A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?
Abstract 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 cond...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-023-02147-8 |
| _version_ | 1827635758685487104 |
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| author | Mohamed Ali Chaouch Mohammed Iqbal Hussain Amine Gouader Abdallah Amine Lahdhiri Alessandro Mazzotta Adriano Carneiro da Costa Bassem Krimi Faouzi Noomen Hani Oweira |
| author_facet | Mohamed Ali Chaouch Mohammed Iqbal Hussain Amine Gouader Abdallah Amine Lahdhiri Alessandro Mazzotta Adriano Carneiro da Costa Bassem Krimi Faouzi Noomen Hani Oweira |
| author_sort | Mohamed Ali Chaouch |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-09T15:31:59Z |
| format | Article |
| id | doaj.art-3e37993b170f4c4f83dce3661818c7a6 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-09T15:31:59Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-3e37993b170f4c4f83dce3661818c7a62023-11-26T12:11:37ZengBMCBMC Surgery1471-24822023-08-0123111110.1186/s12893-023-02147-8A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?Mohamed Ali Chaouch0Mohammed Iqbal Hussain1Amine Gouader2Abdallah Amine Lahdhiri3Alessandro Mazzotta4Adriano Carneiro da Costa5Bassem Krimi6Faouzi Noomen7Hani Oweira8Department of Visceral and Digestive Surgery, Fattouma Bourguiba Hospital, University of MonastirDepartment of General Surgery, Portsmouth Hospitals University NHS TrustDepartment of Surgery, Perpignan Hospital CenterDepartment of Anesthesia and Intensive Care, Farhat Hached Hospital, University of SousseDepartment of Digestive, Metabolic, and Oncologic Surgery, Institute Mutualist of MontsourisDepartment of Digestive, Metabolic, and Oncologic Surgery, Institute Mutualist of MontsourisDepartment of Surgery, Perpignan Hospital CenterDepartment of Visceral and Digestive Surgery, Fattouma Bourguiba Hospital, University of MonastirDepartment of Surgery, Universitäts medizin Mannheim, Heidelberg UniversityAbstract 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.https://doi.org/10.1186/s12893-023-02147-8Hernia repairReductionTransectionTotal extraperitonealTransabdominal preperitonealSeroma |
| spellingShingle | Mohamed Ali Chaouch Mohammed Iqbal Hussain Amine Gouader Abdallah Amine Lahdhiri Alessandro Mazzotta Adriano Carneiro da Costa Bassem Krimi Faouzi Noomen Hani Oweira A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection? BMC Surgery Hernia repair Reduction Transection Total extraperitoneal Transabdominal preperitoneal Seroma |
| title | A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection? |
| title_full | A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection? |
| title_fullStr | A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection? |
| title_full_unstemmed | A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection? |
| title_short | A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection? |
| title_sort | systematic review and meta analysis of hernia sac management in laparoscopic groin hernia mesh repair reduction or transection |
| topic | Hernia repair Reduction Transection Total extraperitoneal Transabdominal preperitoneal Seroma |
| url | https://doi.org/10.1186/s12893-023-02147-8 |
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