Evidence map›Paper›PMID 36508006›Full record

ArticleSurgical endoscopy2023

Comparison of post-operative outcomes of large direct inguinal hernia repairs based on operative approach (open vs. laparoscopic vs. robotic) using the ACHQC (Abdominal Core Health Quality Collaborative) database.

Dimitrios N Varvoglis, Manuel Sanchez-Casalongue, Molly A Olson, Noah DeAngelo, Ian Garbarine, Jeffrey Lipman, Timothy M Farrell, David Wayne Overby, Arielle Perez, Randal Zhou

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Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

6 citing papers in PubMed.

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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

10 authors.

Dimitrios N VarvoglisDepartment of Surgery, UNC at Chapel Hill, 321 S Columbia Street, Chapel Hill, NC, 27514, USA.
Manuel Sanchez-CasalongueDivision of Gastrointestinal Surgery, UNC School of Medicine, 321 S Colymbia Street, Chapel Hill, NC, 27278, USA.
Molly A OlsonDepartment of Population Health Sciences, Weil Cornell Medicine, 402 E 67th Street, New York, NY, 10065, USA.
Noah DeAngeloUNC School of Medicine, 321 S Columbia Street, Chapel Hill, NC, 27516, USA.
Ian GarbarineUNC School of Medicine, 321 S Columbia Street, Chapel Hill, NC, 27516, USA.
Jeffrey LipmanUNC School of Medicine, 321 S Columbia Street, Chapel Hill, NC, 27516, USA.
Timothy M FarrellDivision of Gastrointestinal Surgery, UNC School of Medicine, 321 S Colymbia Street, Chapel Hill, NC, 27278, USA.
David Wayne OverbyDepartment of Surgery, UNC Health Care Hillsborough Campus, 460 Waterstone, Drive, Hillsborough, NC, 27278, USA.
Arielle PerezDivision of Gastrointestinal Surgery, UNC School of Medicine, 321 S Colymbia Street, Chapel Hill, NC, 27278, USA.
Randal ZhouDivision of Bariatric and Minimally Invasive Surgery, Yale School of Medicine, 333, Cedar Street, New Haven, CT, 06519, USA. randal.zhou@yale.edu.ORCID 0000-0001-6713-4933

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare clinical outcomes for open, laparoscopic, and robotic hernia repairs for direct, unilateral inguinal hernia repairs, with particular focus on 30-day morbidity surgical site infection (SSI); surgical site occurrence (SSO); SSI/SSO requiring procedural interventions (SSOPI), reoperation, and recurrence.

methodsThe Abdominal Core Health Quality Collaborative database was queried for patients undergoing elective, primary, > 3 cm medial, unilateral inguinal hernia repairs with an open (Lichtenstein), laparoscopic, or robotic operative approach. Preoperative demographics and patient characteristics, operative techniques, and outcomes were studied. A 1-to-1 propensity score matching algorithm was used for each operative approach pair to reduce selection bias.

resultsThere were 848 operations included: 297 were open, 285 laparoscopic, and 266 robotic hernia repairs. There was no evidence of a difference in primary endpoints at 30 days including SSI, SSO, SSI/SSO requiring procedural interventions (SSOPI), reoperation, readmission, or recurrence for any of the operative approach pairs (open vs. robotic, open vs. laparoscopic, robotic vs. laparoscopic). For the open vs. laparoscopic groups, QoL score at 30 day was lower (better) for laparoscopic surgery compared to open surgery (OR 0.53 [0.31, 0.92], p = 0.03), but this difference did not hold at the 1-year survey (OR 1.37 [0.48, 3.92], p = 0.55). Similarly, patients who underwent robotic repair were more likely to have a higher (worse) 30-day QoL score (OR 2.01 [1.18, 3.42], p = 0.01), but no evidence of a difference at 1 year (OR 0.83 [0.3, 2.26] p = 0.71).

conclusionsOur study did not reveal significant post-operative outcomes between open, laparoscopic, and robotic approaches for large medial inguinal hernias. Surgeons should continue to tailor operative approach based on patient needs and their own surgical expertise.

Indexed as

Hernia, InguinalLaparoscopyRobotic Surgical ProceduresAbdominal CoreHumansQuality of LifeSurgical Wound InfectionAmericas hernia society quality collaborativeLaparoscopic inguinal hernia repairLarge direct herniasOpen inguinal hernia repairRobotic inguinal hernia repair

Identifiers

PMID36508006

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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.