Evidence map›Paper›PMID 23887595›Full record

ArticleWorld journal of surgery2013

Lower reoperation rate for recurrence after mesh versus sutured elective repair in small umbilical and epigastric hernias. A nationwide register study.

M W Christoffersen, F Helgstrand, J Rosenberg, H Kehlet, T Bisgaard

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07156188 (The PAPYRUS Study), which is not on this map. Cited by 51 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 5 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.

NCT07156188 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The PAPYRUS Study: Permanent vs. Absorbable Sutures in PrimarY Repair of Umbilical HerniaS: A Multicentre, Single-blind, Non-inferiority, Randomized Controlled Trial

TypeinterventionalSponsorUniversity of British ColumbiaRan2026 to 2030Enrolled914ConditionsHernia Surgery, Umbilical Hernia RepairArmsPermanent Suture, Absorbable
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Laparoscopic versus open repair for umbilical hernia: outcomes and complications.Hernia : the journal of hernias and abdominal wall surgery · 2026
    Pooled it
  3. Pooled it
  4. A systematic review on surgical treatment of primary epigastric hernias.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Pooled it
  5. Abdominal wall hernia and pregnancy: a systematic review.Hernia : the journal of hernias and abdominal wall surgery · 2015
    Pooled it
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  13. Efficacy of slowly absorbable versus permanent sutures in primary repair of umbilical hernias.Hernia : the journal of hernias and abdominal wall surgery · 2026
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

M W ChristoffersenDepartment of Surgery, Hvidovre Hospital, University Hospital of Copenhagen, Kettegård Alle 30, 2650, Hvidovre, Denmark, mette.willaume@gmail.com.
F Helgstrand
J Rosenberg
H Kehlet
T Bisgaard

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRepair for a small (≤ 2 cm) umbilical and epigastric hernia is a minor surgical procedure. The most common surgical repair techniques are a sutured repair or a repair with mesh reinforcement. However, the optimal repair technique with regard to risk of reoperation for recurrence is not well documented. The aim of the present study was in a nationwide setup to investigate the reoperation rate for recurrence after small open umbilical and epigastric hernia repairs using either sutured or mesh repair. MATERIALS AND

methodsThis was a prospective cohort study based on intraoperative registrations from the Danish Ventral Hernia Database (DVHD) of patients undergoing elective open mesh and sutured repair for small (≤ 2 cm) umbilical and epigastric hernias. Patients were included during a 4-year study period. A complete follow-up was obtained by combining intraoperative data from the DVHD with data from the Danish National Patient Register. The cumulative reoperation rates were obtained using cumulative incidence plot and compared with the log rank test. RESULTS AND

conclusionsIn total, 4,786 small (≤ 2 cm) elective open umbilical and epigastric hernia repairs were included. Age was median 48 years (range 18-95 years). Follow-up was 21 months (range 0-47 months). The cumulated reoperation rates for recurrence were 2.2 % for mesh reinforcement and 5.6 % for sutured repair (P = 0.001). The overall cumulated reoperation rate for sutured and mesh repairs was 4.8 %. In conclusion, reoperation rate for recurrence for small umbilical and epigastric hernias was significantly lower after mesh repair compared with sutured repair. Mesh reinforcement should be routine in even small umbilical or epigastric hernias to lower the risk of reoperation for recurrence avoid recurrence.

Indexed as

Surgical MeshSuture TechniquesAdolescentAdultAgedAged, 80 and overDenmarkFemaleHernia, UmbilicalHerniorrhaphyHumansIncidenceMaleMiddle AgedProspective StudiesRecurrence

Identifiers

PMID23887595

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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.