title: Inguinal hernia surgery in The Netherlands: a baseline study before the introduction of the Dutch Guidelines.
abstract: 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.
authors.affiliation: Department of Surgery, Slotervaart Ziekenhuis, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands.
authors.forename: D H
authors.initials: DH
authors.lastname: de Lange
authors.forename: Th J
authors.initials: TJ
authors.lastname: Aufenacker
authors.forename: M
authors.initials: M
authors.lastname: Roest
authors.forename: R K J
authors.initials: RK
authors.lastname: Simmermacher
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: M P
authors.initials: MP
authors.lastname: Simons
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D019317:Evidence-Based Medicine; D005260:Female; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000592:standards* / Q000706:statistics & numerical data; D007813:Laparotomy / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D011336:Probability; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013526:Surgical Mesh; D016896:Treatment Outcome
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