Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Department of General Surgery, Aberdeen Royal Infirmary, Aberdeen, UK.
World J Surg. 2020 Oct;44(10):3312-3321. doi: 10.1007/s00268-020-05587-y.
The aims of the present systematic review and meta-analysis were to compare non-mesh Desarda technique with standard mesh-based Lichtenstein technique for inguinal hernia repair.
A systematic literature search for RCTs comparing between DT and LT was conducted using electronic databases and Google scholar service. Studies were evaluated for recurrence and post-operative complications. We pooled the data using fixed effects model and random effects model after assessing the heterogeneity among the included studies.
A total number of 8 RCTs studies were included in this meta-analysis with total number of 3177 patients divided between Desarda group and Lichtenstein group as follows: 1551 patients and 1,626 patients, respectively. There was no difference in terms of recurrence between the Desarda repair and Lichtenstein repair groups [P = 0.44]. There was a lower rate of overall post-operative complications [P = 0.003], seroma [P = 0.0004] and surgical site infections (SSIs) [P = 0.04] in the Desarda group.
DT and LT were found to have comparable results in terms of recurrence rate, haematoma formation, testicular atrophy and time to return to normal daily activity/work. DT is superior to LT in terms of reducing post-operative mesh-attributed complications, such as SSI and Seroma formation.
本系统评价和荟萃分析的目的是比较非网片的 Desarda 技术与标准网片的 Lichtenstein 技术在腹股沟疝修补术中的应用。
使用电子数据库和 Google 学术服务，对比较 DT 和 LT 的 RCT 进行系统文献检索。评估研究的复发和术后并发症。在评估纳入研究之间的异质性后，使用固定效应模型和随机效应模型汇总数据。
这项荟萃分析共纳入 8 项 RCT 研究，共有 3177 名患者分为 Desarda 组和 Lichtenstein 组，分别为 1551 名和 1626 名。在复发方面，Desarda 修复和 Lichtenstein 修复两组之间没有差异[P=0.44]。Desarda 组的总体术后并发症[P=0.003]、血清肿[P=0.0004]和手术部位感染（SSI）[P=0.04]的发生率较低。
DT 和 LT 在复发率、血肿形成、睾丸萎缩和恢复正常日常活动/工作的时间方面结果相当。在减少术后与网片相关的并发症方面，如 SSI 和血清肿形成，DT 优于 LT。
