Evidence map›Paper›PMID 28779253›Full record

ArticleSurgical endoscopy2018

Comparison of peritoneal closure versus non-closure in laparoscopic trans-abdominal preperitoneal inguinal hernia repair with coated mesh.

Erica D Kane, Marc Leduc, Kathryn Schlosser, Nicole Parentela, Donna Wilson, John R Romanelli

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.5field-weighted citation impact, top 17% 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

9 citing papers in PubMed, 14 citations in OpenAlex.

  1. Review
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  9. [Lower right abdominal pain and anal bleeding : A rare cause for nonspecific complaints].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2018
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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

6 authors at 2 institutions in 1 country.

Erica D KaneDepartment of Surgery, University of Massachusetts Medical School-Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA. Erica.KaneMD@baystatehealth.org.
Marc LeducDepartment of Surgery, University of Massachusetts Medical School-Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA.
Kathryn SchlosserDepartment of Surgery, University of Massachusetts Medical School-Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA.
Nicole ParentelaAcademic Affairs: Office of Research, University of Massachusetts Medical School-Baystate Medical Center, Springfield, MA, USA.
Donna WilsonAcademic Affairs: Epidemiology/Biostatistics Research Core, University of Massachusetts Medical School-Baystate Medical Center, Springfield, MA, USA.
John R RomanelliDepartment of Surgery, University of Massachusetts Medical School-Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA.
University of Massachusetts Chan Medical School · USBaystate Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeritoneal closure during laparoscopic trans-abdominal preperitoneal (TAPP) inguinal hernia repair has been the standard of care to prevent bowel obstruction due to adhesions generated by contact with mesh. However, with newer coated meshes, leaving the peritoneal layer open may be safe. While many studies compare methods of peritoneal flap closure, there is a deficit of literature reporting the outcomes of non-closure.

methodsA retrospective comparison of peritoneal flap closure versus non-closure during primary laparoscopic TAPP inguinal hernia repair with coated mesh was performed for all patients at Baystate Medical Center meeting inclusion criteria between January 2005 and August 2016. Primary outcome was any procedure-related adverse outcome following repair. Secondary outcomes included operative time, resolution of pre-operative pain and/or gastrointestinal symptoms, and hernia recurrence.

resultsOf 231 patients, 55 (24%) underwent peritoneal flap closure and 176 (76%) underwent non-closure. Demographic, comorbidity, and hernia characteristics were comparable between groups with the exception of obesity (p = 0.01), current smoking status (p = 0.05) and hernia side [p = 0.04 (left), 0.0003 (right)]. Mean operative time was higher in the closure group than non-closure (98.1 ± 37.1 min vs. 76.8 ± 32.9, p < 0.0001). No cases were converted to open. Average follow-up was 21.6 ± 23.8 months. Ninety-three percent of closure patients had documented resolution of pre-operative pain versus 94.0% of non-closure (p = 0.81). The closure group experienced a higher percentage of post-operative complications, though this did not reach significance (5.5 vs. 2.3%; p = 0.36). Compared to the closure group, the non-closure groups experienced similar post-operative pain (3.6 vs. 1.2%; p = 0.24) and recurrence rate (1.8 vs. 4.0%; p = 0.68). There were no bowel obstructions, surgical site infections, unplanned readmissions, or unplanned re-operations.

conclusionsEquivalent patient outcomes were seen for both procedure types post-operatively and during follow-up. Operative times were significantly shorter for non-closure patients. Larger study population and longer follow-up is necessary to evaluate true long-term complication rates in flap non-closure.

Indexed as

AdultAgedFemaleHernia, InguinalHumansLaparoscopyMaleMiddle AgedPeritoneumPlastic Surgery ProceduresRetrospective StudiesSurgical FlapsSurgical MeshSuture TechniquesCoated meshHerniaInguinalLaparoscopicPeritoneal flapTransabdominal

Identifiers

PMID28779253
OpenAlexW2744917758

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.