[Watchful waiting vs surgical repair of oligosymptomatic incisional hernias: Current status of the AWARE study]

Chirurg. 2016 Jan;87(1):47-55. doi: 10.1007/s00104-015-0011-2.
[Article in German]

Abstract

Introduction: Incisional hernias are one of the the most frequent complications in visceral surgery and incisional hernia repair has a relevant complication rate. Therefore, there have to be solid indications before carrying out incisional hernia repair. To date, there is a lack of evidence concerning the correct indications for surgical repair of incisional hernias. The AWARE trial compares watchful waiting to surgical repair of incisional hernias.

Material and methods: The AWARE trial is a prospective randomized multicenter trial. Patients with asymptomatic or oligosymptomatic incisional hernia are randomized into the watchful waiting or the surgical repair group with a follow-up of 2 years. The primary endpoint is pain during normal activities due to the hernia or the hernia repair after 2 years measured on the hernia-specific surgical pain scale (SPS).

Results: In this study 36 centers are participating throughout Germany, more than 1600 patients had been screened up to 31 December 2014 and 234 (14.6%) of the screened patients could be recruited.

Conclusion: The AWARE study will provide evidence concerning the two therapeutic options of watchful waiting and surgical repair of incisional hernia.

Keywords: AWARE study; Oligosymptomatic incisional hernia; Prospective randomized trial; Surgical repair; Watchful waiting.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Evidence-Based Medicine
  • Follow-Up Studies
  • Germany
  • Humans
  • Incisional Hernia / diagnosis
  • Incisional Hernia / etiology
  • Incisional Hernia / surgery*
  • Pain Measurement
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Prospective Studies
  • Quality of Life
  • Watchful Waiting*