Since combined therapy with octreotide and tamoxifen can be administered comfortably for outpatient treatment, this seems to represent progress in the palliative therapy of pancreatic cancer.

Laparoscopic inguinal hernia repair by means of the transabdominal preperitoneal technique (TAPP) was compared with open plug-and-patch-repair (PP) in a prospective study. From September 1992 until July 1994, 86 patients were operated using the TAPP technique; after introduction of PP in August 1994, 105 patients were operated using this technique. From August 1994 until April 1995, 24 more patients wanted the laparoscopic procedure. The two groups were comparable with regard to age, sex and the distribution of hernia types. Eighty-eight (84%) of the PP patients were operated under local anesthesia, while the others chose general anesthesia. The only intraoperative complication was a bleeding from the epigastric vessel in the laparoscopic group. Postoperative complications were three wound hematomas after TAPP (2.2%) and two wound hematomas and one superficial wound infection after PP (2.4%). All complications healed spontaneously. No detectable statistical difference was noted between the two groups with respect to postoperative pain, the consumption of analgetics, duration of hospitalization and reconvalescence. After a median follow-up of 34 months, two recurrences after TAPP (1.4%) and no recurrences after PP has been detected. Based on our experience we prefer PP for inguinal hernia repair in adults because it affords the same patient comfort as TAPP but is less expensive and can be performed under local anesthesia.

A retrospective study of the possible value of standardized follow-up examinations was undertaken in a group of 251 patients (163 men, 88 women; mean age at diagnosis 58 [33-78] years) who had undergone putatively curative gastric resection for adenocarcinoma between 1.1. 1978 and 31. 12. 1987 and had survived at least 3 months after the operation. 113 patients (45%) regularly had follow-up examinations according to a standardized diagnostic protocol, 67 (27%) only irregularly, while 71 (28%) had none. Follow-up examination revealed tumour recurrence in 53 patients (30%), which in 18 (34%) was still asymptomatic. In one of these patients resection of the recurrence was again undertaken with curative intent, a palliative operation was performed in five, chemotherapy in seven, three received radiotherapy and 37 were treated purely symptomatically. The results do not indicate that the survival rate was improved by the standardized follow-up protocol and it is concluded that symptom-oriented and individualized follow-up examination without standardized protocol is sufficient in this type of case, except for scientific purposes.