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Meta-Analysis
. 2023 Aug 23;23(1):249.
doi: 10.1186/s12893-023-02147-8.

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

Mohamed Ali Chaouch  1 , Mohammed Iqbal Hussain  2 , Amine Gouader  3 , Abdallah Amine Lahdhiri  4 , Alessandro Mazzotta  5 , Adriano Carneiro da Costa  5 , Bassem Krimi  3 , Faouzi Noomen  6 , Hani Oweira  7
Affiliations
Meta-Analysis

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

Mohamed Ali Chaouch et al. BMC Surg. .

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.

Keywords: Hernia repair; Outcomes; Reduction; Seroma; Total extraperitoneal; Transabdominal preperitoneal; Transection.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram of the included studies
Fig. 2
Fig. 2
Forest plot of the different outcomes
See this image and copyright information in PMC

References

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