Madsen L J, Oma E, Jorgensen L N, Jensen K K
Digestive Disease Centre, Research Department, Bispebjerg and Frederiksberg Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Nielsine Nielsens Vej 11, Entrance 8, Ground Floor, DK-2400, Copenhagen, NV, Denmark.
BJS Open. 2020 Jun;4(3):369-379. doi: 10.1002/bjs5.50276. Epub 2020 Apr 6.
Mesh repair of umbilical hernia has been associated with a reduced recurrence rate compared with suture closure, but potentially at the expense of increased postoperative complications and chronic pain. The objective of this systematic review and meta-analysis was to examine the outcomes after elective open mesh and suture repair for umbilical hernia in adults.
A literature search was conducted to identify studies presenting original data on elective open mesh and suture repair of umbilical hernia. The primary outcome was hernia recurrence. Secondary outcomes included surgical-site infection (SSI), seroma, haematoma and chronic pain. Meta-analyses were undertaken.
The search resulted in 5353 hits and led to 14 studies being included (6 RCTs and 8 observational studies) describing a total of 2361 patients. Compared with suture, mesh repair was associated with a lower risk of recurrence (risk ratio (RR) 0·48, 95 per cent c.i. 0·30 to 0·77), with number needed to treat 19 (95 per cent c.i. 14 to 31). Mesh repair was associated with a higher risk of seroma (RR 2·37, 1·45 to 3·87), with number needed to harm 30 (17 to 86). There was no significant difference in the risk of SSI, haematoma or chronic pain.
The use of mesh in elective repair of umbilical hernia reduced the risk of recurrence compared with suture closure without altering the risk of chronic pain.
与缝合修补相比，脐疝的补片修补术可降低复发率，但可能会增加术后并发症和慢性疼痛的风险。本系统评价和荟萃分析的目的是研究成人脐疝择期开放补片修补术和缝合修补术后的结局。
进行文献检索，以确定提供成人脐疝择期开放补片修补术和缝合修补术原始数据的研究。主要结局为疝复发。次要结局包括手术部位感染（SSI）、血清肿、血肿和慢性疼痛。进行荟萃分析。
检索共获得5353条结果，纳入14项研究（6项随机对照试验和8项观察性研究），共涉及2361例患者。与缝合修补相比，补片修补术复发风险较低（风险比（RR）0.48，95%置信区间0.30至0.77），需治疗人数为19（95%置信区间14至31）。补片修补术血清肿风险较高（RR 2.37，1.45至3.87），需伤害人数为30（17至86）。SSI、血肿或慢性疼痛风险无显著差异。
与缝合修补相比，脐疝择期修补术中使用补片可降低复发风险，且不改变慢性疼痛风险。
