ArticleSurgical endoscopy2016
Has endoscopic (TEP, TAPP) or open inguinal hernia repair a higher risk of bleeding in patients with coagulopathy or antithrombotic therapy? Data from the Herniamed Registry.
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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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.
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.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Comparison of open and laparoscopic groin hernia repair in elderly patients or octogenarians, an updated systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- The safe and risk assessment of perioperative antiplatelet and anticoagulation therapy in inguinal hernia repair, a systematic review.Surgical endoscopy · 2019Pooled it
- International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018Guideline
- Cessation vs no cessation of acetylsalicylic acid preoperatively in laparoscopic totally extraperitoneal inguinal hernia repair (CAPTAIN): final report from a multi-center, single-blinded, randomized-controlled trial.Hernia : the journal of hernias and abdominal wall surgery · 2025Trial
- Cessation vs. no cessation of acetylsalicylic acid preoperatively in laparoscopic totally extraperitoneal inguinal hernia repair (CAPTAIN): interim report from a multicentre, single-blind, randomised controlled trial.Hernia : the journal of hernias and abdominal wall surgery · 2025Trial
- Continuation of low-dose acetylsalicylic acid during perioperative period of laparoscopic inguinal hernia repair is safe: results of a prospective clinical trial.Hernia : the journal of hernias and abdominal wall surgery · 2019Trial
- Safety of Laparoscopic Hernia Surgery in Patients With Preoperative Antiplatelet Continuation Therapy.Cureus · 2025Article
- Percutaneous inguinal canal semi-closure during laparoscopic repair for large indirect inguinal hernia.Surgical endoscopy · 2025Article
- Laparoscopic vs. open inguinal hernia repair outcomes in patients aged 65 years and older.Frontiers in surgery · 2025Article
- [Outpatient treatment for hernia surgery in Germany].Chirurgie (Heidelberg, Germany) · 2024Review
- Glued suture-less peritoneum closure in laparoscopic inguinal hernia repair reduces acute postoperative pain.Scientific reports · 2024Article
- Sutureless Repair for Open Treatment of Inguinal Hernia: Three Techniques in Comparison.Journal of clinical medicine · 2024Article
- [Inguinal hernia operations-Always outpatient?]Chirurgie (Heidelberg, Germany) · 2023Review
- Article
- Laparoscopic versus Open Inguinal Hernia Repair in Aging Patients: A Propensity Score Matching-Based Retrospective Study.Therapeutics and clinical risk management · 2023Article
- Safety of laparoscopic inguinal hernia repair in the setting of antithrombotic therapy.Surgical endoscopy · 2022Article
- Safety of Inguinal Hernia Repair in the Elderly with Perioperative Continuation of Antithrombotic Therapy.Visceral medicine · 2021Article
- Continuation of antithrombotic therapy increases minor bleeding but does not increase the risk other morbidities in open inguinal hernia repair: A propensity score-matched analysis.Hernia : the journal of hernias and abdominal wall surgery · 2020Article
- The reality of general surgery training and increased complexity of abdominal wall hernia surgery.Hernia : the journal of hernias and abdominal wall surgery · 2019Review
- Laparoscopic repair is a treatment of choice for selected patients with incarcerated obturator hernia.Hernia : the journal of hernias and abdominal wall surgery · 2018Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionInguinal hernia operations in the presence of antithrombotic therapy, based on antiplatelet or anticoagulant drugs, or existing coagulopathy are associated with a markedly higher risk for onset of postoperative secondary bleeding. To date, there is a paucity of concrete data on this important clinical aspect of inguinal hernia surgery. Up till now, the endoscopic (TEP, TAPP) techniques have been considered to be more risky because of the extensive dissection involved. PATIENTS AND
methodsOut of the 82,911 patients featured in the Herniamed Hernia Registry who had undergone inguinal hernia repair, 9115 (11 %) were operated on while receiving antithrombotic therapy or with existing coagulopathy. The implications of that risk profile for onset of postoperative bleeding were investigated in multivariable analysis. In addition, other influence variables were identified.
resultsThe rate of postoperative secondary bleeding, at 3.91 %, was significantly higher in the risk group with coagulopathy or receiving antithrombotic therapy than in the group without that risk profile at 1.12 % (p < 0.001). Multivariable analysis revealed other influence variables which, in addition to coagulopathy or antithrombotic therapy, had a relevant influence on the occurrence of postoperative bleeding. These were open operation, a higher age, a higher ASA score, recurrence, male gender and a large hernia defect. Patients receiving antithrombotic therapy or with existing coagulopathy who undergo inguinal hernia operation have a fourfold higher risk for onset of postoperative secondary bleeding. Despite the extensive dissection required for endoscopic (TEP, TAPP) inguinal hernia repair, the risk of bleeding complications and complication-related reoperation appears to be lower.
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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.