Evidence map›Paper›PMID 21487873›Full record

SynthesisSurgical endoscopy2011

A meta-analysis of randomized controlled trials of fixation versus nonfixation of mesh in laparoscopic total extraperitoneal inguinal hernia repair.

Yuan Jun Teng, Shu Mei Pan, Ya Li Liu, Ke Hu Yang, You Cheng Zhang, Jin Hui Tian, Jian Xu Han

2 registry-linked trialsAbstract readComparative StudyMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 54 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 11 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.

NCT02712827 nacompletednot on this mapstarted 2016, after this paper: background citation

A Randomized Controlled Trial Comparing Short Term Outcomes of Self-gripping (Progrip) Mesh With Fibrin Glue Mesh Fixation in Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair

TypeinterventionalSponsorThe University of Hong KongRan2016 to 2018Enrolled150ConditionsHernia, InguinalArmsProgrip, Non-Progrip
NCT03564535 naunknown statusnot on this mapstarted 2018, after this paper: background citation

Comparison of Mesh Fixation With Tackers to Use of Self Fixating Mesh in Total Extra Peritoneal Inguinal Hernia Repair: A Double Blinded Randomized Controlled Trial

TypeinterventionalSponsorAll India Institute of Medical Sciences, BhubaneswarRan2018 to 2021Enrolled112ConditionsInguinal Hernia, AdultArmsSelf fixating group, Tacker fixation group
3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Intestinal erosions following inguinal hernia repair: a systematic review.Hernia : the journal of hernias and abdominal wall surgery · 2021
    Pooled it
  6. Pooled it
  7. TEP for elective primary unilateral inguinal hernia repair in men: what do we know?Hernia : the journal of hernias and abdominal wall surgery · 2019
    Pooled it
  8. International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Guideline
  9. Pooled it
  10. Guideline
  11. Guideline
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Mesh Displacement After Bilateral Inguinal Hernia Repair With No Fixation.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Trial
  19. Article
  20. Article
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

7 authors.

Yuan Jun TengEvidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Dong Gang West Road No. 199, Chengguan, Lanzhou, Gansu 730000, China.
Shu Mei Pan
Ya Li Liu
Ke Hu Yang
You Cheng Zhang
Jin Hui Tian
Jian Xu Han

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMesh fixation during laparoscopic total extraperitoneal (TEP) inguinal hernia repair is still controversial. Although many surgeons considered it necessary to fix the mesh, some published studies supported elimination of mesh fixation. Therefore, a meta-analysis based on randomized controlled trials (RCTs) was conducted to compare the effectiveness and safety of fixation versus nonfixation of mesh in TEP.

methodsRCTs were identified from PubMed, Embase, the Cochrane Library, SCI, and the Chinese Biomedical Literature Database (CBM). Two reviewers assessed the quality of the studies and extracted data independently. The methodological quality was evaluated according to the Cochrane Handbook 5.0.2. Statistical analysis was conducted using the Cochrane software RevMan 5.0.21.

resultsSix RCTs involving 772 patients were included. The nonfixation group had advantages in length of hospital stay [MD =-0.37, 95% CI (-0.57, -0.17), p = 0.0003], operative time [MD = -4.19, 95% CI (-7.77, -0.61), p = 0.02], and costs. However, there was no statistically significant difference in hernia recurrence [OR = 2.01, 95% CI (0.37, 11.03), p = 0.42], time to return to normal activities [MD = -0.13, 95% CI (-0.45, 0.19), p = 0.43], seroma [OR = 1.25, 95% CI (0.30, 5.18), p = 0.75], and postoperative pain on postoperative day 1 [MD = -0.21, 95% CI (-0.52, 0.10), p = 0.18] and day 7 [MD = -0.11, 95% CI (-0.42, 0.20), p = 0.47].

conclusionsWithout increasing the risk of early hernia recurrence, the nonfixation of mesh in TEP appears to be a safe alternative that is associated with less costs, shorter operative time, and hospital stay for the selected patients. Further adequately powered RCTs are required to clarify whether mesh fixation is necessary for the patients with different types of hernias and larger hernia defects.

Indexed as

Surgical MeshSuture TechniquesAdultCosts and Cost AnalysisDouble-Blind MethodHernia, InguinalHerniorrhaphyHumansLaparoscopyLength of StayPeripheral Nerve InjuriesPostoperative ComplicationsPostoperative PainRandomized Controlled Trials as TopicSelection BiasSeroma

Identifiers

PMID21487873

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.