Federal University of Health Sciences of Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, Centro Histórico, Porto Alegre, 90050-170, Brazil.
Universidade Federal da Fronteira Sul, Passo Fundo, Brazil.
Hernia. 2024 Apr;28(2):291-300. doi: 10.1007/s10029-023-02865-1. Epub 2023 Aug 30.
There is considerable variability among surgeons regarding the type of mesh used in ventral hernia repair. There has been an increasing incidence of mesh fractures with lightweight (LW) and mediumweight (MW) meshes. However, HW mesh has been associated with a greater foreign body sensation and chronic pain. This meta-analysis aims to compare the outcomes of HW and non-heavyweight (NHW) meshes in ventral hernia repair.
We systematically reviewed the PubMed, Embase, Cochrane, and Scopus databases to identify studies comparing HW with NHW meshes in hernia repair. Outcomes analyzed included hernia recurrence, seroma, hematoma, foreign body sensation, postoperative pain, and wound infection. We performed two subgroup analyses focusing on randomized controlled trials and open retromuscular repairs. Statistical analysis was performed using RevMan 5.4.
We screened 1704 studies. Nine studies were finally included in this meta-analysis and comprised 3001 patients from 4 RCTs and 5 non-randomized. The majority of patients (57.1%) underwent open retromuscular repair. HW mesh was significantly associated with increased in foreign body sensation (OR 3.71; 95% CI 1.40-9.84; p = 0.008), but there was no difference in other outcomes. In RCTs analysis, there was no difference between meshes. In open retromuscular repairs, HW mesh was associated with more seromas (OR 1.48; 95% CI 1.01-2.17; p = 0.05).
Our study found that HW mesh was associated with more foreign body sensation. Also, open retromuscular repairs analysis showed that HW was associated with more seromas. Further randomized studies are needed to understand better the role of HW mesh in ventral hernia repair.
在腹疝修补术中，外科医生使用的网片类型存在很大差异。随着轻量（LW）和中量（MW）网片的使用增加，网片断裂的发生率也在增加。然而，HW 网片与更大的异物感和慢性疼痛有关。本荟萃分析旨在比较 HW 和非重（NHW）网片在腹疝修补术中的效果。
我们系统地检索了 PubMed、Embase、Cochrane 和 Scopus 数据库，以确定比较 HW 与 NHW 网片在疝修补术中应用的研究。分析的结果包括疝复发、血清肿、血肿、异物感、术后疼痛和伤口感染。我们进行了两次亚组分析，重点是随机对照试验和开放式后肌修复。统计分析使用 RevMan 5.4 进行。
我们筛选了 1704 篇研究。最终有 9 项研究纳入本荟萃分析，包括 4 项 RCT 和 5 项非随机研究的 3001 例患者。大多数患者（57.1%）接受开放式后肌修复。HW 网片与异物感增加显著相关（OR 3.71；95% CI 1.40-9.84；p=0.008），但其他结果无差异。在 RCT 分析中，两种网片之间无差异。在开放式后肌修复中，HW 网片与更多的血清肿相关（OR 1.48；95% CI 1.01-2.17；p=0.05）。
我们的研究发现，HW 网片与更多的异物感有关。此外，开放式后肌修复分析表明，HW 与更多的血清肿有关。需要进一步的随机研究来更好地了解 HW 网片在腹疝修补术中的作用。
