ReviewJournal of abdominal wall surgery : JAWS2025
Randomized Controlled Trials of Weight Loss Before Hernia Surgery: A Systematic Review and Meta-Analysis.
Review in Journal of abdominal wall surgery : JAWS, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- The prehabilitation paradox in ventral hernia: from universal to personalized care.Hernia : the journal of hernias and abdominal wall surgery · 2026Review
- Multimodal Prehabilitation for Hernia Repair: Linking Metabolic Modulation and Mechanical Methods.Biomedicines · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Hernia repairs are one of the commonest operations performed in the world. In Europe and the United States of America more than half of patients undergoing hernia surgery are overweight or obese; body weight is therefore key modifiable risk factor before surgery. We aimed to identify, appraise, and synthesise the randomized controlled trial (RCT) evidence for any weight loss interventions before any form of hernia surgery. Methods: A search was performed in April 2025 of the PubMed, EMBASE and CENTRAL databases. Meta-analysis was performed using random effects to assess mean difference in weight, and fixed effects for odds ratio of complications. Bias was assessed using the Cochrane Rob2 tool. Certainty effect was assessed using GRADE methodology. This review was registered with PROSPERO (ID 1024784). Results: 1,707 studies were screened, 20 retrieved, and 4 reports of 3 RCTs included. A total population of 219 patients largely underwent ventral hernia repair, although 2 RCTs also included patients undergoing non-hernia surgery. Interventions comprised very low calorie diets (VLCD), and a multidisciplinary programme. Meta-analysis for VLCD did not show a reduction in weight loss (3.64 kg [95% confidence interval -2.07 - 9.35]) or complications [odds ratio 0.36 (0.1-1.28)]. Risk of bias was "high," and certainty of effect "very low." Discussion: Despite the prevalence and importance of obesity in patients undergoing elective hernia repair, and the popularity of weight loss as part of prehabilitation, the randomized evidence of how to effect weight loss, and whether this translates into an improvement in clinical outcomes is minimal. This highlights the urgent need for large and robust RCTs to determine if weight loss before hernia repair is effective in improving outcomes for patients, and how this is best achieved.
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Registered trials
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