Comment to: analysing topics using different methods promotes constructive debates. Author's reply
| Autor: | Klinge, U. |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty TEPP Hernia Inguinal Review Constructive Total extraperitoneal hernioplasty Lichtenstein technique Recurrence Inguinal hernia repair Medicine Humans Letter to the Editor Herniorrhaphy Randomized Controlled Trials as Topic Mesh business.industry Endoscopy Surgical Mesh Epistemology Surgery Groin hernia Pyrazines Hernia repair Female Laparoscopy Peritoneum business |
| Zdroj: | Hernia |
| ISSN: | 1248-9204 |
| Popis: | Background–purpose Totally extraperitoneal (TEP) endoscopic hernioplasty and Lichtenstein hernioplasty are the most commonly used approaches for inguinal hernia repair. However, current evidence on which is the preferred approach is inconclusive. This updated meta-analysis was conducted to track the accumulation of evidence over time. Methods Studies were identified by a systematic literature search of the EMBASE, PubMed, Cochrane Library, and Google Scholar databases. Fixed- and random-effects models were used to cumulatively assess the accumulation of evidence over time. Results The TEP cohort showed significantly higher rates of recurrences and vascular injuries compared to the Lichtenstein cohort; [Peto Odds ratio (OR) = 1.58 (1.22, 2.04), p = 0.005], [Peto OR = 2.49 (1.05, 5.88), p = 0.04], respectively. In contrast, haematoma formation rate, time to return to usual activities, and local paraesthesia were significantly lower in the TEP cohort compared to the Lichtenstein cohort; [Peto OR = 0.26 (0.16, 0.41), p ≤ 0.001], [mean difference = − 6.32 (− 8.17, − 4.48), p ≤ 0.001], [Peto OR = 0.26 (0.17, 0.40), p ≤ 0.001], respectively. Conclusions This study, which is based on randomised-controlled trials (RCTs) of high quality, showed significantly higher rates of recurrences and vascular injuries in the TEP cohort than in the Lichtenstein cohort. In contrast, rate of postoperative haematoma formation, local paraesthesia, and time to return to usual activities were significantly lower in the TEP cohort than in the Lichtenstein cohort. Future multicentre RCTs with strict adherence to the standards recommended in the Consolidated Standards of Reporting Trials guidelines will shed further light on the topic. Electronic supplementary material The online version of this article (10.1007/s10029-019-02049-w) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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