Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Hernia. 2020 Aug;24(4):733-745. doi: 10.1007/s10029-019-02106-4. Epub 2019 Dec 9.
Lichtenstein repair (LR), mesh-plug repair (MPR), and prolene hernia system (PHS) are three common open tensionless repair techniques for inguinal hernia (IH); each technique has its supporters and controversies never stop. It is necessary to perform a meta-analysis to evaluate the clinical efficacy of these three open tensionless repair techniques.
RCTs comparing at least any two of the three open tensionless repair techniques for IH were searched in online databases. Literature screening and quality assessment were carried out basing on the established inclusion criteria and exclusion criteria. Statistical analyses were carried out using RevMan software 5.3. The primary outcomes were recurrence, chronic pain and time to return to work. Secondary outcomes were inguinal paresthesia, testicular and scrotal problems, hematoma, seroma and wound infection.
Twenty-two references on fifteen RCTs involving a total of 3716 hernias were selected for the meta-analysis. In these trials, seven comparing LR and MPR, five comparing LR and PHS, and three comparing LR, MPR and PHS. All primary and secondary outcomes could be pooled analyzed in comparison of MPR and PHS with LR, while only two primary outcomes (recurrence and chronic pain) and one secondary outcome (wound infection) could be pooled analyzed in comparison of MPR with PHS. Results of this meta-analysis demonstrated that MPR and PHS were comparable to LR in all primary and secondary outcomes, and MPR and PHS were comparable in terms of recurrence, chronic pain and wound infection.
This meta-analysis indicates that MPR and PHS seem comparable to LR in terms of recurrence, chronic pain, time to return to work, inguinal paresthesia, testicular and scrotal problems, hematoma, seroma and wound infection. MPR and PHS seem comparable in terms of recurrence, chronic pain and wound infection.
Lichtenstein 修补术（LR）、网塞修补术（MPR）和 prolene 疝修补系统（PHS）是三种常用于治疗腹股沟疝（IH）的开放式无张力修复技术；每种技术都有其支持者，争议从未停止过。有必要进行一项荟萃分析来评估这三种开放式无张力修复技术的临床疗效。
在在线数据库中搜索了比较至少两种这三种开放式无张力修复技术治疗 IH 的 RCT。根据既定的纳入和排除标准进行文献筛选和质量评估。使用 RevMan 软件 5.3 进行统计分析。主要结局是复发、慢性疼痛和恢复工作的时间。次要结局是腹股沟感觉异常、睾丸和阴囊问题、血肿、血清肿和伤口感染。
选择了 22 篇关于 15 项 RCT 的参考文献，共涉及 3716 例疝气，用于荟萃分析。这些试验中，7 项比较 LR 和 MPR，5 项比较 LR 和 PHS，3 项比较 LR、MPR 和 PHS。MPR 和 PHS 与 LR 比较的所有主要和次要结局均可以进行汇总分析，而 MPR 与 PHS 比较的只有两个主要结局（复发和慢性疼痛）和一个次要结局（伤口感染）可以进行汇总分析。这项荟萃分析的结果表明，在所有主要和次要结局方面，MPR 和 PHS 与 LR 相当，而在复发、慢性疼痛和伤口感染方面，MPR 和 PHS 也相当。
这项荟萃分析表明，在复发、慢性疼痛、恢复工作时间、腹股沟感觉异常、睾丸和阴囊问题、血肿、血清肿和伤口感染方面，MPR 和 PHS 似乎与 LR 相当。在复发、慢性疼痛和伤口感染方面，MPR 和 PHS 似乎相当。
