Department of Colorectal Surgery, Worthing Hospital, Worthing, UK.
Am J Surg. 2013 Jun;205(6):726-36. doi: 10.1016/j.amjsurg.2012.07.046. Epub 2013 Apr 3.
A systematic analysis was conducted of randomized controlled trials (RCTs) comparing lightweight mesh (LWM) with heavyweight mesh in laparoscopic inguinal hernia repair.
Data extracted from the included RCTs were analyzed according to the principles of meta-analysis.
Eleven RCTs encompassing 2,189 patients were analyzed. In a fixed-effects model, operating time, postoperative pain, and recurrence rate were statistically similar between LWM and heavyweight mesh. LWM was associated with fewer perioperative complications and a reduced risk for developing chronic groin pain. There was also a reduced risk for developing other groin symptoms, such as foreign body sensations, but it was not statistically significant.
The use of LWM for laparoscopic inguinal hernia repair is not associated with an increased risk for hernia recurrence. LWM reduces the incidence of chronic groin pain, groin stiffness, and foreign body sensations. Therefore, LWM may routinely be used in laparoscopic inguinal hernia repair. However, high-quality RCTs with longer follow-up periods are required to validate these findings.
系统分析了比较腹腔镜腹股沟疝修补术中使用轻质网片(LWM)与重质网片的随机对照试验(RCT)。
根据荟萃分析的原则,对纳入的 RCT 中提取的数据进行分析。
分析了 11 项 RCT,共纳入 2189 例患者。在固定效应模型中,LWM 与重质网片在手术时间、术后疼痛和复发率方面无统计学差异。LWM 与较少的围手术期并发症和慢性腹股沟疼痛的风险降低相关。其他腹股沟症状(如异物感)的发生风险也降低,但无统计学意义。
在腹腔镜腹股沟疝修补术中使用 LWM 并不增加疝复发的风险。LWM 降低了慢性腹股沟疼痛、腹股沟僵硬和异物感的发生率。因此,LWM 可常规用于腹腔镜腹股沟疝修补术。但是,需要高质量、随访时间更长的 RCT 来验证这些发现。