Meta-analysis of randomized trials comparing nonpenetrating vs mechanical mesh fixation in laparoscopic inguinal hernia repair - 14/12/15
, Gernot Köhler, M.D., Ph.D. c, George A. Antoniou, M.D., M.Sc., Ph.D., F.E.B.V.S. d, Filip E. Muysoms, M.D., Ph.D. e, Rudolph Pointner, M.D., Ph.D. f, Frank-Alexander Granderath, M.D., Ph.D. aAbstract |
Background |
Evidence for open groin hernia repair demonstrates less pain with bioglue mesh fixation compared with invasive methods. This study aimed to assess the short- and long-term effects of laparoscopic groin hernia repair with noninvasive and invasive mesh fixation.
Data Sources |
A systematic review of MEDLINE, CENTRAL, and OpenGrey was undertaken. Randomized trials assessing the outcome of laparoscopic groin hernia repair with invasive and noninvasive fixation methods were considered for data synthesis. Nine trials encompassing 1,454 patients subjected to laparoscopic hernia repair with mesh fixation using biologic or biosynthetic glue were identified. Short-term data were inadequate for data synthesis. Chronic pain was less frequently reported by patients subjected to repair with biologic glue fixation than with penetrating methods (odds ratio .46, 95% confidence interval .22 to .93). Duration of surgery, incidence of seroma/hematoma, morbidity, and recurrence were similar.
Conclusions |
Laparoscopic groin hernia repair with bioglue mesh fixation was associated with a reduced incidence of chronic pain compared with mechanical fixation, without increasing morbidity or recurrence. Longer term data on recurrence are necessary.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Bioglue has recently emerged as an alternative means of mesh fixation in open and laparoscopic groin hernia repair. |
• | Synthesis of data suggests that this method reduces chronic postoperative pain, without increasing morbidity or recurrence. |
• | Longer term data on recurrence are needed. |
Keywords : Groin hernia, Fibrin glue, Fibrin sealant, Cyanoacrylate glue, Biologic glue, Mesh fixation
Plan
| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
|
| The authors declare no conflicts of interest. |
Vol 211 - N° 1
P. 239 - janvier 2016 Retour au numéro
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