Watchful waiting to surgery in men with mildly symptomatic or asymptomatic inguinal hernia: an individual participant data meta-analysis of long-term follow-up of randomized controlled trials
- 24.07.2024
- Original Article
Erschienen in:
- Verfasst von
- Marcus Yeow
- Alberto Aiolfi
- Davide Lomanto
- Sean Lee Kien Fatt
- Sujith Wijerathne
- Erschienen in
- Hernia | Ausgabe 5/2024
Abstract
Background
Individual studies on men with mildly symptomatic or asymptomatic inguinal hernia who have opted for watchful waiting (WW) vary considerably. Furthermore, long-term data on such patients who cross over to herniorrhaphy is scarce.
Methods
PubMed, EMBASE, and Cochrane databases were searched systematically from inception to 3rd April 2024 for long-term follow-up of randomized controlled trials (RCTs) on men with mildly symptomatic or asymptomatic inguinal hernia. Individual participant survival data of cross over rates from WW to herniorrhaphy were extracted, reconstructed and combined. Secondary outcome was reason for cross over to herniorrhaphy.
Results
Long-term follow-up of three RCTs with 592 participants was included. A total of 344/592 participants crossed over to herniorrhaphy during a median follow up period that ranged from 3.2 to 12.0 years. The median cumulative cross over rate was 54.2% (95% CI 45.5% – 66.3%). The cumulative 1-year, 5-year, and 10- year cross over rates were 28.7% (95% CI 25.2% – 32.5%), 51.5% (95% CI 47.4% – 55.6%), and 70.6% (95% CI 66.2% – 74.9%) respectively. During follow-up, the most frequent reasons for cross over to herniorrhaphy were increased pain 198/344 (57.6%) and incarceration 15/344 (4.4%).
Conclusion
This study provides valuable long-term data for patient counselling, indicating that while WW is a safe strategy for men with mildly symptomatic or asymptomatic inguinal hernia, symptoms would likely progress eventually, necessitating operative repair.
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- Titel
- Watchful waiting to surgery in men with mildly symptomatic or asymptomatic inguinal hernia: an individual participant data meta-analysis of long-term follow-up of randomized controlled trials
- Verfasst von
-
Marcus Yeow
Alberto Aiolfi
Davide Lomanto
Sean Lee Kien Fatt
Sujith Wijerathne
- Publikationsdatum
- 24.07.2024
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 5/2024
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03118-5
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