A Prospective Assessment of Clinical and Patient‐Reported Outcomes of Initial Non‐Operative Management of Ventral Hernias

Holihan, Julie L.; Flores-Gonzalez, Juan R.; Mo, Jiandi; Ko, Tien C.; Kao, Lillian S.; Liang, Mike K.

doi:10.1007/s00268-016-3859-5

Cited by 22 publications

(9 citation statements)

References 35 publications

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“…9 Moreover, nonoperative management results in poor quality of life and functional status. 10,33 In a 2016 prospective, case-matched study 10 of operative vs nonoperative management of ventral hernia, operative management improved overall function and quality of life. Another prospective study from 2019 34 that compared long-term outcomes of operative vs nonoperative management found that this improvement was sustained 3 years after the surgical procedure and that nearly 40% of patients in the nonoperative group ultimately went on to undergo hernia repair.…”

Section: Discussionmentioning

confidence: 99%

Costs Associated With Modifiable Risk Factors in Ventral and Incisional Hernia Repair

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Costs Associated With Modifiable Risk Factors in Ventral and Incisional Hernia Repair

et al. 2019

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“…Data specifically on umbilical and epigastric hernias were not available. In a small prospective observational study 22 of 25 patients in whom non-operative treatment of a primary ventral hernia was planned, and who were followed for a median of 12 months, 20 and 4 per cent underwent elective and emergency repair respectively.…”

Section: Quality Of Evidence: Strength Of Recommendation: Weakmentioning

confidence: 99%

Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society

Henriksen

Montgomery

Kaufmann

et al. 2020

British Journal of Surgery

211

198

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Background: Umbilical and epigastric hernia repairs are frequently performed surgical procedures with an expected low complication rate. Nevertheless, the optimal method of repair with best short-and long-term outcomes remains debatable. The aim was to develop guidelines for the treatment of umbilical and epigastric hernias. Methods: The guideline group consisted of surgeons from Europe and North America including members from the European Hernia Society and the Americas Hernia Society. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, the Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists, and the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument were used. A systematic literature search was done on 1 May 2018, and updated on 1 February 2019. Results: Literature reporting specifically on umbilical and epigastric hernias was limited in quantity and quality, resulting in a majority of the recommendations being graded as weak, based on low-quality evidence. The main recommendation was to use mesh for repair of umbilical and epigastric hernias to reduce the recurrence rate. Most umbilical and epigastric hernias may be repaired by an open approach with a preperitoneal flat mesh. A laparoscopic approach may be considered if the hernia defect is large, or if the patient has an increased risk of wound morbidity. Conclusion: This is the first European and American guideline on the treatment of umbilical and epigastric hernias. It is recommended that symptomatic umbilical and epigastric hernias are repaired by an open approach with a preperitoneal flat mesh.

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“…WW of ventral hernias is associated with a low risk of requiring emergency surgery (2.6% over one year) [ 12 ]. Overall, 16-23% of patients cross over, requiring surgical repair during relatively short follow-up periods of one to five years [ 13 , 14 ]. It has also been demonstrated that patients undergoing ventral hernia repair at index presentation had a statistically significant improvement in their quality of life compared to those who underwent WW [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Severe Mental Illness: A Contraindication to Watchful Waiting in Hernia Management?

Milne¹,

Naraynsingh²,

Goolcharan

2021

Cureus

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Watchful waiting (WW) is a strategy that can be used to manage hernias whereby patients who are asymptomatic or minimally symptomatic are observed until symptoms worsen or complications develop, prompting surgical intervention. The successful implementation of a WW strategy requires patients to report changes in their clinical condition to receive timely care. Patients who have severe mental illness may defer seeking care when appropriate. This case report describes our experience treating a patient with severe mental illness who had a primary ventral hernia managed by WW. She was lost to follow-up and subsequently presented with a strangulated epigastric hernia which fistulized to the skin. The case report highlights the challenges of attempting WW in patients with severe mental illness. We suggest that poorly controlled severe mental illness should be considered a relative contraindication to WW.

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A Prospective Assessment of Clinical and Patient‐Reported Outcomes of Initial Non‐Operative Management of Ventral Hernias

Cited by 22 publications

References 35 publications

Costs Associated With Modifiable Risk Factors in Ventral and Incisional Hernia Repair

Costs Associated With Modifiable Risk Factors in Ventral and Incisional Hernia Repair

Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society

Severe Mental Illness: A Contraindication to Watchful Waiting in Hernia Management?

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