Evidence map›Paper›PMID 35233657›Full record

ArticleSurgical endoscopy2022

Emergent and urgent ventral hernia repair: comparing recurrence rates amongst procedures utilizing mesh versus no mesh.

Rachel Whittaker, Zachary Lewis, Margaret A Plymale, Michael Nisiewicz, Ajadi Ebunoluwa, Daniel L Davenport, Jessica K Reynolds, John Scott Roth

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 21% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. Emergency repair and smoking predict recurrence in a large cohort of ventral hernia patients.Hernia : the journal of hernias and abdominal wall surgery · 2022
    Article
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

8 authors at 1 institution in 1 country.

Rachel WhittakerUniversity of Kentucky College of Medicine, Bowling Green, KY, USA.
Zachary LewisUniversity of Kentucky College of Medicine, Bowling Green, KY, USA.
Margaret A PlymaleDepartment of Surgery, University of Kentucky, Lexington, KY, USA.
Michael NisiewiczUniversity of Kentucky College of Medicine, Lexington, KY, USA.
Ajadi EbunoluwaUniversity of Kentucky College of Medicine, Lexington, KY, USA.
Daniel L DavenportDepartment of Surgery, University of Kentucky, Lexington, KY, USA.
Jessica K ReynoldsDepartment of Surgery, University of Kentucky, Lexington, KY, USA.
John Scott RothDepartment of Surgery, University of Kentucky, Lexington, KY, USA. s.roth@uky.edu.ORCID http://orcid.org/0000-0003-0332-7220
University of Kentucky · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe decision for emergent and urgent ventral hernia repair (VHR) is driven by acute symptomatology, concern for incarceration and strangulation, and perforation. Although mesh has been established to reduce hernia recurrences, the potential for mesh complications may impact the decision for utilization in emergent repairs. This study evaluates hernia repair outcomes in the emergent setting with/without mesh.

methodsAn IRB-approved review of NSQIP and retrospective chart review data of emergent/urgent VHRs performed between 2013 and 2017 was conducted at a single academic institution. Six-month postoperative emergency department and surgery clinic visits, hospital readmissions, and hernia recurrences were recorded. Patients were grouped based on mesh utilization. Perioperative and outcome variables were compared using Chi-square, Fisher's exact, and t-tests.

resultsAmong 94 patients, 41 (44%) received mesh; 53 (56%) did not. Synthetic mesh was used in 27 cases (65.9%); bioresorbable or biologic mesh was used in 14 cases (34.1%). ASA class (p = 0.016) was higher in the no-mesh group, as were emergent vs. urgent cases (p ≤ 0.001). Preoperative SIRS/Sepsis, COPD, and diabetes were increased in the no-mesh group. Hernia recurrence was significantly higher in the no-mesh group vs. the mesh group (24.5% vs. 7.3%, p = 0.03). No difference was found in wound complications between groups. ED visits occurred almost twice as often in the mesh group (42% vs. 23%, p = 0.071). Postoperative surgery clinic visits were more frequent among the mesh group (> 1 visit 61% vs. 24%, p = 0.004).

conclusionsMesh-based hernia repairs in the urgent/emergent patient population are performed in fewer than half of patients in our tertiary care referral center. Repairs without mesh were associated with over a three-fold increase in recurrence without a difference in the risk of infectious complications. Efforts to understand the rationale for suture-based repair compared to mesh repair are needed to reduce hernia recurrences in the emergent population.

Indexed as

Biological ProductsHernia, VentralHerniorrhaphyHumansPostoperative ComplicationsRecurrenceRetrospective StudiesSurgical MeshTreatment OutcomeBiological ProductsEmergent ventral hernia repairUrgent ventral hernia repairVentral hernia mesh repairVentral hernia recurrence

Identifiers

PMID35233657
OpenAlexW4214772182

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.