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  • Eklund, Arne, 1957-, et al. (författare)
  • A cost-minimisation analysis comparing TEP with Lichtenstein for treatment of inguinal hernia in Sweden
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Laparoscopic surgery has emerged as a new treatment modality for inguinal hernia. It is important to analyse its long-term costs in relation to other methods.Methods: A randomized multicenter study comparing totally extraperitoneal laparoscopic repair (TEP) with open repair according to Lichtenstein was performed on men with a primary inguinal hernia. Long-term follow-up collecting data on recurrences and complications up to five years after operation was carried out. Taking treatment costs into consideration, a cost-minimisation analysis was conducted.Results: Altogether 1370 patients were operated, 665 in the TEP and 705 in the Lichtenstein group. The total hospital cost for the index operation was €710.6 higher for TEP (P<0.001). Including costs for recurrences and complications, this difference increased to €795.1 (P<0.001). Taking community costs into account, the difference decreased with €503.1 to €292.0 (P=0.024).Conclusion: With five-year follow-up including complication, reoperation and community costs, there was a small but significant difference in total costs between the two methods.
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  • Eriksson, Jonathan, et al. (författare)
  • Preoperative MRI in women with newly diagnosed breast cancer: re-excision rates and additional findings
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • AbstractBackground: Preoperative breast magnetic resonance imaging (MRI) is still controversial as an adjunct to conventional breast cancer workup in terms of the effect on re-excision rates. Our objective was to analyse whether the introduction of preoperative breast MRI influences the rate of re-excisions in women with newly diagnosed breast cancer and to study the additional ipsi- and contralateral MRI findings and their impact on surgical management.Methods: Women with newly diagnosed breast cancer having preoperative MRI and surgery at Vastmanland County Hospital Breast Unit from January–June 2018 (n = 84) were compared with women not undergoing preoperative MRI from January–June 2016 (n = 97). Data were collected from retrospective reviews of patients’ medical records.Results: The re-excision rate was one of 84 (1.2%) in 2018 and three of 97 (3.1%) in 2016. There was no statistically significant difference in re-excision rates between the two study periods. In the MRI cohort, seven patients of 84 (8%) had malignancy in the ipsilateral and two (2%) in the contralateral breast not previously detected by conventional imaging. Additional malignant findings were more common in women of age < 59 years, and more often resulted in mastectomy.Conclusions: Preoperative breast MRI in women with newly diagnosed breast cancer did not reduce the number of re-excisions. Additional malignant findings were more common in women younger than 59 years and influenced surgical management. MRI resulted in no delay of surgery.
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