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Meta-Analysis
. 2023 Dec;27(6):1397-1413.
doi: 10.1007/s10029-023-02874-0. Epub 2023 Sep 7.

Mesh repair versus non-mesh repair for incarcerated and strangulated groin hernia: an updated systematic review and meta-analysis

P Marcolin  1 , Sérgio Mazzola Poli de Figueiredo  2 , Vitor Moura Fé de Melo  3 , Sérgio Walmir de Araújo  4 , Marcella Mota Constante  5 , Rui-Min Diana Mao  2 , A Villasante-Tezanos  6 , R Lu  2
Affiliations
Meta-Analysis

Mesh repair versus non-mesh repair for incarcerated and strangulated groin hernia: an updated systematic review and meta-analysis

P Marcolin et al. Hernia. 2023 Dec.

Abstract

Background: Mesh repair in incarcerated or strangulated groin hernia is controversial, especially when bowel resection is required. We aimed to perform a meta-analysis comparing mesh and non-mesh repair in patients undergoing emergency groin hernia repair.

Methods: We performed a literature search of databases to identify studies comparing mesh and primary suture repair of patients with incarcerated or strangulated inguinal or femoral hernias who underwent emergency surgery. Postoperative outcomes were assessed by pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I2 statistics.

Results: 1095 studies were screened and 101 were thoroughly reviewed. Twenty observational studies and four randomized controlled trials comprising 12,402 patients were included. We found that mesh-based repair had reduced recurrence (OR 0.36; 95% CI 0.19, 0.67; P = 0.001; I2 = 35%), length of hospital stay (OR - 1.02; 95% CI - 1.87, - 0.17; P = 0.02; I2 = 94%) and operative time (OR - 9.21; 95% CI - 16.82, - 1.61; P = 0.02; I2 = 95%) without increasing surgical site infection, mortality or postoperative complications such as seroma, chronic, ileus or urinary retention. In the subgroup analysis of patients that underwent bowel resection, we found that mesh repair was associated with an increased risk of surgical site infection (OR 1.74; 95% CI 1.04, 2.91; P = 0.04; I2 = 9%).

Conclusions: Mesh repair for incarcerated and strangulated groin hernias reduces recurrence without an increase in postoperative complications and should be considered in clean cases. However, in the setting of bowel resection, mesh repair might increase the incidence of surgical site infection.

Keywords: Emergency hernia repair; Femoral hernia; Inguinal hernia; Mesh; Suture.

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References

    1. Kumar D, Wu D, Tan B et al (2022) Emergency groin hernia: outcome after mesh and non‐mesh repair. ANZ J Surg ans.18212. https://doi.org/10.1111/ans.18212
    1. The HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165. https://doi.org/10.1007/s10029-017-1668-x - DOI
    1. Samuel JC, Tyson AF, Mabedi C et al (2014) Development of a ratio of emergent to total hernia repairs as a surgical capacity metric. Int J Surg 12:906–911. https://doi.org/10.1016/j.ijsu.2014.07.019 - DOI - PubMed - PMC
    1. Alvarez JA, Baldonedo RF, Bear IG et al (2004) Incarcerated groin hernias in adults: presentation and outcome. Hernia 8:121–126. https://doi.org/10.1007/s10029-003-0186-1 - DOI - PubMed
    1. Simon KL, Frelich MJ, Gould JC et al (2015) Inpatient outcomes after elective versus nonelective ventral hernia repair. J Surg Res 198:305–310. https://doi.org/10.1016/j.jss.2015.03.073 - DOI - PubMed - PMC

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