Evidence map›Paper›PMID 21279398›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2011

Analysis of outcome of Lichtenstein groin hernia repair by surgeons-in-training versus a specialized surgeon.

A Frisén, J Starck, S Smeds, P O Nyström, A Kald

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Guideline
  2. Uniformity of Chronic Pain Assessment after Inguinal Hernia Repair: A Critical Review of the Literature.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2017
    Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

A FrisénDepartment of Surgery, University Hospital, 581 85, Linköping, Sweden. angelica.frisen@lio.se
J Starck
S Smeds
P O Nyström
A Kald

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGroin hernia repair is a common procedure in general surgery, and is taught to and performed by surgeons early in their training. The aim of this observational study was to compare hernia repair performance and results of surgical trainees with those of a specialized surgeon, to identify what factors may influence short and long-term outcome, and areas for improvement in surgical training.

methodsA non-randomized parallel cohort study was designed; 200 Lichtenstein repairs in adult males were included, of which 96 were performed by surgical trainees. Patient characteristics, surgical experience, and operative data, including duration of procedural parts and surgical complexity, were noted at surgery. Postoperative complications, recurrence, chronic pain and residual symptoms were assessed at long-term follow-up after a median of 34.5 months.

resultsSurgical trainees required longer overall operative time, with a disproportionally longer time for mobilizing the sac and cord. They perceived exposure and mobilization as more difficult than the specialist, and also a greater demand on their own experience during surgery. The trainee repairs had a higher rate of postoperative complications (14.7% vs 5.0%) but recurrence rate was the same as for specialist repairs. At long-term follow-up, specialist repairs had higher symptom burden and more chronic pain.

conclusionsIt was more efficient, but not necessarily better, to let a specialized surgeon perform the repairs. It seems likely that targeted training in dissection and mobilization could decrease level of perceived complexity and shorten the operative time required by surgical trainees.

Indexed as

Clinical CompetencePostoperative PainAdultAgedAttitude of Health PersonnelChronic DiseaseFollow-Up StudiesGeneral SurgeryHernia, InguinalHumansMaleMiddle AgedRecurrenceSurveys and QuestionnairesTime and Motion StudiesTime Factors

Identifiers

PMID21279398

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.