Systematic review and meta-analysis of published randomized controlled trials comparing the role of self-gripping mesh against suture mesh fixation in patients undergoing open inguinal hernia repair

Abstract

The objective of this article is to analyze systematically the randomized, controlled trials comparing the use of self-gripping mesh (SGM) versus suture mesh fixation (SMF) in patients undergoing open inguinal hernia repair. Randomized, controlled trials comparing the use of SGM versus SMF in patients undergoing open inguinal hernia repair were analyzed using RevMan(®), and combined outcomes were expressed as odds ratio (OR) and standardized mean difference (SMD). Four randomized, controlled trials recruiting 1,115 patients undergoing open inguinal hernia repair using SGM versus SMF were retrieved from the search of medical electronic databases. There were 553 patients in the SGM group and 562 patients in the SMF group. The incidence of chronic groin pain (OR 1.04; 95% CI 0.72, 1.49; z = 0.21; p = 0.83), recurrence (OR 0.76; 95% CI 0.14, 4.08; z = 0.32; p = 0.75), postoperative complications and length of hospital stay were similar in SGM and SMF groups. The duration of operation (SMD -0.36; 95% CI -0.47, -0.24; z = 5.88; p < 0.00001) was shorter following the use of SGM in open inguinal hernia repair. SGM failed to demonstrate the reduced incidence of postoperative groin pain following open inguinal hernia repair. In addition, hernia recurrence, postoperative complications and length of stay was also unchanged. However, SGM was associated with overall shorter operative time.