Evidence map›Paper›PMID 38142262›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2024

Open preperitoneal inguinal hernia repair has superior 1-year patient-reported outcomes compared to Shouldice non-mesh repair.

Tina Bharani, Divyansh Agarwal, Nora Fullington, Lauren Ott, Molly Olson, Daelyn McClain, Lulu Lima, Benjamin Poulose, Jeremy Warren, Michael Reinhorn

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Article in Hernia : the journal of hernias and abdominal wall surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. A Call to Change the Nomenclature of "Open" Inguinal Hernia Repair.Journal of abdominal wall surgery : JAWS · 2024
    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

10 authors.

Tina BharaniDepartment of Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
Divyansh AgarwalDepartment of Surgery, Massachusetts General Hospital, 55 Fruit St., GRB 425, Boston, MA, 02114, USA. dagarwal@mgh.harvard.edu.ORCID 0000-0003-0404-6877
Nora FullingtonBoston Hernia, 20 Walnut Street, Suite 100, Wellesley, MA, 02481, USA.
Lauren OttBoston Hernia, 20 Walnut Street, Suite 100, Wellesley, MA, 02481, USA.
Molly OlsonDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Daelyn McClainBoston Hernia, 20 Walnut Street, Suite 100, Wellesley, MA, 02481, USA.
Lulu LimaBoston Hernia, 20 Walnut Street, Suite 100, Wellesley, MA, 02481, USA.
Benjamin PouloseCenter for Abdominal Core Health, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Jeremy WarrenDepartment of Surgery, Division of Minimal Access, and Bariatric Surgery, Prisma Health Upstate, 701 Grove Rd, ST 3, Greenville, SC, 29605, USA.
Michael ReinhornBoston Hernia, 20 Walnut Street, Suite 100, Wellesley, MA, 02481, USA. mreinhorn@bostonhernia.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe Shouldice method for inguinal hernia repair remains the gold standard for prosthesis-free repairs. Nonetheless, international guidelines have favored posterior mesh reinforcement as the standard of care for inguinal hernia repair due to lower risk of recurrence and chronic pain, avoidance of general anesthesia, and favorable biomechanical properties. Recent publications have shown the benefits of an open approach to posterior repairs. Herein, we use the Abdominal Core Health Quality Collaborative (ACHQC) registry to compare patient-reported outcomes after a Shouldice no-mesh repair versus open preperitoneal (OPP) mesh repair.

methodsWe performed a propensity score matched analysis to compare patient-reported quality of life (QoL) and peri/postoperative outcomes after a Shouldice repair versus OPP. Data from 2012 to 2022 were obtained from the ACHQC, and 1:1 optimal matching was performed. EuraHS scores were used to estimate QoL, and further analysis on the EuraHS domains of pain, aesthetics, and activity restriction were performed between the two cohorts.

resultsMatching resulted in 257 participants in each, Shouldice and OPP cohorts. OPP was associated with a better QoL score compared to Shouldice at 30 days after surgery (Median (IQR) 7.75 (2.0-17.0) vs 13.0 (4.0-26.1); OR 0.559 [0.37, 0.84]; p = 0.003). This difference persisted at 6 months and 1 year postoperatively (OR 0.447 [0.26, 0.75] and 0.492 [0.26, 0.93], respectively). We did not observe any significant differences in hernia recurrence risk at 1-year, or rates of 30-day SSOs/SSIs, postoperative bleeding, peripheral nerve injury, DVTs, or UTIs.

conclusionOur data suggest that OPP is associated with significantly better patient-reported QoL, in the first month after surgery and up to 1 year postoperatively, especially with respect to lesser pain, when compared to the Shouldice repair. In specialized inguinal hernia practices, open posterior mesh repairs may lead to better outcomes than non-mesh repairs. We encourage more training in both repairs to facilitate larger prospective studies and evaluation of the generalizability of these results to all surgeons performing IHR.

Indexed as

Chronic PainHernia, InguinalHerniorrhaphyHumansProspective StudiesQuality of LifeRecurrenceSurgical MeshInguinal herniaPreperitoneal repairQuality of lifeShouldiceTREPP/OPP

Identifiers

PMID38142262

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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.