Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Delaying surgery for hernia repair a safe option

18.01.2006


Men who delay surgical repair of a hernia until the hernia becomes uncomfortable fare as well those who undergo immediate surgery, according to a study at five North American medical centers.



In the study, published in the Jan. 18 issue of JAMA, a journal of the American Medical Association, 720 men with inguinal hernia (a small part of the large or small intestine protruding into the groin) were randomly assigned to either "watchful waiting" or standard hernia repair surgery and followed up for two to 4.5 years.

In an earlier study, the researchers had compared non-invasive laparoscopic hernia operations with open procedures. "But there are a lot of men walking around with hernias who say, ’If it’s not bothering me, I won’t bother it,’" said Dr. Olga Jonasson, professor of surgery at the University of Illinois at Chicago, who initiated the study. "We wanted to know if it was safe to delay surgery altogether."


Of the 364 men assigned to watchful waiting, 23 percent later chose to have surgery, usually because of increased pain. Seventeen percent of the 356 men assigned to surgery chose instead to cross over into watchful waiting. Waiting did not increase the rate of complications from surgery in those patients who eventually had it, and the rate of complications from hernias left unrepaired was even lower.

After two years, the same proportion of men in each group reported developing pain great enough to interfere with everyday activities, but both groups overall reported less pain at the end of the two years. Patients who received surgical repair reported significantly greater improvement in their ability to perform a range of everyday activities.

The authors conclude that a strategy of watchful waiting is "a safe and acceptable option" for men whose hernias are not causing discomfort that interferes with their day-to-day activities. Hernia complications occur only rarely, and patients who develop symptoms have no greater risk of operative complications than those undergoing preventative hernia repair.

Because the risk of complication increases with the length of time a hernia is present and is more common in the elderly, the researchers established a voluntary long-term registry for the clinical trial participants to access the occurrence of hernia complications and recurrences annually.

Other authors on the study include Dr. Robert Fitzgibbons Jr. of Creighton University; Dr. Jon Thompson of the Omaha VA Medical Center; Anita Giobbie-Hurder, Domenic J. Reda and Jia Wang of the VA Cooperative Studies Program in Hines, Ill.; James Gibbs, Dorothy Dunlop and Martin McCarthy Jr. of Northwestern University; Dr. Leigh Neumayer of the University of Utah; Dr. Jeffrey Barkun of McGill University; Dr. James Hoehn of Marshfield University; Drs. Joseph Murphy and George Sarosi Jr. of the Dallas VA Medical Center; and Dr. William Syme of the University of Nebraska, Omaha.

Jeanne Galatzer-Levy | EurekAlert!
Further information:
http://www.uic.edu

More articles from Studies and Analyses:

nachricht Do microplastics harbour additional risks by colonization with harmful bacteria?
05.04.2018 | Leibniz-Institut für Ostseeforschung Warnemünde

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Writing and deleting magnets with lasers

Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.

Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...

Im Focus: Gamma-ray flashes from plasma filaments

Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.

The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...

Im Focus: Basel researchers succeed in cultivating cartilage from stem cells

Stable joint cartilage can be produced from adult stem cells originating from bone marrow. This is made possible by inducing specific molecular processes occurring during embryonic cartilage formation, as researchers from the University and University Hospital of Basel report in the scientific journal PNAS.

Certain mesenchymal stem/stromal cells from the bone marrow of adults are considered extremely promising for skeletal tissue regeneration. These adult stem...

Im Focus: Like a wedge in a hinge

Researchers lay groundwork to tailor drugs for new targets in cancer therapy

In the fight against cancer, scientists are developing new drugs to hit tumor cells at so far unused weak points. Such a “sore spot” is the protein complex...

Im Focus: The Future of Ultrafast Solid-State Physics

In an article that appears in the journal “Review of Modern Physics”, researchers at the Laboratory for Attosecond Physics (LAP) assess the current state of the field of ultrafast physics and consider its implications for future technologies.

Physicists can now control light in both time and space with hitherto unimagined precision. This is particularly true for the ability to generate ultrashort...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

IWOLIA: A conference bringing together German Industrie 4.0 and French Industrie du Futur

09.04.2018 | Event News

 
Latest News

Diamond-like carbon is formed differently to what was believed -- machine learning enables development of new model

19.04.2018 | Materials Sciences

Electromagnetic wizardry: Wireless power transfer enhanced by backward signal

19.04.2018 | Physics and Astronomy

Ultrafast electron oscillation and dephasing monitored by attosecond light source

19.04.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>