Evidence map›Paper›PMID 31073960›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2019

Minimally invasive inguinal hernia repair is superior to open: a national database review.

B Pokala, P R Armijo, L Flores, D Hennings, D Oleynikov

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 40 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing 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

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

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  17. Usefulness of laparoscopic inguinal hernia repair using the Endoscope Manipulator Robot (EMARO).Hernia : the journal of hernias and abdominal wall surgery · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

B PokalaMinimally Invasive and Bariatric Surgery, Department of Surgery, General Surgery, 986246 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
P R ArmijoCenter for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE, USA.
L FloresCenter for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, NE, USA.
D HenningsMinimally Invasive and Bariatric Surgery, Department of Surgery, General Surgery, 986246 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-6246, USA.
D OleynikovMinimally Invasive and Bariatric Surgery, Department of Surgery, General Surgery, 986246 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-6246, USA. doleynik@unmc.edu.ORCID http://orcid.org/0000-0002-0656-6596

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMany publications have focused on single-surgeon or single-center data, comparing surgical approach in inguinal hernia repair. This study evaluated outcomes in patients who underwent open (OIHR), laparoscopic (LIHR) or robotic (RIHR) inguinal hernia repair using a national database.

methodsThe Vizient clinical database was queried using ICD-9 and ICD-10 procedure and diagnosis codes for RIHR, LIHR, and OIHR from 2013 to 2017. Elective procedures classified as minor or moderate risk severity were included. Complications, 30-day readmission, mortality, LOS, and intra-hospital opiate utilization were analyzed using IBM SPSS v.23.0.

results3547 patients (OIHR: N = 2413, LIHR: N = 540, RIHR: N = 594) were included in the study. Majority were male (OIHR 84.1%, LIHR 80.4%, RIHR 95.3%), ≥ 51 years (OIHR 81.5%, LIHR 81.7%, RIHR 95.3%), and Caucasian (OIHR 75.7%, LIHR 77.0%, RIHR 81.5%). RIHR had the least overall complications (0.67%) compared to LIHR (4.44%) and OIHR (3.85%), p < 0.05. OIHR had the highest postoperative infection rate (8.33%), versus LIHR (0.56%) and RIHR (0.0%), p < 0.05. OIHR had longer length of stay (3.57 ± 4.1 days) when compared to both groups (LIHR 2.2 ± 2.13 days, RIHR 1.75 ± 1.62 days), p < 0.001. OIHR had higher 30-day readmission rates (3.61%) compared to RIHR (0.84%), p = 0.001. Mortality was similar between groups (OIHR 0.21%, LIHR 0.19%, RIHR 0.17%), p = 0.081. Opiate use was higher with OIHR (96.0%), compared to both LIHR (93.1%), and RIHR (93.8%), p = 0.004.

conclusionRIHR outcomes were improved compared to OIHR or LIHR. OIHR had the highest rate of opiate use, there was no difference between LIHR and RIHR. Further studies are needed to determine the role of RIHR and to assess whether surgeon or patient selection contributes to outcomes.

Indexed as

AdolescentAdultAgedDatabases, FactualFemaleHernia, InguinalHerniorrhaphyHumansLaparoscopyMaleMiddle AgedMinimally Invasive Surgical ProceduresRobotic Surgical ProceduresUnited StatesYoung AdultCostInguinal herniaMinimally invasive surgeryOpen surgeryOpiate useOutcomes

Identifiers

PMID31073960

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.