There are at least 20 studies in the literature. The most recent paper by O'Leary DH et al, NEJM 1999;340:14-22 was a prospective study with a sample size of 5858 subjects and a median follow-up of 6.2 years. It will be most helpful. If you need any other information on this subject you can contact me. Nicos Labropoulos Assistant Professor of Surgery Dept. of Surgery Loyola Univ Med Ctr 2160 S. 1st Ave Maywood, IL 60153 tel: 708 327-2898 fax: 708 327-2698