Evidence map›Paper›PMID 31916607›Full record

ReviewThe British journal of surgery2020

Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society.

N A Henriksen, A Montgomery, R Kaufmann, F Berrevoet, B East, J Fischer, W Hope, D Klassen, R Lorenz, Y Renard and 3 more

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in The British journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07156188 (The PAPYRUS Study), which is not on this map. Cited by 184 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
184citing papers in PubMed, 11 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.

NCT07156188 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The PAPYRUS Study: Permanent vs. Absorbable Sutures in PrimarY Repair of Umbilical HerniaS: A Multicentre, Single-blind, Non-inferiority, Randomized Controlled Trial

TypeinterventionalSponsorUniversity of British ColumbiaRan2026 to 2030Enrolled914ConditionsHernia Surgery, Umbilical Hernia RepairArmsPermanent Suture, Absorbable
3 · Its place in the literature

Who cites it

184 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  7. UMBILICAL AND EPIGASTRIC HERNIA REPAIR: A SYSTEMATIC REVIEW.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024
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124 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

N A HenriksenDepartment of Surgery, Zealand University Hospital, Koege, Denmark.ORCID 0000-0002-1805-9866
A MontgomeryDepartment of Surgery, Lund University, Skåne University Hospital, Malmö, Sweden.
R KaufmannErasmus University Medical Centre, Rotterdam, the Netherlands.ORCID 0000-0003-1039-0607
F BerrevoetDepartment of General and Hepatopancreatobiliary Surgery, Ghent University Hospital, Ghent, Belgium.
B EastThird Department of Surgery at Motol University Hospital, First and Second Faculty of Medicine at Charles University, Prague, Czech Republic.
J FischerUniversity of Pennsylvania Health System, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA.
W HopeNew Hanover Regional Medical Center, Wilmington, North Carolina, USA.
D KlassenDepartment of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
R LorenzPraxis 3+ Chirurgen, Berlin, Germany.
Y RenardDepartment of Digestive Surgery, Robert Debré University Hospital, Reims, France.ORCID 0000-0001-6036-0006
M A Garcia UrenaHenares University Hospital, Faculty of Health Sciences, Francisco de Vitoria University, Madrid, Spain.ORCID 0000-0002-7356-6211
M P SimonsDepartment of Surgery, OLVG Hospital, Amsterdam, the Netherlands.
European and Americas Hernia Societies (EHS and AHS)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUmbilical and epigastric hernia repairs are frequently performed surgical procedures with an expected low complication rate. Nevertheless, the optimal method of repair with best short- and long-term outcomes remains debatable. The aim was to develop guidelines for the treatment of umbilical and epigastric hernias.

methodsThe guideline group consisted of surgeons from Europe and North America including members from the European Hernia Society and the Americas Hernia Society. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, the Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists, and the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument were used. A systematic literature search was done on 1 May 2018, and updated on 1 February 2019.

resultsLiterature reporting specifically on umbilical and epigastric hernias was limited in quantity and quality, resulting in a majority of the recommendations being graded as weak, based on low-quality evidence. The main recommendation was to use mesh for repair of umbilical and epigastric hernias to reduce the recurrence rate. Most umbilical and epigastric hernias may be repaired by an open approach with a preperitoneal flat mesh. A laparoscopic approach may be considered if the hernia defect is large, or if the patient has an increased risk of wound morbidity.

conclusionThis is the first European and American guideline on the treatment of umbilical and epigastric hernias. It is recommended that symptomatic umbilical and epigastric hernias are repaired by an open approach with a preperitoneal flat mesh.

Indexed as

Practice Guidelines as TopicSocieties, MedicalEuropeHernia, AbdominalHernia, UmbilicalHerniorrhaphyHumansLaparoscopyPlastic Surgery ProceduresSurgical MeshUnited States

Identifiers

PMID31916607

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.