Which is the best laparoscopic approach for inguinal hernia repair : TEP or TAPP? A systematic review of the literature with a network meta-analysis

Background Totally extraperitoneal (TEP) repair and transabdominal preperitoneal (TAPP) repair are the most used laparoscopic techniques for inguinal hernia treatment. However, many studies have shown that laparoscopic hernia repair compared with open hernia repair (OHR) may offer less pain and shorter convalescence. Few studies compared the clinical efficacy between TEP and TAPP technique. The purpose of this study is to provide a comparison between TEP and TAPP for inguinal hernia repair to show the best approach. Methods We performed an indirect comparison between TEP and TAPP techniques by considering only randomized, controlled trials comparing TEP with OHR and TAPP with OHR in a network meta-analysis. We considered the following outcomes: operative time, postoperative complications, hospital stay, postoperative pain, time to return to work, and recurrences. Results The two techniques improved some short outcomes (such as time to return to work) with respect to OHR. In the network meta-analysis, TEP and TAPP were equivalent for operative time, postoperative complications, postoperative pain, time to return to work, and recurrences, whereas TAPP was associated with a slightly longer hospital stay compared with TEP. Conclusions TEP and TAPP improved clinical outcomes compared with OHR, but the network meta-analysis showed that TEP and TAPP efficacy is equivalent. TAPP was associated with a slightly longer hospital stay compared with TEP

Constraint Handling Rules - What Else?

www.constraint-handling-rules.org Abstract. Constraint Handling Rules (CHR) is both an effective con-current declarative constraint-based programming language and a versa-tile computational formalism. While conceptually simple, CHR is distin-guished by a remarkable combination of desirable features: – a semantic foundation in classical and linear logic, – an effective and efficient sequential and parallel execution model – guaranteed properties like the anytime online algorithm properties – powerful analysis methods for deciding essential program properties. This overview of some CHR-related research and applications is by no means meant to be complete. Essential introductory reading for CHR provide the survey article [125] and the books [56, 63]. Up-to-date in-formation on CHR can be found online at the CHR web-page www. constraint-handling-rules.org, including the slides of the keynote talk associated with this article. In addition, the CHR website dtai

Molecular aspects of tissue engineering in the dental field

Tissue engineering is a multidisciplinary field with the potential to replace tissues lost as a result of trauma, cancer surgery, or organ dysfunction. The successful production, integration, and maintenance of any tissue-engineered product are a result of numerous molecular interactions inside and outside the cell. We consider the essential elements for successful tissue engineering to be a matrix scaffold, space, cells, and vasculature, each of which has a significant and distinct molecular underpinning (Fig. 1). Our approach capitalizes on these elements. Originally developed in the rat, our chamber model (Fig. 2) involves the placement of an arteriovenous loop (the vascular supply) in a polycarbonate chamber (protected space) with the addition of cells and an extracellular matrix such as Matrigel or endogenous fibrin (34, 153, 246, 247). This model has also been extended to the rabbit and pig (J. Dolderer, M. Findlay, W. Morrison, manuscript in preparation), and has been modified for the mouse to grow adipose tissue and islet cells (33, 114, 122) (Fig. 3)..