Analysis of the SAGES Outcomes Initiative groin hernia database

Velanovich, Vic; Shadduck, Phillip P.; Khaitan, Leena; Morton, John M.; Maupin, G W; Traverso, L. William

doi:10.1007/s00464-005-0436-7

Cited by 14 publications

(7 citation statements)

References 19 publications

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“…The total number of publications included was therefore 23 (figure 1; table 1). (13-35) After averaging data from publications from the same country and inclusion of the primary data from Malawi, 13 countries were included in the analysis, including four LICs (Malawi, Sierra Leone, Tanzania and Uganda), two L-MICs (Ghana and Nigeria), two H-MICs (Malaysia and Turkey) and five HICs (Denmark, Italy, Sweden, United Kingdom and United States) (table 2). Most hernias included in this analysis were inguinal; in studies reporting other types of hernias, these represented a minority of patients ( femoral, 0.1% to 8%; ventral,3 to 11%).…”

Section: Resultsmentioning

confidence: 99%

Development of a ratio of emergent to total hernia repairs as a surgical capacity metric

Samuel

Tyson

Mabedi

et al. 2014

International Journal of Surgery

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Summary INTRODUCTION Non-communicable diseases including surgical conditions are gaining attention in developing countries. Despite this there are few metrics for surgical capacity. We hypothesized that (a) the ratio of emergent to total hernia repairs (E/TH) would correlate with per capita health care expenditures for any given country, and (b) the E/TH is easy to obtain in resource-poor settings. METHODS We performed a systematic review to identify the E/TH for as many countries as possible (Prospero registry CRD42013004645). We screened 1285 English language publications since 1990; 23 met inclusion criteria. Primary data was also collected from Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. A total of 13 countries were represented. Regression analysis was used to determine the correlation between per capita healthcare spending and the E/TH. RESULTS There is a strong correlation between the log values of the ratio emergent to total groin hernias and the per capita health care spending that is robust across country income levels (R2=0·823). Primary data from KCH was easily obtained and demonstrated a similar correlation. CONCLUSIONS The ratio of emergent to total groin hernias is a potential measure of surgical capacity using data that is easily attainable. Further studies should validate this metric against other accepted health care capacity indicators.

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Section: Resultsmentioning

confidence: 99%

Development of a ratio of emergent to total hernia repairs as a surgical capacity metric

Samuel

Tyson

Mabedi

et al. 2014

International Journal of Surgery

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“…Seven clinical outcomes assessment tools specific to hernia surgery are in use internationally, 167 – 174 as is one patient outcomes assessment tool. 175 Several hernia registries exist (Swedish Hernia Registry, Danish Hernia Registry, HerniaMed, Club Hernie, EuraHS, Dutch Hernia Registry, Evereg and AHSQC).…”

Section: Outcomes and Quality Assessmentmentioning

confidence: 99%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,557

712

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IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

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“…Lichtenstein procedure and plug and patch repair, or endoscopic approach, e.g. TAPP and TEP) have been analysed in various trials and result in a quicker postoperative recovery [ 41 , 46 , 56 , 68 , 129 , 147 , 168 , 176 , 178 , 197 , 198 , 272 , 311 ].…”

Section: Guidelines For the Treatment Of Inguinal Hernia In Adultsmentioning

confidence: 99%

European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Simons

Aufenacker

Bay‐Nielsen

et al. 2009

Hernia

1,333

979

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The European Hernia Society (EHS) is proud to present the EHS Guidelines for the Treatment of Inguinal Hernia in Adult Patients. The Guidelines contain recommendations for the treatment of inguinal hernia from diagnosis till aftercare. They have been developed by a Working Group consisting of expert surgeons with representatives of 14 country members of the EHS. They are evidence-based and, when necessary, a consensus was reached among all members. The Guidelines have been reviewed by a Steering Committee. Before finalisation, feedback from different national hernia societies was obtained. The Appraisal of Guidelines for REsearch and Evaluation (AGREE) instrument was used by the Cochrane Association to validate the Guidelines. The Guidelines can be used to adjust local protocols, for training purposes and quality control. They will be revised in 2012 in order to keep them updated. In between revisions, it is the intention of the Working Group to provide every year, during the EHS annual congress, a short update of new high-level evidence (randomised controlled trials [RCTs] and meta-analyses). Developing guidelines leads to questions that remain to be answered by specific research. Therefore, we provide recommendations for further research that can be performed to raise the level of evidence concerning certain aspects of inguinal hernia treatment. In addition, a short summary, specifically for the general practitioner, is given. In order to increase the practical use of the Guidelines by consultants and residents, more details on the most important surgical techniques, local infiltration anaesthesia and a patient information sheet is provided. The most important challenge now will be the implementation of the Guidelines in daily surgical practice. This remains an important task for the EHS. The establishment of an EHS school for teaching inguinal hernia repair surgical techniques, including tips and tricks from experts to overcome the learning curve (especially in endoscopic repair), will be the next step. Working together on this project was a great learning experience, and it was worthwhile and fun. Cultural differences between members were easily overcome by educating each other, respecting different views and always coming back to the principles of evidence-based medicine. The members of the Working Group would like to thank the EHS board for their support and especially Ethicon for sponsoring the many meetings that were needed to finalise such an ambitious project.

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Analysis of the SAGES Outcomes Initiative groin hernia database

Cited by 14 publications

References 19 publications

Development of a ratio of emergent to total hernia repairs as a surgical capacity metric

Development of a ratio of emergent to total hernia repairs as a surgical capacity metric

International guidelines for groin hernia management

European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

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