Evidence map›Paper›PMID 30244343›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2019

Reoperation for inguinal hernia recurrence in Ontario: a population-based study.

J K Ramjist, F Dossa, T A Stukel, D R Urbach, L Fu, N N Baxter

Abstract read
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In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 3 pooled it
3.1field-weighted citation impact, top 9% 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

17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. State of the art: open mesh-based inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Pooled it
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
  9. Long-Term Outcomes Following Inguinal Hernia Repair With Mesh Performed by Medical Doctors and Surgeons in Ghana.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024
    Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Case - Recurrent incarcerated inguinal bladder hernia with small bowel obstruction.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2019
    Article
  15. Article
  16. Pure tissue repairs: a timely and critical revival.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Review
  17. Review
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 5 institutions in 1 country.

J K RamjistInstitute for Medical Sciences, University of Toronto, Toronto, ON, Canada.
F DossaLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
T A StukelInstitute of Health Policy, Management and Education, University of Toronto, Toronto, ON, Canada.
D R UrbachInstitute for Medical Sciences, University of Toronto, Toronto, ON, Canada.
L FuInstitute for Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
N N BaxterInstitute for Medical Sciences, University of Toronto, Toronto, ON, Canada. BaxterN@smh.ca.
University of Toronto · CAInstitute for Clinical Evaluative Sciences · CASt. Michael's Hospital · CASunnybrook Health Science Centre · CASunnybrook Research Institute

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDespite the frequency with which inguinal hernia repairs (IHR) are performed, the real-world comparative effectiveness of laparoscopic versus open repairs is not well established. We compared the rate of recurrent inguinal hernia after laparoscopic and open mesh procedures.

methodsWe designed a population-based retrospective cohort study using linked administrative databases including adult patients in Ontario, Canada, who underwent primary IHR from April 1, 2003 to December 31, 2012. Patients were followed to August 31, 2014. Our primary outcome was reoperation for recurrent IHR, with covariate adjustment using Cox proportional hazards modeling. We constructed separate models to evaluate the effect of surgeon caseload on recurrence rates.

resultsWe identified 93,501 adults undergoing primary IHR (85.4% open with mesh and 14.6% laparoscopic) with a median follow-up of 5.5 years. The 5-year cumulative risk of recurrent IHR was 2.0% in the open group and 3.4% in the laparoscopic group. After adjusting for patient and surgeon factors, we found that patients who underwent laparoscopic repair had a higher risk of recurrent IHR than those who underwent open repair when annual surgeon volume in the preceding year was ≤25 technique-specific cases (HR 1.76; 95% CI 1.45-2.13) or 26-50 technique-specific cases (HR 1.78; 95% CI 1.08-2.93). Few high-volume laparoscopic surgeons (> 50 cases/year) could be identified. Laparoscopic IHR did not carry a higher risk of recurrence for patients whose surgeons had performed > 50 technique-specific cases in the preceding year (HR 1.21; 95% CI 0.45-3.26).

conclusionLaparoscopic IHR is generally associated with a higher risk of recurrence than open IHR. Though high-volume surgeons may be able to achieve equivalent results with laparoscopic and open techniques, few surgeons in our study population met this volume criterion for laparoscopic repairs.

Indexed as

ReoperationAdultAgedDatabases, FactualFemaleHernia, InguinalHerniorrhaphyHumansLaparoscopyMaleMiddle AgedOntarioRecurrenceRetrospective StudiesInguinal herniaLaparoscopicMeshRecurrenceVolume

Identifiers

PMID30244343
OpenAlexW2893754190

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.