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开放式腹股沟疝修补术中自固定网片与缝合网片的比较:荟萃分析结果。

The comparison of self-gripping mesh and sutured mesh in open inguinal hernia repair: the results of meta-analysis.

机构信息

From the Department of General Surgery, Affiliated Zhong-Da Hospital, Southeast University, Nanjing, JiangSu, People's Republic of China.

出版信息

Ann Surg. 2014 Jun;259(6):1080-5. doi: 10.1097/SLA.0000000000000408.

DOI:10.1097/SLA.0000000000000408
PMID:24374518
Abstract

OBJECTIVE

The aim of this study was to compare the postoperative chronic pain and other postoperative complications after the use of the self-gripping Progrip meshes and the application of conventional suture-fixed Lichtenstein procedure.

BACKGROUND

Chronic pain after inguinal hernia repair is a complex problem. Many efforts have been put to reduce the postoperative chronic pain after open inguinal hernia repair, and the results are conflicting.

METHODS

A systematic literature review was undertaken to identify studies comparing the outcomes of open inguinal hernia repair with self-gripping Progrip meshes and the conventional Lichtenstein technique.

RESULTS

The present meta-analysis pooled the effects of outcomes of total 1353 patients enrolled into 5 randomized controlled trials and 2 prospective comparative studies. Statistically, there was no difference in the incidence of chronic pain [odds ratio = 0.74, 95% confidence interval (CI) (0.51-1.08)]. And there was no statistical difference in the incidence of acute postoperative pain [odds ratio = 1.32, 95% CI (0.68-2.55)], hematoma or seroma [odds ratio = 0.89, 95% CI (0. 56-1.41)], wound infection [risk difference = -0.01, 95% CI (-0.02 to 0.01)], and recurrence [risk difference = 0.00, 95% CI (-0.01 to 0.01)]. The self-gripping mesh group was associated with a shorter operating time (1-9 minutes).

CONCLUSIONS

When the self-gripping mesh compared with the conventional suture fixed Lichtenstein technique, while there was a difference in operative time, there were no differences in pain (chronic or acute) or other complications.

摘要

目的

本研究旨在比较使用自固位 Progrip 网片和传统缝线固定 Lichtenstein 手术治疗后术后慢性疼痛和其他术后并发症。

背景

腹股沟疝修补术后慢性疼痛是一个复杂的问题。许多人努力减少开放式腹股沟疝修补术后的慢性疼痛,但结果相互矛盾。

方法

系统文献回顾旨在确定比较自固位 Progrip 网片和传统 Lichtenstein 技术治疗开放式腹股沟疝修补术的结果的研究。

结果

本荟萃分析汇总了 5 项随机对照试验和 2 项前瞻性比较研究共纳入的 1353 例患者的结果。统计学上,慢性疼痛的发生率没有差异[比值比=0.74,95%置信区间(CI)(0.51-1.08)]。急性术后疼痛的发生率也没有统计学差异[比值比=1.32,95%置信区间(CI)(0.68-2.55)]、血肿或血清肿[比值比=0.89,95%置信区间(CI)(0.56-1.41)]、伤口感染[风险差=-0.01,95%置信区间(-0.02 至 0.01)]和复发[风险差=0.00,95%置信区间(-0.01 至 0.01)]。自固位网片组的手术时间更短(1-9 分钟)。

结论

与传统缝线固定 Lichtenstein 技术相比,自固位网片虽然手术时间有所不同,但在疼痛(慢性或急性)或其他并发症方面没有差异。

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