Evidence map›Paper›PMID 31161285›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2019

Open versus laparoscopic mesh repair of primary unilateral uncomplicated inguinal hernia: a systematic review with meta-analysis and trial sequential analysis.

N L Bullen, L H Massey, S A Antoniou, N J Smart, R H Fortelny

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis 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 80 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 8 pooled it
16.3field-weighted citation impact, top 1% 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

80 citing papers in PubMed, 8 syntheses or guidelines pooled it, 155 citations in OpenAlex.

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  5. Transversus abdominis plane blocks in laparoscopic inguinal hernia repair: a review.Hernia : the journal of hernias and abdominal wall surgery · 2023
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20 more citing papers are in PubMed but not listed here.

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

5 authors at 3 institutions in 3 countries.

N L BullenDepartment of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK. n.bullen@nhs.net.ORCID http://orcid.org/0000-0001-8948-6497
L H MasseyDepartment of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK.
S A AntoniouSurgical Department, St Loukas Hospital, Thessaloniki, Greece.
N J SmartDepartment of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK.
R H FortelnyDepartment of General, Visceral and Oncological Surgery, Wilhelminenspital, 1160, Vienna, Austria.
Royal Devon & Exeter NHS Foundation Trust · GBEuropean University Cyprus · CYSigmund Freud Privatuniversität Wien · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOne standard repair technique for groin hernias does not exist. The objective of this study is to perform an update meta-analysis and trial sequential analysis to investigate if there is a difference in terms of recurrence between laparoscopic and open primary unilateral uncomplicated inguinal hernia repair.

methodsThe reporting methodology conforms to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Randomised controlled trials only were included. The intervention was laparoscopic mesh repair (transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP)). The control group was Lichtenstein repair. The primary outcome was recurrence rate and secondary outcomes were acute and chronic post-operative pain, morbidity and quality of life.

resultsThis study included 12 randomised controlled trials with 3966 patients randomised to Lichtenstein repair (n = 1926) or laparoscopic repair (n = 2040). There were no significant differences in recurrence rates between the laparoscopic and open groups (odds ratio (OR) 1.14, 95% CI 0.51-2.55, p = 0.76). Laparoscopic repair was associated with reduced rate of acute pain compared to open repair (mean difference 1.19, CI - 1.86, - 0.51, p ≤ 0.0006) and reduced odds of chronic pain compared to open (OR 0.41, CI 0.30-0.56, p ≤ 0.00001). The included trials were, however, of variable methodological quality. Trial sequential analysis reported that further studies are unlikely to demonstrate a statistically significant difference between the two techniques.

conclusionThis meta-analysis and trial sequential analysis report no difference in recurrence rates between laparoscopic and open primary unilateral inguinal hernia repairs. Rates of acute and chronic pain are significantly less in the laparoscopic group.

Indexed as

Hernia, InguinalHerniorrhaphyHumansLaparoscopyMaleSurgical MeshTreatment OutcomeInguinal herniaLichtensteinTAPPTEP

Identifiers

PMID31161285
OpenAlexW2948528132

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.