Evidence map›Paper›PMID 28593417›Full record

ArticleSurgical endoscopy2017

Laparoscopic approach for the treatment of chronic groin pain after inguinal hernia repair : Laparoscopic approach for inguinodynia.

Bruce Ramshaw, Vincent Vetrano, Mayuri Jagadish, Brandie Forman, Eric Heidel, Matthew Mancini

Abstract read
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Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 14% 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

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

  1. Pooled it
  2. Pooled it
  3. Article
  4. Observational
  5. Article
  6. Article
  7. 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

6 authors at 2 institutions in 1 country.

Bruce RamshawDepartment of Surgery, University of Tennessee, Knoxville, 1934 Alcoa Hwy, Bldg D, Suite 285, Knoxville, TN, 37920, USA. BRamshaw@utmck.edu.ORCID 0000-0002-2313-2466
Vincent VetranoDepartment of Surgery, University of Tennessee, Knoxville, 1934 Alcoa Hwy, Bldg D, Suite 285, Knoxville, TN, 37920, USA.
Mayuri JagadishDepartment of Surgery, University of Tennessee, Knoxville, 1934 Alcoa Hwy, Bldg D, Suite 285, Knoxville, TN, 37920, USA.
Brandie FormanDepartment of Surgery, University of Tennessee, Knoxville, 1934 Alcoa Hwy, Bldg D, Suite 285, Knoxville, TN, 37920, USA.
Eric HeidelDepartment of Surgery, University of Tennessee, Knoxville, 1934 Alcoa Hwy, Bldg D, Suite 285, Knoxville, TN, 37920, USA.
Matthew ManciniDepartment of Surgery, University of Tennessee, Knoxville, 1934 Alcoa Hwy, Bldg D, Suite 285, Knoxville, TN, 37920, USA.
Alcoa (United States) · USUniversity of Tennessee Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTraditional methods of clinical research may not be adequate to improve the value of care for patients with complex medical problems such as chronic pain after inguinal hernia repair. This problem is very complex with many potential factors contributing to the development of this complication.

methodsWe have implemented a clinical quality improvement (CQI) effort in an attempt to better measure and improve outcomes for patients suffering with chronic groin pain (inguinodynia) after inguinal hernia repair. Between April 2011 and June 2016, there were 93 patients who underwent 94 operations in an attempt to relieve pain (1 patient had two separate unilateral procedures). Patients who had prior laparoscopic inguinal hernia repair (26) had their procedure completed laparoscopically. Patients who had open inguinal hernia repair (68) had a combination of a laparoscopic and open procedure in an attempt to relieve pain. Initiatives to attempt to improve measurement and outcomes during this period included the administration of pre-operative bilateral transversus abdominis plane and intra-operative inguinal nerve blocks using long-acting local anesthetic as a part of a multimodal regimen, the introduction of a low pressure pneumoperitoneum system, and the expansion of a pre-operative questionnaire to assess emotional health pre-operatively.

resultsThe results included the assessment of how much improvement was achieved after recovery from the operation. Forty-five patients (48%) reported significant improvement, 39 patients (41%) reported moderate improvement, and 10 patients (11%) reported little or no improvement. There were 3 (3%) complications, 13 (11%) hernia recurrences, and 15 patients (13%) developed a new pain in the inguinal region after the initial pain had resolved.

conclusionsThe principles of CQI can be applied to a group of patients suffering from chronic pain after inguinal hernia repair. Based on these results additional process improvement ideas will be implemented in an attempt to improve outcomes.

Indexed as

AdultAgedAged, 80 and overAnesthetics, LocalChronic PainFemaleGroinHernia, InguinalHerniorrhaphyHumansLaparoscopyMaleMiddle AgedNerve BlockPain ManagementPain MeasurementAnesthetics, LocalChronic painClinical quality improvement (CQI)Data scienceInguinal herniaInguinodyniaLaparoscopy

Identifiers

PMID28593417
OpenAlexW2623957389

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.