Evidence map›Paper›PMID 21461904›Full record

Trial reportHernia : the journal of hernias and abdominal wall surgery2011

One-year results of a prospective, randomised clinical trial comparing four meshes in laparoscopic inguinal hernia repair (TAPP).

R Bittner, B J Leibl, B Kraft, J Schwarz

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report 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 21 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 5 pooled it
5.0field-weighted citation impact, top 5% of its field
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

21 citing papers in PubMed, 5 syntheses or guidelines pooled it, 51 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Guideline
  4. Guideline
  5. Pooled it
  6. Trial
  7. Trial
  8. Review
  9. Article
  10. Article
  11. Article
  12. Varying convalescence recommendations after inguinal hernia repair: a systematic scoping review.Hernia : the journal of hernias and abdominal wall surgery · 2022
    Article
  13. Causes of recurrence in laparoscopic inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Review
  14. Review
  15. Pain after totally extraperitoneal (TEP) hernia repair might fade out within a year.Hernia : the journal of hernias and abdominal wall surgery · 2015
    Article
  16. Article
  17. [Recurrence after hernia surgery: complication or natural course?].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2014
    Review
  18. Article
  19. Article
  20. Inguinal hernia repair: current surgical techniques.Langenbeck's archives of surgery · 2012
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

R BittnerDepartment of General and Visceral Surgery, Hernia Center, EuromedClinic Fürth, Europaallee 1, 90763 Fürth, Germany. bittnerfamilie@web.de
B J Leibl
B Kraft
J Schwarz
Marienhospital Stuttgart · DEEuromedic · PLKlinikum Coburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA low rate of chronic pain and maximum postoperative comfort are the main goals today in inguinal hernia repair. This four-arm randomised trial compares these parameters after laparoscopic hernia repair (TAPP) with a standard heavyweight mesh (HW), a pure middleweight polypropylene mesh (MW), a lightweight composite polypropylene mesh (LW), or a titanised lightweight mesh (TLW). The primary endpoint of the study was the incidence of chronic pain of any severity at the site of hernia repair at 1 year.

methodsA total of 600 patients with a laparoscopic inguinal hernia repair and a defect diameter of 3-5 cm were included in the trial. In all patients, a non-invasive mesh fixation technique was performed using fibrin glue. Patients were assessed for pain, foreign body sensation, and physical activities preoperatively, early postoperatively, at 4 weeks, at 6 months, and at 1 year by questionnaire, and were examined clinically. Postoperatively, seroma formation was measured by ultrasound.

resultsAt 1 year after TAPP, frequency of pain did not differ statistically between the four groups (depending on type of activity: between 6-8% with HW mesh, 2-4% with middleweight mesh, and 2-4.7% with both lightweight meshes); average intensity of pain was very low, at between VAS 0.4 ± 3.1 and 1.5 ± 7.8 (MW, LW, TLW) and between 1.9 ± 8.6 and 2.3 ± 9.1 (HW) depending on activity (n.s.). Early postoperatively between 31.3% (LW) and 21.3% (TLW) of the patients needed pain medication (n.s.); at 1 year this percentage had dropped to 0.3% (one HW, one MW). Foreign body sensation did not differ but impairment of physical activities (P = 0.0437) was significantly less in the MW, LW, and TLW group (6-12.7%) compared to HW (15.3%) at 4 weeks; at 1 year this percentage was between 0 and 1.3% (n.s.).

conclusionCompared to HW mesh, the use of MW, LW, and TLW meshes for laparoscopic hernia repair did not significantly affect rate of chronic pain, but seemed to improve early postoperative convalescence. No difference was found between middleweight pure polypropylene (MW), composite lightweight (LW), or titanised lightweight polypropylene (TLW) meshes.

Indexed as

AdultAgedAnalgesicsAnalysis of VarianceChronic PainEquipment DesignFemaleFibrin Tissue AdhesiveHernia, FemoralHernia, InguinalHerniorrhaphyHumansLaparoscopyMaleMiddle AgedMotor ActivityAnalgesicsFibrin Tissue AdhesivePolypropylenesTissue AdhesivesTitanium

Identifiers

PMID21461904
OpenAlexW2040954844

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.