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[Asymptomatic inguinal hernia: is there an indication for surgery].
1Universitätsklinik für Viszerale Chirurgie und Medizin, Inselspital, Bern.
Therapeutische Umschau. Revue Therapeutique
|December 3, 2014
Summary
Watchful waiting for asymptomatic groin hernias is a safe alternative to immediate repair, with low incarceration rates. Most patients eventually require surgery due to symptom development over time.
Area of Science:
- Surgical outcomes
- Hernia repair
- Clinical trials
Context:
- Traditionally, asymptomatic groin hernias were repaired to prevent incarceration.
- Inguinal hernia incarcerations are infrequent and manageable with early symptom presentation.
- Recent randomized controlled trials (RCTs) evaluated watchful waiting versus immediate repair.
Purpose:
- To assess the safety and efficacy of watchful waiting for asymptomatic groin hernias.
- To determine the incidence of incarceration in patients managed conservatively.
- To evaluate the long-term need for surgical intervention in the watchful waiting group.
Summary:
- Watchful waiting for asymptomatic inguinal hernias does not increase incarceration risk.
- Early presentation allows adequate treatment of rare incarceration events.
- 50-70% of patients in watchful waiting groups underwent surgery within seven years, primarily due to symptom progression.
Impact:
- Watchful waiting is a viable, safe option for select patients with asymptomatic groin hernias.
- This approach avoids unnecessary surgery for a significant portion of patients.
- Patient-reported outcomes and symptom development are key factors in the decision for delayed repair.
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