Evidence map›Paper›PMID 28726142›Full record

SynthesisSurgical endoscopy2018

Single-incision surgery trocar-site hernia: an updated systematic review meta-analysis with trial sequential analysis by the Minimally Invasive Surgery Synthesis of Interventions Outcomes Network (MISSION).

Stavros A Antoniou, Josep M García-Alamino, Shahab Hajibandeh, Shahin Hajibandeh, Michael Weitzendorfer, Filip E Muysoms, Frank A Granderath, George E Chalkiadakis, Klaus Emmanuel, George A Antoniou and 4 more

Abstract readMeta-AnalysisSystematic Review
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In one paragraph

Synthesis in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 6 pooled it
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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

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

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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

14 authors.

Stavros A AntoniouDepartment of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece. stavros.antoniou@hotmail.com.
Josep M García-AlaminoNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Shahab HajibandehDepartment of General Surgery, Royal Blackburn Hospital, Blackburn, UK.
Shahin HajibandehDepartment of General Surgery, Royal Blackburn Hospital, Blackburn, UK.
Michael WeitzendorferDepartment of Surgery, Paracelsus Medical University, Salzburg, Austria.
Filip E MuysomsDepartment of Surgery, AZ Maria Middelares, Ghent, Belgium.
Frank A GranderathCenter for Minimally Invasive Surgery, Neuwerk Hospital, Mönchengladbach, Germany.
George E ChalkiadakisDepartment of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
Klaus EmmanuelDepartment of Surgery, Paracelsus Medical University, Salzburg, Austria.
George A AntoniouDepartment of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK.
Meropi GioumidouSchool of Medicine, University of Crete, Heraklion, Crete, Greece.
Styliani Iliopoulou-KosmadakiSchool of Medicine, University of Crete, Heraklion, Crete, Greece.
Maria MathioudakiSchool of Medicine, University of Crete, Heraklion, Crete, Greece.
Kyriakos SouliotisSchool of Medicine, University of Crete, Heraklion, Crete, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSingle-incision laparoscopic surgery (SILS) is a new technique that aims to minimize abdominal wall trauma and improve cosmesis. Concerns have been raised about the risk of trocar-site hernia following SILS. This study aims to assess the risk of trocar-site hernia following SILS compared to conventional laparoscopic surgery, and investigate whether current evidence is conclusive.

methodsWe performed a systematic search of MEDLINE, AMED, CINAHL, CENTRAL, and OpenGrey. We considered randomized clinical trials comparing the risk of trocar-site hernia with SILS and conventional laparoscopic surgery. Pooled odds ratios with 95% confidence intervals (CI) were calculated using the Mantel-Haenszel method. Trial sequential analysis using the Land and DeMets method was performed to assess the possibility of type I error and compute the information size.

resultsTwenty-three articles reporting a total of 2471 patients were included. SILS was associated with higher odds of trocar-site hernia compared to conventional laparoscopic surgery (odds ratio 2.37, 95% CI 1.25-4.50, p = 0.008). There was no evidence of between-study heterogeneity or small-study effects. The information size was calculated at 1687 patients and the Z-curve crossed the O'Brien-Fleming α-spending boundaries at 1137 patients, suggesting that the evidence of higher risk of trocar-site hernia with SILS compared to conventional laparoscopic surgery can be considered conclusive.

conclusionsSingle-incision laparoscopic procedures through the umbilicus are associated with a higher risk of trocar-site hernia compared to conventional laparoscopic surgery.

Indexed as

FemaleHumansIncisional HerniaLaparoscopyMaleRandomized Controlled Trials as TopicRisk AssessmentSurgical InstrumentsUmbilicusIncisional herniaLaparoscopic surgerySILSSingle-incision laparoscopic surgeryTrocar-site hernia

Identifiers

PMID28726142

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.