Transinguinal preperitoneal (TIPP) versus Lichtenstein for inguinal hernia repair: a systematic review and meta-analysis.

Autor: Silveira CAB; Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil. carlossilveira18.1@bahiana.edu.br., Poli de Figueiredo SM; Cleveland Clinic, Cleveland, OH, USA., Dias YJM; Washington University in St. Louis, St. Louis, MO, USA., Martin RRH; Endocrine Surgery Department, Beth Israel Deaconess Medical Center, Boston, MA, USA., Rasador ACD; Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil., Fernandez MG; Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil., Lu R; University of Texas Medical Branch, Galveston, TX, USA.
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2023 Dec; Vol. 27 (6), pp. 1375-1385. Date of Electronic Publication: 2023 Sep 16.
DOI: 10.1007/s10029-023-02882-0
Abstrakt: Purpose: We aimed to perform a systematic review and meta-analysis comparing postoperative outcomes in inguinal hernia repair with TIPP versus Lichtenstein technique.
Methods: Cochrane Central, Scopus, and PubMed were systematically searched for studies comparing TIPP and Lichtenstein´s technique for inguinal hernia repair. Outcomes assessed were operative time, bleeding, surgical site events, hospital stay, the Visual Analogue Pain Score, chronic pain, paresthesia rates, and recurrence. Statistical analysis was performed using RevMan 5.4.1. Heterogeneity was assessed with I 2 statistics and random-risk effect was used if I 2  > 25%.
Results: 790 studies were screened and 44 were thoroughly reviewed. A total of nine studies, comprising 8428 patients were included, of whom 4185 (49.7%) received TIPP and 4243 (50.3%) received Lichtenstein. We found that TIPP presented less chronic pain (OR 0.43; 95% CI 0.20-0.93 P = 0.03; I 2  = 84%) and paresthesia rates (OR 0.27; 95% CI 0.07-0.99; P = 0.05; I 2  = 63%) than Lichtenstein group. In addition, TIPP was associated with a lower VAS pain score at 14 postoperative day (MD - 0.93; 95% CI - 1.48 to - 0.39; P = 0.0007; I 2  = 99%). The data showed a lower operative time with the TIPP technique (MD - 7.18; 95% CI - 12.50, - 1.87; P = 0.008; I 2  = 94%). We found no statistical difference between groups regarding the other outcomes analyzed.
Conclusion: TIPP may be a valuable technique for inguinal hernias. It was associated with lower chronic pain, and paresthesia when compared to Lichtenstein technique. Further long-term randomized studies are necessary to confirm our findings. Study registration A review protocol for this meta-analysis was registered at PROSPERO (CRD42023434909).
(© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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