Self-gripping versus sutured mesh for inguinal hernia repair: A systematic review and meta-analysis of current literature

摘要

Background: Lichtenstein tension-free mesh repair is the most commonly used technique for open inguinal hernia. However, mesh fixation with sutures to avoid dislocation has been considered as a cause of chronic pain and discomfort. A new self-gripping mesh (Parietene Progrip; Coviden) has been developed, which is making the use of sutureless for inguinal hernia repair. The aim of this systematic review was to compare the outcomes of open Lichtenstein inguinal hernia repair using new self-gripping mesh or sutured mesh. Methods: PubMed/MEDLINE, CENTRAL, and reference lists were searched for controlled trials of self-gripping mesh versus sutured mesh for open inguinal hernia repair from January 2005 to February 2013. The primary outcomes were chronic pain and recurrence. Secondary outcomes were duration of operation, wound infection, hematoma, seroma formation, postoperative pain, hospital stay, and time to return to work. The methodology was in accordance with the Cochrane Handbook for interventional systematic reviews and written based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: A total of seven studies, representing 1353 patients were included. There was no effect on chronic pain (risk difference-0.02 [95% confidence interval-0.07 to 0.03], P = 0.40) or recurrence (risk difference-0.00 [95% confidence interval-0.01 to 0.01], P = 0.57). No significant differences were noted in terms of secondary outcomes, such as wound infection, hematoma, and seroma formation, between self-gripping and sutured mesh repair. But the mean operative duration was shorter in the self-gripping mesh group than sutured mesh group. Conclusions: Based on the results, both meshes appear to result in similar postoperation outcomes. Further long-term analysis may guide surgeon selection of adapted mesh for inguinal hernia repair.