SynthesisBMC surgery2021
Umbilical hernia repair and recurrence: need for a clinical trial?
Synthesis in BMC surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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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.
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.
Who cites it
7 citing papers in PubMed.
- Spontaneous Evisceration Through Umbilical Hernia in Adult Patients: A Scoping Review of Pathophysiology, Clinical Features, Management, and Outcomes.Medicina (Kaunas, Lithuania) · 2026Article
- Hybrid approach for ventral hernia associated with rectus diastasis: endoscopic single-port diastasis plication with open preperitoneal hernia repair. ENDOP technique in 10 steps.Surgical endoscopy · 2026Article
- Trends and Prevalence of Surgical Methods in Umbilical Hernia Repairs in Sweden: A Nationwide Population-Based Registry Cohort Study.Journal of abdominal wall surgery : JAWS · 2026Article
- Primary umbilical hernia repair: does suture type matter?Surgical endoscopy · 2025Article
- Utilizing T-Line Mesh for Periumbilical Hernia Repair: Evaluation of Short-term Outcomes.Plastic and reconstructive surgery. Global open · 2024Article
- Spontaneous bowel evisceration through umbilical hernia in an adult non-cirrhotic patient.BMJ case reports · 2024Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionUmbilical hernia repair, despite its perceived simplicity, is associated with recurrence between 2.7 and 27%, in mesh repair and non mesh repair respectively. Many factors are recognized contributors to recurrence however multiple defects in the linea alba, known to occur in up to 30% of patients, appear to have been overlooked by surgeons.
aimsThis systematic review assessed reporting of second or multiple linea alba defects in patients undergoing umbilical hernia repair to establish if these anatomical variations could contribute to recurrence along with other potential factors.
methodsA systematic review of all published English language articles was undertaken using databases PubMed, Embase, Web of Science and Cochrane Library from January 2014 to 2019. The search terms 'Umbilical hernia' AND 'repair' AND 'recurrence' were used across all databases. Analysis was specified in advance to avoid selection bias, was registered with PROSPERO (154173) and adhered to PRISMA statement.
resultsSix hundred and forty-six initial papers were refined to 10 following article review and grading. The presence of multiple linea alba defects as a contributor to recurrence was not reported in the literature. One paper mentioned the exclusion of six participants from their study due multiple defects. In all 11 factors were significantly associated with umbilical hernia recurrence. These included: large defect, primary closure without mesh, high BMI in 5/10 publications; smoking, diabetes mellitus, surgical site Infection (SSI) and concurrent hernia in 3/10. In addition, the type of mesh, advanced age, liver disease and non-closure of the defect were identified in individual papers.
conclusionThis study identified many factors already known to contribute to umbilical hernia recurrence in adults, but the existence of multiple defects in the linea, despite it prevalence, has evaded investigators. Surgeons need to be consider documentation of this potential confounder which may contribute to recurrence.
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