SynthesisPloS one2018
Balancing mesh-related complications and benefits in primary ventral and incisional hernia surgery. A meta-analysis and trial sequential analysis.
Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Mesh versus suture for elective primary umbilical hernia open repair: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Pooled it
- Comparison of mesh infection management following ventral hernia repair with poly-4-hydroxybutyrate, synthetic, and biologic mesh: a retrospective review.Surgical endoscopy · 2026Article
- Comparative outcomes of bioabsorbable poly-4-hydroxybutyrate versus synthetic mesh in ventral hernia repair: A propensity-matched cohort study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- [Differentiated concept for treatment of incisional hernias].Chirurgie (Heidelberg, Germany) · 2026Review
- Maximizing mesh mileage: evaluating the long-term performance of a novel hybrid mesh for ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Open intraperitoneal onlay mesh repair with anterior component separation as a bail-out procedure in the management of complex hernias.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Midline incisional hernia guidelines: the European Hernia Society.The British journal of surgery · 2023Article
- A Biomechanical Analysis of Prophylactic Mesh Reinforced Porcine Laparotomy Incisions.The Journal of surgical research · 2022Article
- Ultra-Fine Polyethylene Hernia Meshes Improve Biocompatibility and Reduce Intraperitoneal Adhesions in IPOM Position in Animal Models.Biomedicines · 2022Article
- Effects of 5-fluorouracil released from different prosthetic meshes on post-operative adhesion formation in rats.Northern clinics of Istanbul · 2022Article
- Abdominal wall complications after kidney transplantation: A clinical review.Clinical transplantation · 2021Review
- Treatment of small (< 2 cm) umbilical hernias: guidelines and current trends from the Herniamed Registry.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- The darn technique for small (< 2 cm diameter) midline hernias.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Assessment of potential influencing factors on the outcome in small (< 2 cm) umbilical hernia repair: a registry-based multivariable analysis of 31,965 patients.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Re-do surgery after prosthetic abdominal wall repair: intraoperative findings of mesh-related complications.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Long-Term Outcomes in Complex Abdominal Wall Reconstruction Repaired With Absorbable Biologic Polymer Scaffold (Poly-4-Hydroxybutyrate).Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Use of polyvinylidene fluoride (PVDF) meshes for ventral hernia repair in emergency surgery.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Postoperative ileus after laparoscopic primary and incisional abdominal hernia repair with intraperitoneal mesh (DynaMesh®-IPOM versus Parietex™ Composite): a single institution experience.Langenbeck's archives of surgery · 2021Article
- What is the outcome of the open IPOM versus sublay technique in the treatment of larger incisional hernias?: A propensity score-matched comparison of 9091 patients from the Herniamed Registry.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Delayed mesh infection and mesh penetrating the transverse colon and small intestine after abdominal incisional hernia repair.Journal of surgical case reports · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrimary ventral hernia (PVH) and incisional hernia (IH) repair using a mesh appears to reduce hernia recurrence. However, are the benefits of mesh offset in part by mesh-related complications? The aim of this study was to compare placement of a mesh versus simple suture for recurrence and postoperative complications in the repair of PVH or IH.
methodsFive databases were searched for randomized controlled trials (RCTs). The study population was patients with a PVH or IH undergoing hernia repair. Intervention was placement of a nonabsorbable synthetic mesh, regardless of mesh location, surgical technique, hernia characteristics or surgical setting compared to primary suture. Primary outcome was the incidence of hernia recurrence. Secondary outcomes were wound infection, hematoma, seroma, postsurgical pain, duration of operation, and quality of life. A random-effects meta-analysis with trial sequential analysis (TSA) was used.
results10 RCTs with a total of 1270 patients were included. A significant reduction of the incidence of PVH or IH recurrence using a mesh for repair (risk ratio [RR] 0.39, 95% CI 0.27-0.55; P < 0.00001; I2 = 20%) was observed. TSA for recurrence, the accrued information size (1270) was 312% of the estimated required information size (RIS). Subgroup analysis for PVH and IH confirms reduction of recurrence after using a mesh in both groups. Overall postoperative complications did not show statistically significant differences between the mesh and surgical suture groups (RR 1.31, 95% CI 0.94-1.84; P = 0.12; I2 = 27%) but the accrued information size was only 22.4% of RIS and by subgroups complications were only related with IH repair.
conclusionsEvidence for the efficacy of repair of PVH or IH using a nonabsorbable synthetic mesh in terms of recurrence was found to be robust. Evidence for complications remains inconclusive.
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Registered trials
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.