Evidence map›Paper›PMID 40944743›Full record

ArticleSurgical endoscopy2025

Do smokers deserve "No"? Management and outcomes of smokers undergoing elective ventral hernia repair.

Ryan Howard, Anne Ehlers, Brian Fry, Sean O'Neill, Dana Telem, Jenny Shao

Abstract read
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Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

6 authors.

Ryan HowardDivision of Minimally Invasive Surgery, Section of General Surgery, Department of Surgery, University of Michigan, 2924B Taubman Center, SPC 5331, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5331, USA. rhow@med.umich.edu.ORCID http://orcid.org/0000-0001-9877-9603
Anne EhlersDivision of Minimally Invasive Surgery, Section of General Surgery, Department of Surgery, University of Michigan, 2924B Taubman Center, SPC 5331, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5331, USA.
Brian FryDivision of Minimally Invasive Surgery, Section of General Surgery, Department of Surgery, University of Michigan, 2924B Taubman Center, SPC 5331, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5331, USA.
Sean O'NeillDivision of Minimally Invasive Surgery, Section of General Surgery, Department of Surgery, University of Michigan, 2924B Taubman Center, SPC 5331, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5331, USA.
Dana TelemDivision of Minimally Invasive Surgery, Section of General Surgery, Department of Surgery, University of Michigan, 2924B Taubman Center, SPC 5331, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5331, USA.
Jenny ShaoDivision of Minimally Invasive Surgery, Section of General Surgery, Department of Surgery, University of Michigan, 2924B Taubman Center, SPC 5331, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5331, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSmoking has long been regarded as a contraindication to elective ventral hernia repair, however some have begun to question whether this practice is unnecessarily restrictive. In order to better understand the implications of more liberal patient selection for commonly encountered hernias, we evaluated outcomes among smokers and nonsmokers undergoing elective ventral hernia repair.

methodsWe retrospectively reviewed a population-level registry to identify adults who underwent elective ventral hernia repair between 2021 and 2023. The primary explanatory variable was active smoking, which was defined as smoking within the month prior to surgery. Outcomes included 30-day complications, emergency department utilization (including reason for utilization), readmission, and reoperation. Multivariable logistic regression was used to assess the association of smoking with all outcomes while controlling for patient, hernia, and operative characteristics.

results12,233 patients underwent elective ventral hernia repair during the study period. Mean age was 54.3 (14.3) years, 5151 (42.1%) patients were female, and mean hernia width was 3.3 (3.2) cm. 2059 (16.8%) patients smoked prior to surgery. Smokers were younger, had higher ASA classifications, and more pulmonary disease. Regarding management, smokers were less likely to have myofascial release, but there was no difference in surgical approach or mesh use. Smoking was not associated with increased odds of 30-day complications, readmission, or reoperation. Smoking was associated with increased odds of 30-day ED utilization (6.83% [95% CI 5.76-7.90%] vs. 4.87% [95% CI 4.45-5.30%], P < 001), however this was due to pain-related issues (43.3% vs. 32.9%, P = 0.017) and not infectious or wound-related issues.

conclusionsIn this cohort of patients undergoing elective ventral hernia repair, management of smokers and nonsmokers was similar, and smokers did not have significantly worse short-term outcomes than nonsmokers. These findings may help inform patient selection and expectations, however long-term outcomes including recurrence require evaluation as well.

Indexed as

Elective Surgical ProceduresHernia, VentralHerniorrhaphyPostoperative ComplicationsSmokersSmokingAdultAgedFemaleHumansMaleMiddle AgedPatient ReadmissionRegistriesReoperationRetrospective StudiesComplicationsHerniaOutcomesSmoking

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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.