Evidence map›Paper›PMID 23546863›Full record

Trial reportHernia : the journal of hernias and abdominal wall surgery2014

Hernia sac of indirect inguinal hernia: invagination, excision, or ligation?

I Othman, H A Hady

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05308251 (Comparison of Hernia Sac Ligation Versus Invagination in Lichtenstein Tension Free Mesh Hernioplasty. Does Type of Hernia Have a Role on Outcomes?), which is not on this map. Cited by 12 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 4 pooled it
1.5field-weighted citation impact, top 18% 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.

NCT05308251 nacompletednot on this mapstarted 2020, after this paper: background citation

Comparison of Hernia Sac Ligation Versus Invagination in Lichtenstein Tension Free Mesh Hernioplasty. Does Type of Hernia Have a Role on Outcomes?

TypeinterventionalSponsorSamsun Education and Research HospitalRan2020 to 2022Enrolled108ConditionsHernia, Inguinal, Postoperative Pain, RecurrenceArmsLichtenstein Mesh Hernioplasty
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 4 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Guideline
  5. Trial
  6. Article
  7. Review
  8. Review
  9. Article
  10. Article
  11. Article
  12. Malignant epithelial tumors observed in hernia sacs.Hernia : the journal of hernias and abdominal wall surgery · 2014
    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

2 authors at 1 institution in 1 country.

I OthmanDepartment of General Surgery, Tanta University, Tanta, Egypt, ibrahimothman000@yahoo.com.
H A Hady
Tanta University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

unlabelledThis study compares the effect of invaginating excision of hernia sac without ligation with the traditional method of high ligation of the hernia sac on postoperative pain and recurrence. PATIENTS AND

methodsThis multicenter prospective randomized study included 152 patients with 167 primary indirect inguinal hernias. In group I (54 hernias), the sac was not opened and was inverted with the finger into the peritoneal cavity. In group E (56 hernias), the sac was excised at the neck without ligation. In group L (57 hernias), the sac was transfixed at the neck and excised in the traditional manner. The repair of the posterior wall of the inguinal canal was done according to Lichtenstein tension-free technique. Mean length of follow-up was 81.50 ± 22.34, 79.35 ± 26.76, and 77.83 ± 21.26 months, respectively.

resultsPostoperative seroma occurred in 1 patient (0.60%) in group E and 1 patient (0.60%) in group L. Surgical site infection occurred in 2 patients (1.20%) in group I, 1 patient (0.60%) in group E, and 2 patients (1.20%) in group L. Mean postoperative pain score was 3.04 ± 2.11, 3.98 ± 2.33 and 4.06 ± 2.43, respectively (p: 0.049). Chronic pain occurred in 3 patients in group I (1.80%), 3 patients in group E (1.80%), and 5 patients in group L (3.00%) (p: 0.749). The difference between the complications in three groups was statistically insignificant (p: 0.887). Hernia recurrence occurred in 3 patients (1.80%) in group I, 1 patient (0.60%) in group E, and 1 patient (0.60%) in group L (p: 0.429).

conclusionInvagination and excision of the hernia sac do not have adverse effects on repair integrity. They limit the dissection and reduce the morbidity and risk of injury to the spermatic cord and surrounded structures. They are safer and more appropriate for repair of sliding hernia. Ligation of the hernia sac in inguinal hernia surgery is not only unnecessary and time consuming but also leads to increased postoperative pain. Recurrence rates are statistically unaffected by not ligating the sac.

Indexed as

AdultFemaleHernia, InguinalHerniorrhaphyHumansLigationMaleMiddle AgedPain MeasurementPostoperative ComplicationsPostoperative PainProspective StudiesRecurrenceSaudi ArabiaTreatment Outcome

Identifiers

PMID23546863
OpenAlexW2039459548

What OpenQuestion holds

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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.