Hernia, inguinal: Watchful waiting vs elective Surgical repair
DISEASE INTERVENTION COMPARISON RESULTS
Arch Surg. 2012 Mar;147(3):277-81 Systematic Review
IN hernia, inguinal, asymptomatic The Use of
watchful waiting
As Treatment, Chronic
Is equal Than
routine surgical repair
To symptoms at follow-up were not different but it existed a hight crossover ratio (23% to 72%) from watchful waiting to surgery : most patients will develop symptoms (mainly pain) over time and will require operation
Ann Surg. 2017 Mar 27. doi: 10.1097/SLA.0000000000002243. [Epub ahead of print] Randomized Controlled Trial, Multicenter Study
IN hernia, inguinal, asymptomatic or minimally symptomatic The Use of
watchful waiting
As Treatment, Chronic
Is worse Than
elective surgical repair
To modify 4-point pain/discomfort score at 2 years: 0.58 watchful VS 0.35 surgery. 34% watchful patients underwent surgery. 2% had acute hernia complications.
JAMA. 2006 Jan 18;295(3):285-92 Randomized Controlled Trial, Multicenter Study
IN hernia, inguinal, minimally symptomatic The Use of
watchful waiting
As Treatment, Chronic
Is equal Than
routine surgical repair
To improve pain and discomfort interfering with usual activities at 2 years: 5.1% waiting VS 2.2% repair. 1.8/1000 patients-years in waiting group have incarceration.