Inguinal hernia surgery in The Netherlands: a baseline study before the introduction of the Dutch Guidelines

Hernia - Tập 9 - Trang 172-177 - 2005
D. H. de Lange1, Th. J. Aufenacker2, M. Roest2, R. K. J. Simmermacher3, D. J. Gouma4, M. P. Simons2
1Department of Surgery, Slotervaart Ziekenhuis, Amsterdam, The Netherlands
2Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
3Department of Surgery, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
4Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Tóm tắt

Background: In 2003 the Dutch Guidelines for treatment of inguinal hernia (IH) were published. For treatment of IH in adults, the evidence-based guidelines recommend the use of a mesh repair technique. In order to be able to evaluate the effects of these guidelines, a baseline analysis of inguinal hernia surgery before the introduction of these guidelines had to be performed. The second analysis will be performed two years (January–March 2005) after the publication of the Guidelines. Objective: To make an inventory of IH surgery in the Netherlands, before the introduction of guidelines for IH treatment, to serve as a baseline for future evaluation of the impact of the implementation of these guidelines. Methods: A retrospective descriptive study was performed in 2003 using patient and operation charts including IH repairs performed in The Netherlands over a three-month period (January-March 2001). Results: 97/133 (73%) hospitals cooperated with the study, generating data from a total of 4386 IH in 3979 patients (3284 adults, 695 children). Mesh techniques were used in 2839 (78%) adult inguinal hernias while 800 (22%) patients were treated with non-mesh techniques. 484 (14.7%) adult patients were operated on during the study period for a recurrent hernia from previous years. Early recurrence (<1 year) occurred in 2.2% of all patients. Wound infection was documented in 0.8% of all IH. The mortality rate was 0.1%. 1257 of the 3284 (38.3%) adults, and 566 of the 695 children (81.4%), were operated on in ambulatory care. Conclusions: In the episode prior to implementation of the Dutch evidence-based Guidelines for treatment of inguinal hernia, 2839 (78%) adult patients were treated with mesh repair and 484 (13.3%) patients were treated for a recurrent hernia.

Tài liệu tham khảo

Association of Surgeons of the Netherlands (2003) Dutch guidelines for inguinal hernia. Van Zuiden Communications BV, Alphen Simons MP, de Lange D, Beets GL, van Geldere D, Heij HA, Go PM (2003) The ‘Inguinal Hernia’ guideline of the Association of Surgeons of the Netherlands. Ned Tijdschr Geneeskd 147:2111–2117 Burd RS, Heffington SH, Teague JL (2001) The optimal approach for management of metachronous hernias in children: a decision analysis. J Pediatr Surg. 36:1190–1195 Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P, Juul P, Callesen T (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128 Hair A, Duffy K, McLean J, Taylor S, Smith H, Walker A, MacIntyre IM, O’Dwyer PJ (2000) Groin hernia repair in Scotland. Br J Surg 87:1722–1726 Nilsson E, Haapaniemi S, Gruber G, Sandblom G (1998) Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996. Br J Surg 85:1686–1691 Grant AM (2002) Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data Hernia 6:130–136 Grant AM (2002) Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data. Hernia 6:2–10 Collaboration EH (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:854–859 EU Hernia Trialists Collaboration (2002) Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 235:322–332 Simons MP, Kleijnen J, van Geldere D, Hoitsma HF, Obertop H (1996) Role of the Shouldice technique in inguinal hernia repair: a systematic review of controlled trials and a meta-analysis. Br J Surg 83:734–738 Mitchell JB, Harrow B (1977) Costs and outcomes of inpatient versus outpatient hernia repair. Am J Surg 133:146–148 Ruckley CV, Cuthbertson C, Fenwick N, Prescott RJ, Garraway WM (1978) Day care after operations for hernia or varicose veins: a controlled trial. Br J Surg 65:456–459 Davies KE, Houghton K, Montgomery JE (2001) Obesity and day-case surgery. Anaesthesia 56:1112–1115 Jarret PE (2001) Day care surgery. Eur J Anaesthiol 23:32–35 Prabhu A, Chung F (2001) Anaesthetic strategies towards developments in day care surgery. Eur J Anaesthesiol 23:36–42 Go PM (2003) Laparoscopic cholecystectomy in day care; implementation of a guideline for clinical practice. Ned Tijdschr Geneeskd 147:1335–1336 Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R, Jr., Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827 O’Dwyer PJ, Serpell MG, Millar K, Paterson C, Young D, Hair A, Courtney CA, Horgan P, Kumar S, Walker A, Ford I (2003) Local or general anesthesia for open hernia repair: a randomized trial. Ann Surg 237:574–579 Courtney CA, Duffy K, Serpell MG, O’Dwyer PJ (2002) Outcome of patients with severe chronic pain following repair of groin hernia. Br J Surg 89:1310–1314 Page B, Paterson C, Young D, O’Dwyer PJ (2002) Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 89:1315–1318