Evidence map›Paper›PMID 39299962›Full record

ArticleSurgical endoscopy2024

Heterogeneity in the surgical approach to recurrent abdominal wall hernias: an opportunity for quality improvement.

Leah J Schoel, Joshua Sinamo, Jonathan Williams, Alexander Hallway, Brian T Fry, Michael Rubyan, Jenny M Shao, Sean M O'Neill, Dana A Telem, Anne P Ehlers

Abstract read
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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.

Leah J SchoelDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA. leschoel@med.umich.edu.ORCID 0000-0003-0461-2998
Joshua SinamoCenter for Healthcare Outcomes and Policy, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Jonathan WilliamsDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Alexander HallwayCenter for Healthcare Outcomes and Policy, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Brian T FryDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Michael RubyanCenter for Healthcare Outcomes and Policy, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Jenny M ShaoDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Sean M O'NeillDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Dana A TelemDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Anne P EhlersDepartment of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.

Funding

Combining Policy and Implementation Science to Optimize Clinical PracticeR01DK128179 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Dana Alexa Telem · 2022 to 2026
$3.2M
Physician Scientist Training in Age-Related DiseasesT32AG062403 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MIN, LILLIAN CHIANG, MODY, LONA · 2020 to 2025
$2.7M
Sex as a Biologic Variable in Groin HerniaK08DK135919 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Anne Pugel Ehlers · 2024 to 2026
$478k
NIA NIH HHS T32 AG062403NIA NIH HHS T32-AG062403NIDDK NIH HHS K08 DK135919NIDDK NIH HHS L30 DK134076NIDDK NIH HHS R01 DK128179NIDDK NIH HHS R01DK128179-01A1NIDDK NIH HHS T32-K10874004
6 · The paper itself

Abstract

backgroundDespite being a challenging and morbid clinical problem, operative approaches to recurrent abdominal wall hernia repairs receive little attention. Given this, we performed a retrospective study to evaluate surgical techniques of recurrent abdominal wall hernias requiring reoperation.

methodsAdult patients from the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry (MSQC-COHR) were included in this study. All elective ventral hernia operations performed between January 1, 2020, and March 31, 2023, were included. Descriptive analyses via t-tests and Fisher exact tests were conducted to evaluate sociodemographic, operative, and hernia-specific attributes associated with primary and recurrent hernia repairs.

resultsWe identified 8587 patients who underwent elective abdominal wall hernia repair. Of these, 7887 (91.8%) underwent primary repair, and 700 (8.2%) underwent recurrent repair. Patients who underwent recurrent hernia repair were older (mean age 57.9 years vs. 54.1 years, p < 0.001), more often female (53.8% vs. 41.9%, p < 0.001), and had higher BMI (34.0 vs. 32.6, p < 0.001). Patients with recurrent hernias were more likely to have comorbid conditions including hypertension (p < 0.001), diabetes (p < 0.005), COPD (p < 0.01), and BMI > 40 (p < 0.05). Recurrent hernia repairs were more likely to have any 30-day complication (6.4% versus 1.9%, p < 0.001), including higher rates of all surgical site infections. There was no difference in 30-day readmission rates.

conclusionConsiderable variation persists in operative management of recurrent abdominal wall hernias. Importantly, not all recurrent hernias were managed with mesh, which may precipitate additional recurrences and further morbidity. Understanding outcomes for these varied approaches to recurrent hernia repairs is critical to optimize management of this complex clinical problem and prevent future episodes of recurrence.

Indexed as

Hernia, VentralHerniorrhaphyQuality ImprovementRecurrenceAbdominal WallAdultAgedFemaleHumansMaleMichiganMiddle AgedPostoperative ComplicationsReoperationRetrospective StudiesSurgical MeshHernia careOutcomesRecurrenceRecurrent hernia

Identifiers

PMID39299962
PMCPMC11527558

What OpenQuestion holds

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Registered trials

None linked

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.