Page 202 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 9
Discussion
The literature dealing with abdominal wall surgery often fails to meet good reporting standards and statistical methodology. Moreover the terminology used to describe the hernias and their therapies is very heterogeneous, often due to the lack of commonly accepted standards and de nitions. This was the impetus for the formation of the EuraHS working group. By organising a consensus meeting including the editors of Hernia - the World Journal of Hernia and Abdominal Wall Surgery - and some specialists in statistics or systematic reviews, the aim was to suggest a set of recommendations to provide a standard for investigators writing a study protocol and to authors preparing a manuscript for submission. The recommendations are listed in Table 1.
The CONSORT statement is the common standard to use as guidance in performing and reporting RCT’s (www.consort-statement.org). However, for ventral hernia repair, RCT’s are not frequent and the majority of the literature is comparative retrospective studies or non-comparative cohort studies. For those studies the STROBE statement (STrengthening the Reporting of OBservational studies in Epidemiology) is the relevant guideline (www.strobe-statement.org) and the quality of the studies can be scored using the MINORS scale(32).
We consider that an author checklist speci cally targeted at abdominal wall surgery based on accepted statements and scoring systems would increase the quality of submissions. Editors and reviewers can use a similar checklist for their evaluations.
The consensus panellists strongly believe that an e ort is needed to increase the statistical and methodological basis of the abdominal wall research. Considering recurrence, which is the primary interest of most studies on hernia repair, it is recommended using time-to-event data of the freedom of recurrence to analyse and report study results. The number of dropouts from studies on hernia repair before the measurement of the primary endpoint is often high. Therefore the use of time-to-event data is more suitable in hernia repair studies.
To reduce the heterogeneity of the description of the variables studied and the surgical techniques performed, we recommend using previously published terminology and de nitions. Understanding the study population and the surgical technique is essential for the inference of the results to the larger population of which the study population is part.
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