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网塞平片修补术与李金斯坦修补术治疗原发性腹股沟疝的Meta 分析

Meta-analysis of mesh-plug repair and Lichtenstein repair in the treatment of primary inguinal hernia.

机构信息

Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, 643000, Sichuan, China.

Department of General Surgery, Zigong Fourth People's Hospital, Zigong, 643000, Sichuan, China.

出版信息

Updates Surg. 2021 Aug;73(4):1297-1306. doi: 10.1007/s13304-021-01032-4. Epub 2021 Mar 23.

Abstract

The present study systematically evaluated the clinical effects of mesh-plug and Lichtenstein herniorrhaphy in the treatment of primary inguinal hernia. PubMed, Embase, and the Cochrane Library (cut-off: May 25, 2020) databases were searched to select randomized controlled trials (RCTs) on mesh-plug and Lichtenstein herniorrhaphy for the treatment of primary inguinal hernia. Articles that met the inclusion criteria were screened and evaluated for quality. RevMan 5.3 software was used to perform a meta-analysis of operation time, discomfort in the inguinal region, haematoma, seroma, infection, time to return to normal activities, incidence of postoperative chronic pain, and recurrence rate. Eleven RCTs with 1457 patients in the mesh-plug group and 1472 in the Lichtenstein group were included. Meta-analysis showed that the mesh-plug herniorrhaphy group had a shorter operation time than the Lichtenstein herniorrhaphy group [P < 0.0001] but a longer time to return to normal activities after surgery [MD = 1.48, 95% CI (0.58, 2.38), P = 0.001]. There were no significant differences in postoperative discomfort in the inguinal region [P = 0.90], seroma [P = 0.10], haematoma [P = 0.27], infection [P = 0.40], incidence of postoperative chronic pain [P = 0.90], or recurrence rate [P = 0.77] between groups. Mesh-plug herniorrhaphy requires a shorter operation time than Lichtenstein herniorrhaphy, and there is no significant difference in postoperative complications or recurrence rate between the two methods. Clinical trial registration: INPLASY202070088. Meta-analysis of mesh -plug repair and Lichtenstein repair in the treatment of primary inguinal hernia.

摘要

本研究系统评价了网塞修补术和 Lichtenstein 修补术治疗原发性腹股沟疝的临床效果。检索PubMed、Embase 和 Cochrane Library(截止日期:2020 年 5 月 25 日)数据库,以选择关于网塞修补术和 Lichtenstein 修补术治疗原发性腹股沟疝的随机对照试验(RCT)。筛选符合纳入标准的文章并进行质量评估。使用 RevMan 5.3 软件对手术时间、腹股沟区不适、血肿、血清肿、感染、恢复正常活动时间、术后慢性疼痛发生率和复发率进行荟萃分析。纳入了网塞组 1457 例和 Lichtenstein 组 1472 例的 11 项 RCT。荟萃分析显示,网塞修补术组的手术时间短于 Lichtenstein 修补术组[P<0.0001],但术后恢复正常活动的时间较长[MD=1.48,95%CI(0.58,2.38),P=0.001]。两组术后腹股沟区不适[P=0.90]、血清肿[P=0.10]、血肿[P=0.27]、感染[P=0.40]、术后慢性疼痛发生率[P=0.90]和复发率[P=0.77]差异均无统计学意义。网塞修补术的手术时间短于 Lichtenstein 修补术,两种方法的术后并发症或复发率无显著差异。临床试验注册:INPLASY202070088。网塞修补术和 Lichtenstein 修补术治疗原发性腹股沟疝的荟萃分析。

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