Reply To: Patterns of recurrence associated with specific types of inguinal hernia repair

[MarkT]

Most importantly, this ‘alleged’ conflation would not appear to alter the results anyway…so terming the research inconclusive seems quite inappropriate.

The first study objective was to look at patterns of recurrences by primary repair type…and both Shouldice and open mesh are implicated as ‘higher difficulty’ on a series of markers, but neither were implicated with worse early outcomes. The actual numbers might shift slightly on these markers if a few mesh cases were lumped in with Shoudlice, but it would be *highly* unlikely to alter the broader results. There would need to both be a large number of mesh cases included AND those mesh cases would need to substantially differ from the ‘regular’ Shouldice cases.

Any potential conflation would actually have no bearing on the results for their 2nd purpose (looking at surgical site complications following recurrence repair, by primary repair type), because there was only one complication for the entire Shouldice group (and only one in the open mesh group).

I.e., IF there was a conflation, and IF there were mesh cases in the Shouldice group, it would only have mattered if there were a bunch of post-op complications and this exceeded what was seen for the other groups, because then we wouldn’t know whether to attribute that to the Shouldice repair type or the use of mesh in some cases.

Terming the research ‘inconclusive’ because of your perceived conflation is just not appropriate here, IMHO.