Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

Henriksen, N. A. ; Kaufmann, R. ; Simons, M. P. ; Berrevoet, F. ; East, B. ; Fischer, J. ; Hope, W. ; Klassen, D. ; Lorenz, R. and Renard, Y. , et al. (2020) In BJS Open 4(2). p.342-353
Abstract

BACKGROUND: Rare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management. METHODS: The guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full-text papers. A systematic literature search was performed on 1 May 2018 and updated 1... (More)

BACKGROUND: Rare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management. METHODS: The guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full-text papers. A systematic literature search was performed on 1 May 2018 and updated 1 February 2019. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was followed. RESULTS: Literature was limited in quantity and quality. A majority of the recommendations were graded as weak, based on low quality of evidence. In patients with cirrhosis or on dialysis, a preperitoneal mesh repair is suggested. Subsequent pregnancy is a risk factor for recurrence. Repair should be postponed until after the last pregnancy. For patients with a concomitant rectus diastasis or those with a Spigelian or lumbar hernia, no recommendation could be made for treatment strategy owing to lack of evidence. CONCLUSION: This is the first European and American guideline on the treatment of umbilical and epigastric hernias in patients with special conditions, including Spigelian and lumbar hernias. All recommendations were weak owing to a lack of evidence. Further studies are needed on patients with rectus diastasis, Spigelian and lumbar hernias.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; and (Less)
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BJS Open
volume
4
issue
2
pages
12 pages
publisher
Wiley
external identifiers
  • scopus:85077905317
  • pmid:32207571
ISSN
2474-9842
DOI
10.1002/bjs5.50252
language
English
LU publication?
yes
id
4e0e8136-0ddb-4416-813c-45ea1632435d
date added to LUP
2020-12-18 14:20:02
date last changed
2024-04-17 21:26:32
@article{4e0e8136-0ddb-4416-813c-45ea1632435d,
  abstract     = {{<p>BACKGROUND: Rare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management. METHODS: The guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full-text papers. A systematic literature search was performed on 1 May 2018 and updated 1 February 2019. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was followed. RESULTS: Literature was limited in quantity and quality. A majority of the recommendations were graded as weak, based on low quality of evidence. In patients with cirrhosis or on dialysis, a preperitoneal mesh repair is suggested. Subsequent pregnancy is a risk factor for recurrence. Repair should be postponed until after the last pregnancy. For patients with a concomitant rectus diastasis or those with a Spigelian or lumbar hernia, no recommendation could be made for treatment strategy owing to lack of evidence. CONCLUSION: This is the first European and American guideline on the treatment of umbilical and epigastric hernias in patients with special conditions, including Spigelian and lumbar hernias. All recommendations were weak owing to a lack of evidence. Further studies are needed on patients with rectus diastasis, Spigelian and lumbar hernias.</p>}},
  author       = {{Henriksen, N. A. and Kaufmann, R. and Simons, M. P. and Berrevoet, F. and East, B. and Fischer, J. and Hope, W. and Klassen, D. and Lorenz, R. and Renard, Y. and Garcia Urena, M. A. and Montgomery, A.}},
  issn         = {{2474-9842}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{342--353}},
  publisher    = {{Wiley}},
  series       = {{BJS Open}},
  title        = {{EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances}},
  url          = {{http://dx.doi.org/10.1002/bjs5.50252}},
  doi          = {{10.1002/bjs5.50252}},
  volume       = {{4}},
  year         = {{2020}},
}