Evidence-Based Hernia Treatment in Adults.
Dtsch Arztebl Int
; 113(9): 150-7; quiz 158, 2016 Mar 04.
Article
em En
| MEDLINE
| ID: mdl-26987468
ABSTRACT
BACKGROUND:
Inguinal hernia repair is the most common general surgical procedure in industrialized countries, with a frequency of about 200 operations per 100 000 persons per year. Suture- and mesh-based techniques can be used, and the procedure can be either open or minimally invasive.METHODS:
This review is based on a selective search of the literature, with interpretation of the published findings according to the principles of evidence-based medicine.RESULTS:
Inguinal hernia is diagnosed by physical examination. Surgery is not necessarily indicated for a primary, asymptomatic inguinal hernia in a male patient, but all inguinal hernias in women should be operated on. For hernias in women, and for all bilateral hernias, a laparoscopic or endoscopic procedure is preferable to an open procedure. Primary unilateral hernias in men can be treated either by open surgery or by laparoscopy/endoscopy. Patients treated by laparoscopy/endoscopy develop chronic pain less often than those treated by open surgery. A mesh-based repair is generally recommended; this seems reasonable in view of the pathogenesis of the condition, which involves an abnormality of the extracellular matrix.CONCLUSION:
The choice of procedure has been addressed by international guidelines based on high-level evidence. Surgeons should deviate from their recommendations only in exceptional cases and for special reasons. Guideline conformity implies that hernia surgeons must master both open and endoscopic/laparoscopic techniques.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Laparoscopia
/
Endoscopia
/
Herniorrafia
/
Hérnia Inguinal
Tipo de estudo:
Guideline
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Dtsch Arztebl Int
Assunto da revista:
MEDICINA
/
SAUDE PUBLICA
Ano de publicação:
2016
Tipo de documento:
Article