Watchful waiting was as safe as surgical repair for minimally symptomatic inguinal hernias

Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, et al . Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 2006;295:285–92. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q In men with asymptomatic or minimally symptomatic inguinal hernias, is watchful waiting as safe as surgical repair? Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Surgery—general ★★★★★★★ Surgery—gastrointestinal ★★★★★★★ ### ![Graphic][5] Design: randomised controlled trial. ### ![Graphic][6] Allocation: concealed.* ### ![Graphic][7] Blinding: blinded (site investigators and study personnel were blinded to outcome data).* ### ![Graphic][8] Follow up period: 2 years. ### ![Graphic][9] Setting: 4 community and academic centres in the US (Omaha, NE; Marshfield, WI; Dallas, TX; and Albuquerque, NM) and 1 in Canada (Montreal, Quebec). ### ![Graphic][10] Patients: 724 men who were ⩾18 years of age (mean age 58 y) and had asymptomatic or minimally symptomatic inguinal hernia (including chronically incarcerated hernias). Exclusion criteria: undetectable hernias, local or systemic infection, or American Society of Anesthesiologists physical status >3. 4 patients were excluded after randomisation because of ineligibility. ### ![Graphic][11] Intervention: watchful waiting (n = 366) or tension free hernia repair (n = 358). ### ![Graphic][12] Outcomes: pain and … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.stitle%253DJAMA%26rft.issn%253D0002-9955%26rft.aulast%253DFitzgibbons%26rft.auinit1%253DR.%2BJ.%26rft.volume%253D295%26rft.issue%253D3%26rft.spage%253D285%26rft.epage%253D292%26rft.atitle%253DWatchful%2BWaiting%2Bvs%2BRepair%2Bof%2BInguinal%2BHernia%2Bin%2BMinimally%2BSymptomatic%2BMen%253A%2BA%2BRandomized%2BClinical%2BTrial%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.295.3.285%26rft_id%253Dinfo%253Apmid%252F16418463%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.295.3.285&link_type=DOI [3]: /lookup/external-ref?access_num=16418463&link_type=MED&atom=%2Febmed%2F11%2F3%2F73.atom [4]: /lookup/external-ref?access_num=000234684500021&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif [8]: /embed/inline-graphic-4.gif [9]: /embed/inline-graphic-5.gif [10]: /embed/inline-graphic-6.gif [11]: /embed/inline-graphic-7.gif [12]: /embed/inline-graphic-8.gif