Evidence map›Paper›PMID 29516294›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2018

A meta-analysis comparing open anterior component separation with posterior component separation and transversus abdominis release in the repair of midline ventral hernias.

J D Hodgkinson, C A Leo, Y Maeda, P Bassett, S M Oke, C J Vaizey, J Warusavitarne

Abstract readComparative StudyMeta-AnalysisReview
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 33 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 6 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

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

  1. Pooled it
  2. Pooled it
  3. Botulinum toxin A in complex incisional hernia repair: a systematic review.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Systematic review of transversus abdominis release in complex abdominal wall reconstruction.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Pooled it
  7. Trial
  8. Trial
  9. Interparietal hernias after posterior component separation.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Article
  10. Article
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  12. Follow-up of complex hernia repair with intraoperative fascial traction.Hernia : the journal of hernias and abdominal wall surgery · 2025
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  14. Review
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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

7 authors.

J D HodgkinsonSt Mark's Hospital and Academic Institute, Watford Road, Harrow, London, HA1 3UJ, UK. jonathanhodgkinson@nhs.net.
C A LeoSt Mark's Hospital and Academic Institute, Watford Road, Harrow, London, HA1 3UJ, UK.
Y MaedaSt Mark's Hospital and Academic Institute, Watford Road, Harrow, London, HA1 3UJ, UK.
P BassettStats Consultancy, Amersham, UK.
S M OkeSt Mark's Hospital and Academic Institute, Watford Road, Harrow, London, HA1 3UJ, UK.
C J VaizeySt Mark's Hospital and Academic Institute, Watford Road, Harrow, London, HA1 3UJ, UK.
J WarusavitarneSt Mark's Hospital and Academic Institute, Watford Road, Harrow, London, HA1 3UJ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519-526, 1990), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky et al. (Am J Surg 204(5):709-716, 2012), is being used more frequently and is rapidly becoming the technique of choice in complex ventral hernia repair.

methodsAnalysis was conducted according to PRISMA guidelines. A systematic search of the MEDLINE, EMBASE and Pubmed databases was performed. Studies reporting exclusively on midline ventral hernia repair were reviewed. Studies describing PCSTAR were selected and compared to matched studies describing OACS. Meta-analysis was used to compare outcomes between the two-pooled groups.

resultsSeven studies describing 281 cases of PCSTAR for midline incisional hernia using a retromuscular mesh placement were identified. Six comparable studies describing 285 cases of OACS and retromuscular mesh placement were identified from the same search. Pooled analysis demonstrated a hernia recurrence rate of 5.7% (3.0-8.5) for PCSTAR and 9.5% (4.0-14.9) for OACS. Comparative analysis demonstrated no significant difference between hernia recurrence rate (p = 0.23). The use of bridging mesh was not significantly reduced by the use of PCSTAR (3.1%) when compared to ACS (7.5%) (p = 0.22). No significant difference was found in wound complication rates between PCSTAR and OACS, respectively, 'superficial' 10.9 vs 21.6% (p = 0.15); and 'deep' 9.5 vs 12.7% (p = 0.53).

conclusionsThese data suggest PCSTAR have comparable outcomes to OACS. This analysis is limited by the lack of comparative studies and heterogenicity in the OACS group.

Indexed as

Abdominal MusclesAbdominal WallFemaleHernia, VentralHerniorrhaphyHumansIncisional HerniaMaleMiddle AgedSurgical MeshAbdominal wall reconstructionAnterior component separationPosterior component separationTransversus abdominis release

Identifiers

PMID29516294

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.