Two Controversial Concepts: Standard Procedure in a Standard Patient Versus Tailored Surgery with Procedures Adjusted to Individual Patients
Surgeons have been working for decades to improve their technique and to develop better procedures. In doing so, they try to prove the effect of every modification by clinical randomized controlled trials (RCTs). The process should result in a best technique that can then be considered the gold standard. This recommendation is outlined in so-called guidelines offering evidence-based knowledge to every physician. However, although RCTs have been performed with increasing efforts, these often fail to confirm any significant differences between the groups involved. Furthermore, after replication by other investigators, the overall results differ considerably in outcome, making interpretation of the results rather complicated. Even the collection of several trials in meta-analyses often does not ease interpretation. It appears that for some questions, the RCT instrument needs some support to verify the superiority of one procedure over another.
KeywordsHernia Repair Incisional Hernia Standard Patient Mesh Repair Technical Failure
Unable to display preview. Download preview PDF.
- 9.Rosemar A, Hana N, Ulf A, Staffan H, Pär N (2008) Groin hernia surgery and body mass index: a study based on a national register (S) In: Proceedings of the 30th Congress of EHS GREPA, Sevilla, Spain, 7–10 May 2008Google Scholar