Evidence map›Paper›PMID 21789654›Full record

Trial reportHernia : the journal of hernias and abdominal wall surgery2012

Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results.

C Kim-Fuchs, E Angst, S Vorburger, C Helbling, D Candinas, R Schlumpf

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 10 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

31 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Guideline
  7. Pooled it
  8. 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
  9. Pooled it
  10. Pooled it
  11. Long term inguinal pain comparing TEP to Lichtenstein repair: the TEPLICH RCT 8 years follow-up.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Article
  17. Review
  18. Article
  19. Article
  20. 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

6 authors.

C Kim-FuchsClinic of Surgery, Kantonsspital Aarau, Aarau, Switzerland. Corina.kim@insel.ch
E Angst
S Vorburger
C Helbling
D Candinas
R Schlumpf

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFollowing Lichtenstein hernia repair, up to 25% of patients experience prolonged postoperative and chronic pain as well as discomfort in the groin. One of the underlying causes of these complaints are the compression or irritation of nerves by the sutures used to fixate the mesh. We compared the level and rate of chronic pain in patients operated with the classical Lichtenstein technique fixated by sutures to patients with sutureless mesh fixation technique.

methodsA two-armed randomized trial with 264 male patients was performed. After consent, patients were randomized preoperatively. For the fixation of the mesh we used either sutures with slow-absorbing material (PDS 2.0) (group I, n = 133) or tissue glue (Histoacryl) (group II, n = 131). Follow-up examinations were performed after 3, 12 months and after 5 years.

resultsPatient characteristics in the two groups were similar. No cross-over between groups was observed. After 5 years, long-term follow-up could be completed for 59% of subjects. After 5 years, 10/85 (11.7%) patients in group I and 3/70 (4.2%) in group II suffered from chronic pain in the groin region (P = 0.108). The operation time was significantly shorter in group II (79 min vs 73 min, P = 0.01). One early recurrence occurred in group II (3 months). The recurrence rate was 0 and 0% after 12 months and 5.9% (5/85) and 10% (7/70) after 5 years in group I and group II, respectively (P = 0.379).

conclusionAfter 5 years, the two techniques of mesh fixation resulted in similar rates of chronic pain. Whereas recurrence rates were comparable, fixation of the mesh with tissue glue decreased operating room time significantly. Hence, suture less mesh fixation with Histoacryl is a sensible alternative to suture fixation and should be especially considered for patients prone to pain.

Indexed as

AdultAgedAged, 80 and overChronic PainEnbucrilateFollow-Up StudiesHernia, InguinalHerniorrhaphyHumansHypesthesiaKaplan-Meier EstimateMaleMiddle AgedPostoperative PainRecurrenceSuturesEnbucrilateTissue Adhesives

Identifiers

PMID21789654

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.