Inguinal hernia.
BACKGROUND
The main risk factors for inguinal hernia are male sex and increasing age. Complications of inguinal hernia include strangulation, intestinal obstruction, and infarction. Recurrence can occur after surgery.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of elective treatments for primary unilateral, primary bilateral, and recurrent inguinal hernia in adults? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations, such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: expectant management, open mesh repair, open suture repair, totally extraperitoneal (TEP) laparoscopic repair, and transabdominal preperitoneal (TAPP) laparoscopic repair.
Purkayastha
Sanjay
S
Department of Biosurgery and Surgical Technology, Imperial College, St Mary's Hospital, London, UK.
Chow
Andre
A
Athanasiou
Thanos
T
Tekkis
Paris
P
Darzi
Ara
A
D006552:Hernia, Inguinal; D006801:Humans; D007415:Intestinal Obstruction; D010535:Laparoscopy; D012008:Recurrence; D012307:Risk Factors; D013537:Sutures; D016896:Treatment Outcome