Evaluating mesh fixation techniques for ventral hernia repair: A systematic review and network meta-analysis of randomised control trials - 22/02/24
, Matthew G. Davey b, Jack Whooley b, Eanna J. Ryan b, Odhran K. Ryan b, Jeroen E.H. Ponten d, Andreas Weiss e, John B. Conneely a, c, William B. Robb a, b, Noel E. Donlon a, bAbstract |
Introduction |
There is uncertainty regarding the optimal mesh fixation techniques for laparoscopic ventral and incisional hernia repair.
Aim |
To perform a systematic review and network meta-analysis of randomised control trials (RCTs) to investigate the advantages and disadvantages associated with absorbable tacks, non-absorbable tacks, non-absorbable sutures, non-absorbable staples, absorbable synthetic glue, absorbable sutures and non-absorbable tacks, and non-absorbable sutures and non-absorbable tacks.
Methods |
A systematic review was performed as per PRISMA-NMA guidelines. Odds ratios (ORs) and mean differences (MDs) were extracted to compare the efficacy of the surgical approaches.
Results |
Nine RCTs were included with 707 patients. Short-term pain was significantly reduced in non-absorbable staples (MD; −1.56, confidence interval (CI); −2.93 to −0.19) and non-absorbable sutures (MD; −1.00, CI; −1.60 to −0.40) relative to absorbable tacks. Recurrence, length of stay, operative time, conversion to open surgery, seroma and haematoma formation were unaffected by mesh fixation technique.
Conclusion |
Short-term post-operative pain maybe reduced by the use of non-absorbable sutures and non-absorbable staples. There is clinical equipoise between each modality in relation to recurrence, length of stay, and operative time.
Le texte complet de cet article est disponible en PDF.Highlights |
• | A systematic review and network meta-analysis was performed of 9 randomised control trials with a total of 707 patients. |
• | Outcomes of 7 mesh fixation techniques in ventral hernia repair were analysed. |
• | Short-term post-operative pain maybe reduced by the use of non-absorbable sutures and non-absorbable staples. |
• | There is clinical equipoise between each modality in relation to recurrence, length of stay, and operative time. |
Keywords : Ventral hernia repair, Tack, Suture, Mesh fixation, Network meta-analysis
Plan
Vol 228
P. 62-69 - février 2024 Retour au numéro
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