A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?

A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?

Background There is no consensus regarding hernia sac management during laparoscopic hernia repair, and this systematic review and meta-analysis aimed to compare the postoperative outcomes of sac reduction (RS) and sac transection (TS) during laparoscopic mesh hernia repair. Methods We conducted a s...

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Bibliographic Details
Published in:BMC surgery Vol. 23; no. 1; pp. 1 - 249
Main Authors: Chaouch, Mohamed Ali, Hussain, Mohammed Iqbal, Gouader, Amine, Lahdhiri, Abdallah Amine, Mazzotta, Alessandro, da Costa, Adriano Carneiro, Krimi, Bassem, Noomen, Faouzi, Oweira, Hani
Format: Journal Article
Language:English
Published: London BioMed Central Ltd 23-08-2023
BioMed Central
BMC
Subjects:
Analysis
Bias
Care and treatment
Clinical trials
Dissection
Finite element method
Hernia
Hernia repair
Hernias
Hospitals
Laparoscopic surgery
Laparoscopy
Literature reviews
Medical research
Medicine, Experimental
Meta-analysis
Morbidity
Pain
Postoperative period
Quality assessment
Reduction
Seroma
Systematic review
Total extraperitoneal
Transabdominal preperitoneal
Transection
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Summary:Background There is no consensus regarding hernia sac management during laparoscopic hernia repair, and this systematic review and meta-analysis aimed to compare the postoperative outcomes of sac reduction (RS) and sac transection (TS) during laparoscopic mesh hernia repair. Methods We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 and AMSTAR 2 (Assessing the Methodological Quality of Systematic Reviews) guidelines. We used the RevMan 5.4 statistical package from the Cochrane collaboration for meta-analysis. A random effects model was used. Results The literature search yielded six eligible studies including 2941 patients: 821 patients in the TS group and 2120 patients in the RS group. In the pooled analysis, the TS group was associated with a lower incidence of seroma (OR = 1.71; 95% CI [1.22, 2.39], p = 0.002) and shorter hospital stay (MD = -0.07; 95% CI [-0.12, -0.02], p = 0.008). There was no significant difference between the two groups in terms of morbidity (OR = 0.87; 95% CI [0.34, 2.19], p = 0.76), operative time (MD = -4.39; 95% CI [-13.62, 4.84], p = 0.35), recurrence (OR = 2.70; 95% CI [0.50, 14.50], p = 0.25), and Postoperative pain. Conclusions This meta-analysis showed that hernia sac transection is associated with a lower seroma rate and shorter hospital stay with similar morbidity, operative time, recurrence, and postoperative pain compared to the reduction of the hernia sac. Protocol The protocol was registered in PROSPERO with ID CRD42023391730. Keywords: Hernia repair, Reduction, Transection, Total extraperitoneal, Transabdominal preperitoneal, Seroma, Outcomes
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ISSN:1471-2482
1471-2482
DOI:10.1186/s12893-023-02147-8