Evidence map›Paper›PMID 29305783›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2018

A systematic methodological review of reported perioperative variables, postoperative outcomes and hernia recurrence from randomised controlled trials of elective ventral hernia repair: clear definitions and standardised datasets are needed.

Samuel G Parker, C P J Wood, J W Butterworth, R W Boulton, A A O Plumb, S Mallett, S Halligan, A C J Windsor

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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

21 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. A systematic review on surgical treatment of primary epigastric hernias.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Pooled it
  3. Pooled it
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  6. Article
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  8. ENGINE-An EHS Project for Future Guidelines.Journal of abdominal wall surgery : JAWS · 2024
    Article
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  10. Article
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  12. Article
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  17. INCISIONAL HERNIOPLASTY TECHNIQUES: ANALYSIS AFTER OPEN BARIATRIC SURGERY.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Samuel G ParkerThe Abdominal Wall Unit, University College London Hospital, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK. samgparker@nhs.net.
C P J WoodThe Abdominal Wall Unit, University College London Hospital, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
J W ButterworthUpper Gastrointestinal Surgery Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
R W BoultonThe Abdominal Wall Unit, University College London Hospital, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
A A O PlumbCentre for Medical Imaging, University College London, 3rd Floor East 250 Euston Road, London, NW1 2PG, UK.
S MallettInstitute of Applied Health Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
S HalliganCentre for Medical Imaging, University College London, 3rd Floor East 250 Euston Road, London, NW1 2PG, UK.
A C J WindsorThe Abdominal Wall Unit, University College London Hospital, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.

Funding

Department of Health PB-PG-0816-20005
6 · The paper itself

Abstract

backgroundThis systematic review assesses the perioperative variables and post-operative outcomes reported by randomised controlled trials (RCTs) of VH repair. This review focuses particularly on definitions of hernia recurrence and techniques used for detection.

objectiveOur aim is to identify and quantify the inconsistencies in perioperative variable and postoperative outcome reporting, so as to justify future development of clear definitions of hernia recurrence and a standardised dataset of such variables.

methodsThe PubMed database was searched for elective VH repair RCTs reported January 1995 to March 2016 inclusive. Three independent reviewers performed article screening, and two reviewers independently extracted data. Hernia recurrence, recurrence rate, timing and definitions of recurrence, and techniques used to detect recurrence were extracted. We also assessed reported post-operative complications, standardised operative outcomes, patient reported outcomes, pre-operative CT scan hernia dimensions, intra-operative variables, patient co-morbidity, and hernia morphology.

results31 RCTs (3367 patients) were identified. Only 6 (19.3%) defined hernia recurrence and methods to detect recurrence were inconsistent. Sixty-four different clinical outcomes were reported across the RCTs, with wound infection (30 trials, 96.7%), hernia recurrence (30, 96.7%), seroma (29, 93.5%), length of hospital stay (22, 71%) and haematoma (21, 67.7%) reported most frequently. Fourteen (45%), 11 (35%) and 0 trials reported CT measurements of hernia defect area, width and loss of domain, respectively. No trial graded hernias using generally accepted scales.

conclusionVH RCTs report peri- and post-operative variables inconsistently, and with poor definitions. A standardised minimum dataset, including definitions of recurrence, is required.

Indexed as

HerniorrhaphyPostoperative ComplicationsElective Surgical ProceduresHernia, VentralHumansOutcome Assessment, Health CareRandomized Controlled Trials as TopicRecurrenceAbdominal wall reconstructionStandardisationVentral hernia

Identifiers

PMID29305783

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.