Watchful waiting vs surgical repair of oligosymptomatic incisional hernias: Current status of the AWARE study

• Published in: Chirurg 2016-01, Vol.87 (1), p.47-55
• Main Authors: Lauscher, J C, Leonhardt, M, Martus, P, Zur Hausen, G, Aschenbrenner, K, Zurbuchen, U, Thielemann, H, Kohlert, T, Schirren, R, Simon, T, Buhr, H J, Ritz, J-P, Kreis, M E
• Format: Article
• Language: ger
• Subjects: Evidence-Based Medicine; Follow-Up Studies; Germany; Humans; Incisional Hernia - diagnosis; Incisional Hernia - etiology; Incisional Hernia - surgery; Pain Measurement; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Postoperative Complications - surgery; Prospective Studies; Quality of Life; Watchful Waiting
• ISSN: 1433-0385
• DOI: 10.1007/s00104-015-0011-2

Incisional hernias are one of the the most frequent complications in visceral surgery and incisional hernia repair has a relevant complication rate. Therefore, there have to be solid indications before carrying out incisional hernia repair. To date, there is a lack of evidence concerning the correct indications for surgical repair of incisional hernias. The AWARE trial compares watchful waiting to surgical repair of incisional hernias. The AWARE trial is a prospective randomized multicenter trial. Patients with asymptomatic or oligosymptomatic incisional hernia are randomized into the watchful waiting or the surgical repair group with a follow-up of 2 years. The primary endpoint is pain during normal activities due to the hernia or the hernia repair after 2 years measured on the hernia-specific surgical pain scale (SPS). In this study 36 centers are participating throughout Germany, more than 1600 patients had been screened up to 31 December 2014 and 234 (14.6%) of the screened patients could be recruited. The AWARE study will provide evidence concerning the two therapeutic options of watchful waiting and surgical repair of incisional hernia.