Evidence map›Paper›PMID 25862026›Full record

Trial reportHernia : the journal of hernias and abdominal wall surgery2016

Identification and management of the ilio-inguinal and ilio-hypogastric nerves in open inguinal hernia repair: benefits of self-gripping mesh.

S Smeds, S Nienhuijs, E Kullman, D L Sanders, T Lehnert, P Ziprin, M Gingell-Littlejohn, M Miserez, A Kingsnorth

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 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

6 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  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. Article
  5. Article
  6. 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

9 authors.

S SmedsMedicinskt Centrum, Linköping, St. Larsgatan 42, 582 24, Linköping, Sweden. staffan.smeds@dynatab.se.
S NienhuijsCatharina-Ziekenhuis, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
E KullmanMedicinskt Centrum, Linköping, St. Larsgatan 42, 582 24, Linköping, Sweden.
D L SandersDerriford Hospital, Derriford Road, Plymouth, Devon, PL6 8DH, UK.
T LehnertKlinikum Bremen Mitte, St. Jürgen Straße 1, Bremen, Germany.
P ZiprinImperial College London, St. Mary's Hospital, Praed Street, London, W2 1NY, UK.
M Gingell-LittlejohnWestern Infirmary, 44 Church Street, Glasgow, Scotland, UK.
M MiserezUniversitaire Ziekenhuizen Leuven, Herestraat 49, Louvain, Belgium.
A KingsnorthDerriford Hospital, Derriford Road, Plymouth, Devon, PL6 8DH, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA large randomized, multicenter European study recently reported a reduction in early pain after open inguinal surgery when self-gripping mesh was used compared with sutured Lichtenstein repair. This secondary exploratory study is focused on the influence of nerve identification and handling on post-operative pain.

methodsPost-operative VAS pain data and Surgical Pain Scores (SPS) from 507 patients included in this study were analyzed according to whether inguinal nerves were preserved or resected during surgery to investigate whether identification and peri-operative nerve handling impact post-operative pain.

resultsPreservation of the ilio-hypogastric nerve during Lichtenstein mesh repair with suture fixation was associated with significantly more post-operative pain compared with resection at each follow-up (p ≤ 0.003). This difference was not significant with self-gripping mesh repair. The decrease from baseline in post-operative VAS and SPS scores were significantly greater after self-gripping mesh repair compared to Lichtenstein repair at 1 year, but only when the ilio-hypogastric nerve was preserved (VAS scores, p = 0.009; SPS scores, p = 0.015). No such difference was observed with the ilio-inguinal nerve. When self-gripping mesh was used, preservation of the ilio-hypogastric nerve was associated with significantly greater decreases in post-operative pain (change in VAS score from baseline) compared with Lichtenstein repair at each follow-up (p ≤ 0.018).

conclusionsThe ilio-hypogastric nerve is in danger of being traumatized during Lichtenstein mesh repair with suture fixation. The use of self-gripping mesh was shown to reduce the level of post-operative pain when the ilio-hypogastric nerve was preserved. Resection of the ilio-hypogastric nerve during Lichtenstein repair eliminates this difference.

Indexed as

Surgical MeshAdultAgedHernia, InguinalHerniorrhaphyHumansLumbosacral PlexusMaleMiddle AgedNeuralgiaPostoperative PainSuture TechniquesHernia repairNerve preservationPost-operative painSelf-gripping mesh

Identifiers

PMID25862026

What OpenQuestion holds

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Registered trials

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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.