Operation versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias: The meta-analysis results of randomized controlled trials

Introduction: The aim of this article was to compare and analyze the outcomes of surgical repair and watchful waiting (WW) in the treatment of asymptomatic or minimally symptomatic inguinal hernias. Methods: A systematic literature review was undertaken to identify studies that compare surgical repair and watchful waiting in asymptomatic or minimally symptomatic inguinal hernias. And all related data matching our standards were abstracted for Meta-analysis with RevMan 5.0.1. Results: Less pain was observed in Operation group. However, there were no significant differences in Physical Component Score (PCS), mortality, surgical complications and postoperative hernia recurrence between WW group and Operation group. But a great number of patients would develop significant hernia-related symptoms and cross over to surgery over time in WW group. Conclusions: Patients have relative less pain in operation group compared with WW group. Although WW is safe in patients with asymptomatic or minimally symptomatic inguinal hernias, however, this strategy would merely delay rather than avoid surgical repair of hernias in the majority of inguinal hernia patients.