Abstract
Background
Lichtenstein tension-free mesh repair is the most commonly used technique for open
inguinal hernia. However, mesh fixation with sutures to avoid dislocation has been
considered as a cause of chronic pain and discomfort. A new self-gripping mesh (Parietene
Progrip; Coviden) has been developed, which is making the use of sutureless for inguinal
hernia repair. The aim of this systematic review was to compare the outcomes of open
Lichtenstein inguinal hernia repair using new self-gripping mesh or sutured mesh.
Methods
PubMed/MEDLINE, CENTRAL, and reference lists were searched for controlled trials of
self-gripping mesh versus sutured mesh for open inguinal hernia repair from January 2005 to February 2013.
The primary outcomes were chronic pain and recurrence. Secondary outcomes were duration
of operation, wound infection, hematoma, seroma formation, postoperative pain, hospital
stay, and time to return to work. The methodology was in accordance with the Cochrane
Handbook for interventional systematic reviews and written based on the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses statement.
Results
A total of seven studies, representing 1353 patients were included. There was no effect
on chronic pain (risk difference −0.02 [95% confidence interval −0.07 to 0.03], P = 0.40) or recurrence (risk difference −0.00 [95% confidence interval −0.01 to 0.01],
P = 0.57). No significant differences were noted in terms of secondary outcomes, such
as wound infection, hematoma, and seroma formation, between self-gripping and sutured
mesh repair. But the mean operative duration was shorter in the self-gripping mesh
group than sutured mesh group.
Conclusions
Based on the results, both meshes appear to result in similar postoperation outcomes.
Further long-term analysis may guide surgeon selection of adapted mesh for inguinal
hernia repair.
Keywords
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References
- The tension-free hernioplasty.Am J Surg. 1989; 157: 188
- Open “tensionfree” repair of inguinal hernias: the Lichtenstein technique.Eur J Surg. 1996; 162: 447
- Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair.Br J Surg. 2004; 91: 44
- One year results of a randomized controlled multi-centre study comparing Prolene and Vypro II mesh in Lichtenstein hernioplasty.Hernia. 2005; 9: 223
- A single-surgeon randomized trial comparing three composite meshes on chronic pain after Lichtenstein hernia repair in local anesthesia.Hernia. 2007; 11: 335
- Chronic pain after inguinal herniorrhaphy.J Am Coll Surg. 2007; 205: 333
- The measurement of chronic pain and health-related quality of life following inguinal hernia repair: a review of the literature.Hernia. 2008; 12: 561
- Nerve management during open hernia repair.Br J Surg. 2007; 94: 17
- Tension-free hernia repair is associated with an increase in inflammatory response markers against the mesh.Am J Surg. 2000; 180: 203
- Do absorbable mesh sutures cause less chronic pain than nonabsorbable sutures after Lichtenstein inguinal herniorraphy?.Hernia. 2002; 6: 26
- Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report.Hernia. 2005; 9: 330
- Tension-free open hernia repair using an innovative self-gripping semi-resorbable mesh.Hernia. 2009; 13: 137
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Phys Ther. 2009; 89: 873
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trials.BMJ. 2001; 343: d5928
OCEBM Levels of Evidence Working Group Jeremy Howick ICJLL, Paul Glasziou, Trish Greenhalgh, Carl Heneghan, Alessandro Liberati, Ivan Moschetti, Bob Phillips, Hazel Thornton, Olive Goddard and Mary Hodgkinson. OCEBM Levels of Evidence Working Group. “The Oxford 2011 levels of evidence’’. Oxford Center for Evidence-Based Medicine.
- Randomized controlled multicenter international clinical trial of self-gripping ParietexTM ProGripTM polyester mesh versus lightweight polypropylene mesh in open inguinal hernia repair: interim results at 3 months.Hernia. 2012; 16: 287
- Self-fixating mesh for the Lichtenstein procedure-a prestudy.Langenbecks Arch Surg. 2010; 395: 317
- Randomized clinical trial of self-gripping mesh versus sutured mesh for Lichtenstein hernia repair.Br J Surg. 2013; 100: 474
- Randomized comparison of self-fixating and sutured mesh in open inguinal hernia repair.Br J Surg. 2012; 99: 630
- A prospective comparative study of the efficacy of conventional Lichtenstein versus self-adhesive mesh repair for inguinal hernia.Surg Today. 2011; 41: 1498
- Chronic pain after open inguinal hernia surgery: suture fixation versus self-adhesive mesh repair.Arch Surg. 2012; 397: 1215
- Use of adhesive mesh in hernioplasty compared to the conventional technique. Results of a randomized prospective study.Cir Esp. 2010; 88: 253
- Comparison of a new self-gripping mesh with other fixation methods for laparoscopic hernia repair in a rat model.J Am Coll Surg. 2009; 208: 1107
- Open tension-free hernioplasty using a novel lightweight self-gripping mesh: medium-term experience from two institutions.Langenbecks Arch Surg. 2012; 397: 291
- Lichtenstein inguinal hernioplasty: sutures versus glue.Hernia. 2005; 9: 242
- Use of human fibrin glue (Tissucol) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty: a prospective, randomized study.Ann Surg. 2007; 245: 222
- A single-surgeon randomized trial comparing sutures, N-butyl-2-cyanoacrylate and human fibrin glue for mesh fixation during primary inguinal hernia repair.Can J Surg. 2010; 53: 155
- Open tension-free Lichtenstein repair of inguinal hernia: use of fibrin glue versus sutures for mesh fixation.Hernia. 2011; 15: 7
- Randomized clinical trial of tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair.Br J Surg. 2011; 98: 1245
- Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations.World J Surg. 2010; 34: 1702
Article info
Publication history
Published online: August 12, 2013
Accepted:
July 16,
2013
Received in revised form:
July 4,
2013
Received:
May 28,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
