Evidence map›Paper›PMID 40266425›Full record

Observational studyHernia : the journal of hernias and abdominal wall surgery2025

Optimal surgical and anesthetic approaches for inguinal hernia repair in octogenarians and nonagenarians: a multicenter cohort study in Japan.

Ryosuke Mizuno, Shusaku Honma, Kazuki Nishida, Tomonori Morimoto, Yuta Iwasaki, Yudai Sasaki, Akira Shimada, Yusuke Mishima, Keisuke Tanino, Ryo Ataka and 12 more

Abstract readMulticenter StudyObservational Study
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In one paragraph

Observational study in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

22 authors.

Ryosuke MizunoDepartment of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Shusaku HonmaDepartment of Surgery, Kobe City Medical Center West Hospital, 2-4 Ichibancho, Nagata-ku, Kobe, Hyogo, 653-0013, Japan. shomma74@kuhp.kyoto-u.ac.jp.ORCID 0000-0002-1749-7557
Kazuki NishidaDepartment of Gastrointestinal Surgery, Osaka Redcross Hospital, Osaka, Japan.
Tomonori MorimotoDepartment of Gastroenterological Surgery, Takamatsu Redcross Hospital, Takamatsu, Japan.
Yuta IwasakiDepartment of Gastrointestinal Surgery, Tenri Hospital, Tenri, Japan.
Yudai SasakiDepartment of Gastrointestinal Surgery, Hikone City Hospital, Hikone, Japan.
Akira ShimadaDepartment of Surgery, Uji Tokushukai Hospital, Uji, Japan.
Yusuke MishimaDepartment of Surgery, Shiga General Hospital, Moriyama, Japan.
Keisuke TaninoDepartment of Gastrointestinal Surgery, Amagasaki General Medical Center, Amagasaki, Japan.
Ryo AtakaDepartment of Surgery, Otsu Redcross Hospital, Otsu, Japan.
Yuma TanigawaDepartment of Gastrointestinal Surgery, Shinko Memorial Hospital, Kobe, Japan.
Yuta NishikawaDepartment of Surgery, Kyoto City Hospital, Kyoto, Japan.
Takahiro SuenagaDepartment of Surgery, Kyoto Medical Center, Kyoto, Japan.
Takuma KawarabayashiDepartment of Gastrointestinal Surgery, Toyooka Public Hospital, Toyooka, Japan.
Keita HanadaDepartment of Surgery, Rakuwakai Otowa Hospital, Kyoto, Japan.
Shotaro MatsudaDepartment of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Takayuki KawaiDepartment of Gastrointestinal Surgery, Medical Research Institute Kitano Hospital, Osaka, Japan.
Kaede HirayamaDepartment of Surgery, Obama Municipal Hospital, Obama, Japan.
Masaaki MoriyamaDepartment of Gastrointestinal Surgery, Himeji Medical Center, Himeji, Japan.
Kento MasudaDepartment of Gastrointestinal Surgery, Kansai Electric Power Hospital, Osaka, Japan.
Keiji NagataDepartment of Surgery, Kokura Memorial Hospital, Kyushu, Japan.
Kazutaka ObamaDepartment of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe aimed to develop treatment strategies for older patients with inguinal hernia considering adequate adjustment for operative risks and a comparison that accounts for differences in surgical and anesthetic approaches.

methodsThis retrospective cohort study included 1935 patients aged ≥ 80 years diagnosed with inguinal hernia at 21 facilities in Japan between January 2019 and December 2023. We compared surgical approaches performed under general anesthesia and separately analyzed anesthetic approaches in patients who underwent open surgery. Analysis was conducted using the inverse probability of treatment weighting method to adjust for confounding factors.

resultsOf the 1935 patients, 841 underwent laparoscopic surgery (LS), while 1094 underwent open surgery (OS) with general anesthesia (GA) in 373, spinal anesthesia (SA) in 401, and local anesthesia (LA) in 320. Overall postoperative complication rates of Clavien-Dindo Grade II or higher were comparable between surgical approaches under GA (LS: 3.8% vs. OS: 3.4%; risk ratio [RR]: 1.10; 95% confidence interval [CI]: 0.57, 2.10). Comparisons of anesthetic approaches among patients with OS showed that complication rates were lower in the LA group ([LA: 1.5% vs. GA: 3.5%; RR: 0.43; 95% CI: 0.13, 1.42] and [LA: 1.1% vs. SA: 3.6%; RR: 0.29; 95% CI: 0.10, 0.90]). The LS group had a lower incidence of chronic pain than that in the OS group (LS: 1.7% vs. OS: 3.2%; RR: 0.53; 95% CI: 0.21, 1.30).

conclusionLaparoscopic inguinal hernia repair is a feasible option for octogenarians and nonagenarians. When general anesthesia is avoided, open surgery using local anesthesia is preferred.

Indexed as

Anesthesia, GeneralAnesthesia, SpinalHernia, InguinalHerniorrhaphyLaparoscopyAged, 80 and overAge FactorsAnesthesia, LocalFemaleHumansJapanMalePostoperative ComplicationsRetrospective StudiesAnesthesiaInguinal herniaLaparoscopic surgeryNonagenariansOctogenariansOlder adults

Identifiers

PMID40266425

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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.