Twelve-year outcomes of watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older: a randomised controlled trial
نویسندگان
چکیده
BackgroundInguinal hernia belongs to the most common surgical pathology worldwide. Approximately, one third is asymptomatic. The value of watchful waiting (WW) in patients with asymptomatic or mildly symptomatic inguinal has been established a few randomised controlled trials (RCTs). aim this study was assess long-term outcomes RCT comparing WW and elective surgery.MethodsIn original study, men aged ≥50 years an were randomly assigned repair. In present primary outcome 12-year crossover rate surgery, secondary time-to-crossover, patient regret, pain, quality life incarceration. Dutch Trial Registry: NTR629.FindingsOut 496 originally analysed patients, 488 (98.4%) evaluable for chart review (WW: n = 258, surgery: 230), 200 (41.0%) telephone contact 106, 94) between November 2021 March 2022 median 12 follow-up (IQR 9–14). After years, estimated cumulative surgery 64.2%, which higher than (71.7% versus 60.4%, HR 1.451, 95% CI: 1.064–1.979). Time-to-crossover longer (50% after 6.0 2.0 p 0.019). Patient regret group (37.7 18.0%, 0.002), as well pain/discomfort (p 0.031). Quality did not differ 0.737). group, incarceration occurred 10/255 (3.9%).InterpretationDuring follow-up, crossed over significantly earlier hernia. Considering relatively low rate, might still be option clear preference being well-informed about pros cons.FundingThe initial trial funded by Netherlands Organisation Health Research Development (ZonMW). This receive funding.
منابع مشابه
Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial.
CONTEXT Many men with inguinal hernia have minimal symptoms. Whether deferring surgical repair is a safe and acceptable option has not been assessed. OBJECTIVE To compare pain and the physical component score (PCS) of the Short Form-36 Version 2 survey at 2 years in men with minimally symptomatic inguinal hernias treated with watchful waiting or surgical repair. DESIGN, SETTING, AND PARTICI...
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Canadian Association of General Surgeons and American College of Surgeons evidence-based reviews in surgery. 26. Watchful waiting versus repair of inguinal hernia in minimally symptomatic men.
Objective: To compare pain and physical function in men with minimally symptomatic inguinal hernia with watchful waiting or surgical repair. Design: Randomized controlled trial. Setting: Five community and academic centres in Canada and the United States. Patients: A total of 724 men were randomly assigned to a watchful waiting group (n = 366) versus a standard Lichtenstein open tension-free re...
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ژورنال
عنوان ژورنال: EClinicalMedicine
سال: 2023
ISSN: ['2589-5370']
DOI: https://doi.org/10.1016/j.eclinm.2023.102207