Evidence map›Paper›PMID 27129549›Full record

ArticleSurgical endoscopy2016

Is preoperative withdrawal of aspirin necessary in patients undergoing elective inguinal hernia repair?

Wilson Ong, Tong Shen, Wee Boon Tan, Davide Lomanto

Abstract readEvaluation Study
PubMed Publisher
In one paragraph

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 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 22% 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.

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

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Perioperative Management of Antiplatelet Therapy: A Systematic Review and Meta-analysis.Mayo Clinic proceedings. Innovations, quality & outcomes · 2022
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. 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

4 authors at 2 institutions in 1 country.

Wilson OngYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. prooyf@hotmail.com.
Tong ShenYong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Wee Boon TanDepartment of Surgery, Minimally Invasive Surgical Centre, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Davide LomantoDepartment of Surgery, Minimally Invasive Surgical Centre, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
National University of Singapore · SGNational University Health System · SG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntiplatelets such as aspirin are widely used to reduce thrombotic events in patients with various cardiovascular comorbidities. Continuing aspirin through noncardiac surgery has been shown to reduce risk of major adverse cardiac events (MACE) but may lead to higher bleeding complications. Inguinal hernia repair is a commonly performed surgical procedure among such patients, but no guideline exists regarding perioperative use of aspirin.

objectiveWe aim to investigate the safety profile of aspirin continuation in the perioperative period in patients undergoing elective primary inguinal hernia repair.

methodsAll patients who underwent elective primary inguinal hernia repair from 2008 to 2015 and were on aspirin preoperatively were identified. The patients were divided into two groups: those who continued aspirin through the morning of the operation and those who were advised to stop aspirin therapy 3-7 days prior to operation. All patients underwent either open Lichtenstein mesh repair or laparoscopic total extra-peritoneal mesh repair. Outcomes measured include intraoperative blood loss, operative time, bleeding complications, wound site complications and MACE.

resultsAmong 1841 patients who underwent elective primary inguinal hernia mesh repair, 142 (7.7 %) patients were on preoperative aspirin. Fifty-seven patients underwent laparoscopic repair, while 85 underwent open mesh repair. Twenty-seven out of fifty-seven (47.3 %) from the laparoscopic group and 55/85 (64.7 %) from the open group were instructed to stop aspirin (p = 0.040). There were no significant differences between those who stopped aspirin and those who continued in terms of intraoperative blood loss and operative timing. Immediate postoperative bleeding complications and follow-up wound complications were also similar between the two groups. Overall, there were no MACE among those who underwent laparoscopic repair. Three MACE were recorded in the open group (2 stopped vs. 1 continued; p = 0.943). There was no perioperative mortality.

conclusionContinuation of aspirin is safe and should be preferred in patients with higher cardiovascular risk.

Indexed as

Elective Surgical ProceduresHerniorrhaphyAdultAgedAspirinBlood Loss, SurgicalDrug Administration ScheduleFemaleFollow-Up StudiesHernia, InguinalHumansMaleMiddle AgedOperative TimePerioperative CarePlatelet Aggregation InhibitorsAspirinPlatelet Aggregation InhibitorsAntiplateletsAspirinInguinal herniaRepair

Identifiers

PMID27129549
OpenAlexW2343642896

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.