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BJS Open Sep 2023Groin hernia repair is one of the most common operations performed globally, with more than 20 million procedures per year. The last guidelines on groin hernia...
BACKGROUND
Groin hernia repair is one of the most common operations performed globally, with more than 20 million procedures per year. The last guidelines on groin hernia management were published in 2018 by the HerniaSurge Group. The aim of this project was to assess new evidence and update the guidelines. The guideline is intended for general and abdominal wall surgeons treating adult patients with groin hernias.
METHOD
A working group of 30 international groin hernia experts and all involved stakeholders was formed and examined all new literature on groin hernia management, available until April 2022. Articles were screened for eligibility and assessed according to GRADE methodologies. New evidence was included, and chapters were rewritten. Statements and recommendations were updated or newly formulated as necessary.
RESULTS
Ten chapters of the original HerniaSurge inguinal hernia guidelines were updated. In total, 39 new statements and 32 recommendations were formulated (16 strong recommendations). A modified Delphi method was used to reach consensus on all statements and recommendations among the groin hernia experts and at the European Hernia Society meeting in Manchester on October 21, 2022.
CONCLUSION
The HerniaSurge Collaboration has updated the international guidelines for groin hernia management. The updated guidelines provide an overview of the best available evidence on groin hernia management and include evidence-based statements and recommendations for daily practice. Future guideline development will change according to emerging guideline methodology.
Topics: Adult; Humans; Hernia, Inguinal; Groin; Surgical Mesh; Abdominal Wall
PubMed: 37862616
DOI: 10.1093/bjsopen/zrad080 -
The British Journal of Surgery Nov 2023
Topics: Humans; Abdominal Wall; Plastic Surgery Procedures; Abdominal Wound Closure Techniques; Surgical Mesh
PubMed: 37713648
DOI: 10.1093/bjs/znad294 -
The Surgical Clinics of North America Oct 2023Patients requiring abdominal wall reconstruction may have medical comorbidities and/or complex defects. Comorbidities such as smoking, diabetes, obesity, cirrhosis, and... (Review)
Review
Patients requiring abdominal wall reconstruction may have medical comorbidities and/or complex defects. Comorbidities such as smoking, diabetes, obesity, cirrhosis, and frailty have been associated with an increased risk of postoperative complications. Prehabilitation strategies are variably associated with improved outcomes. Large hernia defects and loss of domain may present challenges in achieving fascial closure, an important part of restoring abdominal wall function. Prehabilitation of the abdominal wall can be achieved with the use of botulinum toxin A, and preoperative progressive pneumoperitoneum.
Topics: Humans; Abdominal Wall; Fascia; Liver Cirrhosis; Obesity; Pneumoperitoneum
PubMed: 37709396
DOI: 10.1016/j.suc.2023.04.022