The gap between evidence-based guidelines and daily practice.

摘要

I read with interest both the paper of Bernhardt et al. [1] and the invited commentary of Holzheimer [2] on the gap between evidence-based guidelines and the daily practice of inguinal hernia surgery.In 2006, the French Society of Digestive Surgery published evidence-based guidelines recommending the use (by nonexpert laparoscopic surgeons) of the conventional approach instead of laparoscopy for primary inguinal hernia repair [3]. These recommendations have been very much criticized by expert surgeons [4] and the French laparoscopic societies [5]. It was stated in the latter guidelines that "the Societies state no negative recommendation regarding laparoscopic hernia repair" [5]. One can be surprised by the publication of two conflicting guidelines on the same topic in the same country, but this is perhaps the so-called "French touch"!!