Evidence map›Paper›PMID 33851270›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2021

Total extraperitoneal (TEP) versus laparoscopic transabdominal preperitoneal (TAPP) hernioplasty: systematic review and trial sequential analysis of randomized controlled trials.

Alberto Aiolfi, Marta Cavalli, Simona Del Ferraro, Livia Manfredini, Francesca Lombardo, Gianluca Bonitta, Piero Giovanni Bruni, Valerio Panizzo, Giampiero Campanelli, Davide Bona

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 9 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

45 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  13. Long-term results of the SOFTGRIP trial: TIPP versus ProGrip Lichtenstein's inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Alberto AiolfiDivision of General Surgery, Department of Biomedical Science for Health, Istitituto Clinico Sant'Ambrogio, University of Milan, Milan, Italy. alberto.aiolfi86@gmail.com.ORCID 0000-0002-7764-6075
Marta CavalliDepartment of Surgery, Istituto Clinico Sant'Ambrogio, University of Insubria, Milan, Italy.
Simona Del FerraroDepartment of Surgery, Istituto Clinico Sant'Ambrogio, University of Insubria, Milan, Italy.
Livia ManfrediniDepartment of Surgery, Istituto Clinico Sant'Ambrogio, University of Insubria, Milan, Italy.
Francesca LombardoDivision of General Surgery, Department of Biomedical Science for Health, Istitituto Clinico Sant'Ambrogio, University of Milan, Milan, Italy.
Gianluca BonittaDivision of General Surgery, Department of Biomedical Science for Health, Istitituto Clinico Sant'Ambrogio, University of Milan, Milan, Italy.
Piero Giovanni BruniDepartment of Surgery, Istituto Clinico Sant'Ambrogio, University of Insubria, Milan, Italy.
Valerio PanizzoDivision of General Surgery, Department of Biomedical Science for Health, Istitituto Clinico Sant'Ambrogio, University of Milan, Milan, Italy.
Giampiero CampanelliDepartment of Surgery, Istituto Clinico Sant'Ambrogio, University of Insubria, Milan, Italy.
Davide BonaDivision of General Surgery, Department of Biomedical Science for Health, Istitituto Clinico Sant'Ambrogio, University of Milan, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo examine the updated evidence on safety, effectiveness, and outcomes of the totally extraperitoneal (TEP) versus the laparoscopic transabdominal preperitoneal (TAPP) repair and to explore the timely tendency variations favoring one treatment over another.

methodsSystematic review and trial sequential analysis (TSA) of randomized controlled trials (RCTs). MEDLINE, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.gov were consulted. Risk Ratio (RR), weighted mean difference (WMD), and 95% confidence intervals (CI) were used as pooled effect size measures.

resultsFifteen RCTs were included (1359 patients). Of these, 702 (51.6%) underwent TAPP and 657 (48.4%) TEP repair. The age of the patients ranged from 18 to 92 years and 87.9% were males. The estimated pooled RR for hernia recurrence (RR = 0.83; 95% CI 0.35-1.96) and chronic pain (RR = 1.51; 95% CI 0.54-4.22) were similar for TEP vs. TAPP. The TSA shows a cumulative z-curve without crossing the monitoring boundaries line (Z = 1.96), thus supporting true negative results while the information size was calculated as adequate for both outcomes. No significant differences were found in term of early postoperative pain, operative time, wound-related complications, hospital length of stay, return to work/daily activities, and costs.

conclusionsTEP and TAPP repair seems comparable in terms of postoperative hernia recurrence and chronic pain. The cumulative evidence and information size are sufficient to provide a conclusive evidence on recurrence and chronic pain. Similar trials or meta-analyses seem unlikely to show diverse results and should be discouraged.

Indexed as

Hernia, InguinalLaparoscopyAdolescentAdultAgedAged, 80 and overHerniorrhaphyHumansMaleMiddle AgedRandomized Controlled Trials as TopicRecurrenceSurgical MeshTreatment OutcomeYoung AdultChronic painInguinal herniaLaparoscopic transabdominal preperitoneal repair (TAPP)RecurrenceTotally extraperitoneal repair (TEP)Trial sequential analysis

Identifiers

PMID33851270
PMCPMC8514389

What OpenQuestion holds

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Registered trials

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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.