Watchful waiting vs repair for asymptomatic or minimally symptomatic inguinal hernia in men: a systematic review
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Watchful waiting vs repair for asymptomatic or minimally symptomatic inguinal hernia in men : a systematic review. / Reistrup, Hugin; Fonnes, Siv; Rosenberg, Jacob.
I: Hernia, Bind 25, Nr. 5, 2021, s. 1121-1128.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Watchful waiting vs repair for asymptomatic or minimally symptomatic inguinal hernia in men
T2 - a systematic review
AU - Reistrup, Hugin
AU - Fonnes, Siv
AU - Rosenberg, Jacob
N1 - Publisher Copyright: © 2020, Springer-Verlag France SAS, part of Springer Nature.
PY - 2021
Y1 - 2021
N2 - Purpose: One-third of patients presenting with inguinal hernia are asymptomatic and the best treatment for these patients is unclear. The aim of this study was to assess the feasibility of applying a watchful waiting strategy for asymptomatic or minimally symptomatic inguinal hernia in men. Methods: PubMed, EMBASE, and Cochrane Library were searched from database inception to May 14, 2020. Included were all types of original data written in English, German, Danish, Swedish, or Norwegian involving ≥ 5 male patients aged ≥ 18 years old with asymptomatic or minimally symptomatic inguinal hernia and undergoing watchful waiting. This review was reported according to the PRISMA guideline. Results: A total of nine studies were included; three randomized controlled trials, three prospective cohort studies, and three retrospective cohort studies. Data on a total of 858 unique patients following a watchful waiting strategy were included. Approximately one-third of patients crossed over from watchful waiting to surgery after 3 years increasing to more than two-thirds after 10 years. The most frequent reason for crossover was hernia-related pain (median 79%, range 48–91%). The rate of acute hernia-related operations was low (2–3%), and watchful waiting was not associated with increased mortality or postoperative complications. Levels of pain and discomfort after randomization were similar over time between patients undergoing elective repair or watchful waiting. Conclusion: Applying a watchful waiting strategy to men with asymptomatic or minimally symptomatic inguinal hernia was safe, but two-thirds of patients crossed over to surgical repair within 10 years mainly due to pain.
AB - Purpose: One-third of patients presenting with inguinal hernia are asymptomatic and the best treatment for these patients is unclear. The aim of this study was to assess the feasibility of applying a watchful waiting strategy for asymptomatic or minimally symptomatic inguinal hernia in men. Methods: PubMed, EMBASE, and Cochrane Library were searched from database inception to May 14, 2020. Included were all types of original data written in English, German, Danish, Swedish, or Norwegian involving ≥ 5 male patients aged ≥ 18 years old with asymptomatic or minimally symptomatic inguinal hernia and undergoing watchful waiting. This review was reported according to the PRISMA guideline. Results: A total of nine studies were included; three randomized controlled trials, three prospective cohort studies, and three retrospective cohort studies. Data on a total of 858 unique patients following a watchful waiting strategy were included. Approximately one-third of patients crossed over from watchful waiting to surgery after 3 years increasing to more than two-thirds after 10 years. The most frequent reason for crossover was hernia-related pain (median 79%, range 48–91%). The rate of acute hernia-related operations was low (2–3%), and watchful waiting was not associated with increased mortality or postoperative complications. Levels of pain and discomfort after randomization were similar over time between patients undergoing elective repair or watchful waiting. Conclusion: Applying a watchful waiting strategy to men with asymptomatic or minimally symptomatic inguinal hernia was safe, but two-thirds of patients crossed over to surgical repair within 10 years mainly due to pain.
KW - Asymptomatic
KW - Conservative treatment
KW - Inguinal hernia
KW - Pain
KW - Systematic review
KW - Watchful waiting
U2 - 10.1007/s10029-020-02295-3
DO - 10.1007/s10029-020-02295-3
M3 - Review
C2 - 32910297
AN - SCOPUS:85090794892
VL - 25
SP - 1121
EP - 1128
JO - Hernia : the journal of hernias and abdominal wall surgery
JF - Hernia : the journal of hernias and abdominal wall surgery
SN - 1265-4906
IS - 5
ER -
ID: 271619466