fujita

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 50 KB
• Volume: 94
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.5902

✦ Synopsis

the analysis and assessment of their respective contribution. We contend for example that the clinical status of patients at the time of arrival in the emergency department has never been appropriately taken into account in an analysis that could assess the influence of hospital delays.

We propose that it makes clinical sense that delays could be associated with perforation. We propose that our analysis (post-hoc), in a limited way, suggests a role for delays when confounding is taken into account. Until an analysis has properly taken into account all the factors mentioned above, we propose that ignoring delays would make no clinical sense, especially since our results point to ways of minimizing them. If one takes the point of view of the population and not only the point of view of the surgeons, one could even argue that we could explore ways of reducing pre-hospital delays (e.g. better training of first-line clinicians and better accessibility of first-line assessments). This would potentially further increase the benefits that would result from avoidance of perforation.