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Review
. 2022 Oct;92(10):2492-2499.
doi: 10.1111/ans.17721. Epub 2022 Apr 21.

Mesh versus non-mesh repair of groin hernias: a rapid review

Sarah M Smith  1 , Adeel A Khoja  1   2 , Jonathan Henry W Jacobsen  1 , Joshua G Kovoor  1   3 , David R Tivey  1   3 , Wendy J Babidge  1   3 , Harsha S Chandraratna  4 , David R Fletcher  5 , Chris Hensman  6 , Alex Karatassas  7 , Ken W Loi  8 , Karen M F McKertich  9 , Jessica M A Yin  10 , Guy J Maddern  1   3
Affiliations
Review

Mesh versus non-mesh repair of groin hernias: a rapid review

Sarah M Smith et al. ANZ J Surg. 2022 Oct.

Abstract

Background: Mesh is frequently utilized intraoperatively for the repair of groin hernias. However, patients may request non-mesh hernia repairs owing to adverse events reported in other mesh procedures. To inform surgical safety, this study aimed to compare postoperative complications between mesh and non-mesh groin hernia repairs and identify other operative and patient-related risk factors associated with poor postoperative outcomes.

Methods: Ovid MEDLINE and grey literature were searched to 9 June 2021 for studies comparing mesh to non-mesh techniques for primary groin hernia repair. Outcomes of interest were postoperative complications, recurrence of hernia, pain and risk factors associated with poorer surgical outcomes. Methodological quality was appraised using the AMSTAR 2 tool.

Results: The systematic search returned 4268 results, which included seven systematic reviews and five registry analyses. Mesh repair techniques resulted in lower hernia recurrence rates, with no difference in chronic pain, seroma, haematoma or wound infection, compared to non-mesh techniques. Risk factors associated with increased risk of hernia recurrence were increased body mass index (BMI), positive smoking status and direct hernia. These were independent of surgical technique. Patients under 40 years of age were at increased risk of postoperative pain.

Conclusions: Surgical repair of primary groin hernias using mesh achieves lower recurrence rates, with no difference in safety outcomes, compared with non-mesh repairs. Additional risk factors associated with increased recurrence include increased BMI, history of smoking and hernia subtype.

Keywords: hernia; mesh; rapid review; recurrence; safety; surgery.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram showing study selection.
See this image and copyright information in PMC

References

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