Suture fixation versus self-gripping mesh for open inguinal hernia repair: a systematic review with meta-analysis and trial sequential analysis

Autor: N. L. Bullen, S. Hajibandeh, N. J. Smart, S. A. Antoniou
Rok vydání: 2020
Předmět:
Zdroj: Surgical Endoscopy. 35:2480-2492
ISSN: 1432-2218
0930-2794
Popis: Morbidity following open inguinal hernia repair is mainly related to chronic pain. ProGrip™ is a self-gripping mesh which aims to reduce rates of chronic pain. The aim of this study is to perform an update meta-analysis to consolidate the non-superiority hypothesis in terms of postoperative pain and recurrence and perform a trial sequential analysis. Systematic review of randomised controlled trials performed according to PRISMA guidelines. Pooled odds ratios with 95% confidence intervals (CI) were calculated using the Mantel–Haenszel (M–H) method. The primary outcome measure was postoperative pain and secondary outcomes were recurrence, operative time, wound complications, length of stay, re-operation rate, and cost. Trial sequential analysis was performed. There were 14 studies included in the quantitative analysis with 3180 patients randomised to self-gripping mesh (1585) or standard mesh (1595). At all follow-up time points, there was no significant difference in the rates of chronic pain between the self-gripping and standard mesh (risk ratio, RR 1.10, 95% confidence interval, CI 0.83–1.46). There were no significant differences in recurrence rates (RR 1.13, CI 0.84–2.04). The mean operating time was significantly shorted in the ProGrip™ mesh group (MD − 7.32 min, CI − 10.21 to − 4.44). Trial sequential analysis suggests findings are conclusive. This meta-analysis has confirmed no benefit of a ProGrip™ mesh when compared to a standard sutured mesh for open inguinal hernia repair in terms of chronic pain or recurrence. No further trials are required to address this clinical question.
Databáze: OpenAIRE
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