Page 4 - International guidelines for groin hernia management

Hernia

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people annually. Surgical treatment is successful in the
PART 1 majority of cases, but recurrences necessitate reoperations
Management of inguinal hernias in adults in 10–15% and long-term disability due to chronic pain
(pain lasting longer than 3 months) occurs in 10–12% of
patients. Approximately 1–3% of patients have severe
chronic pain. This has a tremendous negative effect glob-
Chapter 1 ally on health and healthcare costs.
However, better outcomes are definitely possible. Our
objective is to improve groin hernia patient care worldwide
HerniaSurge: international guidelines for groin by developing and globally distributing standards of care
hernia management based on all available evidence and experience.
Currently, groin hernia treatment is not standardized.
Introduction Three hernia societies have separately published guidelines
M. P. Simons, N. van Veenendaal, H. M. Tran, B. van den aimed at both improving treatment and enhancing the
Heuvel and H. J. Bonjer education of surgeons involved in groin hernia treatment.
In 2009, the European Hernia Society (EHS) published
Lifetime occurrence of groin hernia—viscera or adipose
guidelines covering all aspects of inguinal hernia treatment
tissue protrusions through the inguinal or femoral canal—is 3
1 in adult patients. The EHS guidelines were updated in
27–43% in men and 3–6% in women. Inguinal hernias are 2014. 4 The International Endo Hernia Society (IEHS)
almost always symptomatic; and the only cure is surgery. 2
published guidelines in 2011 covering laparo-endoscopic
A minority of patients are asymptomatic but even a watch- 5
groin hernia repair. In 2013, the European Association for
and-wait approach in this group results in surgery in Endoscopic Surgery (EAES) published a consensus docu-
approximately 70% within 5 years. 2
ment focused on aspects of laparo-endoscopic treat-
Worldwide, inguinal hernia repair is one of the most 5, 6
ments. These three societies began collaborating in
common surgeries, performed on more than 20 million
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