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

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 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 ★★★★★★★


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (site investigators and study personnel were blinded to outcome data).*

Embedded ImageFollow up period:

2 years.

Embedded ImageSetting:

4 community and academic centres in the US (Omaha, NE; Marshfield, WI; Dallas, TX; and Albuquerque, NM) and 1 in Canada (Montreal, Quebec).

Embedded ImagePatients:

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.

Embedded ImageIntervention:

watchful waiting (n = 366) or tension free hernia repair (n = 358).

Embedded ImageOutcomes:

pain and …

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  • * See glossary.

  • For correspondence: Dr O Jonasson, University of Illinois, Chicago, IL, USA. ojonasson{at}

  • Sources of Funding: Agency for Healthcare Research and Quality and American College of Surgeons.

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