Does delaying repair of an asymptomatic hernia have a penalty?

Abstract Background The incidence of hernia accident for inguinal hernias in men who are minimally symptomatic is sufficiently low that watchful waiting is an acceptable alternative to routine repair. Our aim was to determine whether a delay in hernia surgery affects short- and long-term outcomes. M...

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Bibliographic Details
Published in:The American journal of surgery 2008, Vol.195 (1), p.89-93
Main Authors: Thompson, Jon S., M.D, Gibbs, James O., Ph.D, Reda, Domenic J., Ph.D, McCarthy, Martin, Ph.D, Wei, Yongliang, M.S, Giobbie-Hurder, Anita, M.S, Fitzgibbons, Robert J., M.D
Format: Article
Language:English
Subjects:
Adult
Aged
Asymptomatic hernia
Biological and medical sciences
Clinical trials
Fines & penalties
General aspects
Hernia repair
Hernia, Inguinal - surgery
Hernias
Humans
Infections
Inguinal hernia
Male
Medical sciences
Middle Aged
Pain
Surgery
Time Factors
Treatment Outcome
Variables
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Summary:Abstract Background The incidence of hernia accident for inguinal hernias in men who are minimally symptomatic is sufficiently low that watchful waiting is an acceptable alternative to routine repair. Our aim was to determine whether a delay in hernia surgery affects short- and long-term outcomes. Methods Patients from a multicenter randomized clinical trial of immediate tension-free repair versus watchful waiting for minimally symptomatic inguinal hernias were studied. Patients (n = 353) underwent tension-free repair and were classified as immediate repair (≤6 months, N = 288) or delayed repair (>6 months, N = 65). Results Patients were similar at baseline with respect to age, American Society of Anesthesiologists classification, pre-existing conditions, hernia type, and hernia characteristics. Patients undergoing immediate and delayed repair had comparable surgical time, surgical complications, recurrence rates, and satisfaction with outcome. Multivariate analyses found no relation between duration until hernia repair and operative time, incidence of complications, long-term pain, or functional status. Conclusions Delaying hernia repair in patients who are minimally symptomatic does not have an adverse effect on subsequent operation and on other outcomes.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.07.021