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轻量级与重量级在腹股沟疝修补术中的比较:一项荟萃分析。

Lightweight versus heavyweight in inguinal hernia repair: a meta-analysis.

机构信息

Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing 210009, JiangSu, People's Republic of China.

出版信息

Hernia. 2012 Oct;16(5):529-39. doi: 10.1007/s10029-012-0928-z. Epub 2012 Jun 12.

Abstract

PURPOSE

The aim of this article is to compare the outcomes of lightweight mesh and heavyweight mesh in inguinal hernia repair.

METHOD

A comprehensive literature search was undertaken to identify studies comparing the influence of lightweight and heavyweight meshes on inguinal hernia.

RESULTS

The present meta-analysis pooled the effects of outcomes of a total 5,389 patients enrolled into 16 randomized controlled trials and 5 comparative studies. Lightweight mesh repair was associated with a significant less incidence of chronic postoperative pain [OR = 0.72, 95 % CI (0.57, 0.91)] and less feeling of foreign body than heavyweight mesh repair [OR = 0.50, 95 % CI (0.37, 0.67)]. Recurrence at 12 months was marginally increased in lightweight group (p = 0.05) [RD = 0.01, 95 % CI (0.00, 0.02)]. However, statistically there was no difference in the incidence of seroma [OR = 0.80, 95 % CI (0.52, 1.23)], infection [RD = -0.00, 95 % CI (-0.01, 0.00)], and testicular atrophy [RD = 0.01, 95 % CI (-0.01, 0.02)].

CONCLUSION

There was no difference regarding the incidence of seroma, infection, and testicular atrophy between lightweight mesh versus heavyweight mesh for inguinal hernia. There is a concern on the recurrence when lightweight mesh is used in large inguinal hernias. However, lightweight mesh repair do have advantages in terms of chronic postoperative pain and feeling of foreign body, and further well-structured trials with improved standardization of hernia types, operative techniques are necessary.

摘要

目的

本文旨在比较轻量网片和重网片在腹股沟疝修补中的结果。

方法

进行了全面的文献检索,以确定比较轻量网片和重网片对腹股沟疝影响的研究。

结果

本荟萃分析汇总了 16 项随机对照试验和 5 项对照研究中总共 5389 名患者的结局效应。与重网片修补相比,轻网片修补术后慢性疼痛的发生率显著降低[OR = 0.72,95 % CI(0.57,0.91)],异物感明显减少[OR = 0.50,95 % CI(0.37,0.67)]。12 个月时轻网片组的复发率略有增加(p = 0.05)[RD = 0.01,95 % CI(0.00,0.02)]。然而,在血清肿发生率方面,统计学上没有差异[OR = 0.80,95 % CI(0.52,1.23)],感染[RD = -0.00,95 % CI(-0.01,0.00)]和睾丸萎缩[RD = 0.01,95 % CI(-0.01,0.02)]。

结论

在腹股沟疝中,轻量网片与重网片在血清肿、感染和睾丸萎缩的发生率方面没有差异。当使用轻量网片治疗大型腹股沟疝时,存在复发的担忧。然而,轻量网片修补在慢性术后疼痛和异物感方面具有优势,需要进一步进行结构良好的试验,并改善疝类型和手术技术的标准化。

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