دورية أكاديمية
Glue versus mechanical mesh fixation in laparoscopic inguinal hernia repair: meta-analysis and trial sequential analysis of randomized clinical trials.
| العنوان: | Glue versus mechanical mesh fixation in laparoscopic inguinal hernia repair: meta-analysis and trial sequential analysis of randomized clinical trials. |
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| المؤلفون: | Habib Bedwani NAR; Department of General Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK., Kelada M; Imperial College School of Medicine, Imperial College London, London, UK., Smart N; Department of General Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.; Department of Gastrointestinal Surgery, University of Exeter Medical School, University of Exeter, Exeter, UK., Szydlo R; Imperial College School of Medicine, Imperial College London, London, UK., Patten DK; Department of General Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK.; Imperial College School of Medicine, Imperial College London, London, UK.; Deparment of Surgery and Cancer, Imperial Centre for Translational and Experimental Medicine, Imperial College London, London, UK., Bhargava A; Department of General Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK.; Institute of Health Sciences Education, Barts and the London School of Medicine and Dentistry, London, UK. |
| المصدر: | The British journal of surgery [Br J Surg] 2021 Jan 27; Vol. 108 (1), pp. 14-23. |
| نوع المنشور: | Comparative Study; Journal Article; Meta-Analysis; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press on behalf of BJS Foundation Ltd Country of Publication: England NLM ID: 0372553 Publication Model: Print Cited Medium: Internet ISSN: 1365-2168 (Electronic) Linking ISSN: 00071323 NLM ISO Abbreviation: Br J Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2021- : [Oxford] : Oxford University Press on behalf of BJS Foundation Ltd. Original Publication: [Bristol, England : Baltimore : John Wright & Sons ; Williams & Wilkins Co. |
| مواضيع طبية MeSH: | Surgical Mesh*, Adhesives/*therapeutic use , Hernia, Inguinal/*surgery , Herniorrhaphy/*methods , Laparoscopy/*methods, Herniorrhaphy/instrumentation ; Humans ; Laparoscopy/instrumentation ; Pain, Postoperative/epidemiology ; Randomized Controlled Trials as Topic |
| مستخلص: | Background: The optimal choice for mesh fixation in laparoscopic inguinal hernia repair (LIHR) has not been well established. This review compared the effects of glue versus mechanical mesh fixation in LIHR on incidence of chronic postoperative inguinal pain (CPIP) and other secondary outcomes, including acute pain, seroma, haematoma, hernia recurrence and other postoperative complications. Methods: A systematic review of English/non-English studies using MEDLINE, the Cochrane Library, OpenGrey, OpenThesis and Web of Science, and searching bibliographies of included studies was completed. Search terms included laparoscopic, hernia, fibrin glue, Tisseel, Tissucol, cyanoacrylate, Glubran and Liquiband. Only RCTs comparing mechanical with glue-based fixation in adult patients (aged over 18 years) that examined CPIP were included. Two authors independently completed risk-of-bias assessment and data extraction against predefined data fields. All pooled analyses were computed using a random-effects model. Results: Fifteen RCTs met the inclusion criteria; 2777 hernias among 2109 patients were assessed. The incidence of CPIP was reduced with use of glue-based fixation (risk ratio (RR) 0.36, 95 per cent c.i. 0.19 to 0.69; P = 0.002), with moderate heterogeneity that disappeared with sensitivity analysis (8 d.f.) for patient-blinded studies (RR 0.43, 0.27 to 0.86). Trial sequential analysis provided evidence for a relative risk reduction of at least 25 per cent. The incidence of haeamtoma was reduced by using glue-based fixation (RR 0.29, 0.10 to 0.82; P = 0.02) with no significant effects on seroma formation or hernia recurrence (RR 1.07, 0.46 to 2.47; P = 0.88). Conclusion: Glue-based mesh fixation appears to reduce the incidence of CPIP and haematoma after LIHR compared with mechanical fixation, with comparable recurrence rates. (© The Author(s) 2020. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| المشرفين على المادة: | 0 (Adhesives) |
| تواريخ الأحداث: | Date Created: 20210228 Date Completed: 20210426 Latest Revision: 20210426 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1093/bjs/znaa002 |
| PMID: | 33640918 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1365-2168 |
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| DOI: | 10.1093/bjs/znaa002 |