Mesh-fixation technique for inguinal hernia repair: Umbrella review
Issued Date
2022-08-01
Resource Type
eISSN
24749842
Scopus ID
2-s2.0-85134425620
Pubmed ID
35811449
Journal Title
BJS Open
Volume
6
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
BJS Open Vol.6 No.4 (2022)
Suggested Citation
Techapongsatorn S., Tansawet A., Pattanaprateep O., Attia J., McKay G.J., Thakkinstian A. Mesh-fixation technique for inguinal hernia repair: Umbrella review. BJS Open Vol.6 No.4 (2022). doi:10.1093/bjsopen/zrac084 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85673
Title
Mesh-fixation technique for inguinal hernia repair: Umbrella review
Other Contributor(s)
Abstract
Background: Mesh-based repair is the standard of surgical care for symptomatic inguinal hernias. Many systematic reviews and meta-analyses (SRMAs) addressed various aspects of these procedures. This umbrella review aimed to report the evidence from all previous SRMAs for open and laparoscopic inguinal hernia repair. Methods: SRMAs were identified from MEDLINE, Scopus, Cochrane, Embase, DARE, PROSPERO, CINAHL, JBISRIS, EPPI-Centre, Wiley Online Library and ScienceDirect database according to PRISMA guidelines. Data including mesh-fixation techniques and surgical approach were extracted from selected SRMAs. The corrected covered area was calculated to address study overlap across reviews, and an excess significance test was used to assess potential bias. The outcomes of interest were hernia recurrence, chronic groin pain, operating time, postoperative pain, duration of hospital stay, return to daily life activities, and postoperative complication. Results: Thirty SRMAs were included between 2010 and 2019: 16 focused on open repair, and 14 focused on laparoscopic repair, with a high degree of overlap (open repairs, 41 per cent; laparoscopic repairs, 30-57 per cent). Sufficient evidence was available on hernia recurrence, chronic groin pain, and operative time. Effects of glue on hernia recurrence were inconclusive in open and laparoscopy approaches, P = 0.816 and 0.946 respectively. Glue was significantly associated with lower persistent groin pain, in open repair (versus suture) and in laparoscopic repair (versus tack). SRMAs suggested that self-gripping mesh was associated with shorter operating time in open surgery, although with only a few minutes of improvement (0.36-7.85 min, P < 0.001). Conclusion: In this umbrella review, chronic groin pain and operating time were the only outcomes for which there was sufficient evidence supporting the effectiveness respectively of glue and self-gripping mesh.