Stapled versus unstapled mesh in laparoscopic inguinal hernia repair: A systematic review / 第二军医大学学报

ABSTRACT

Objective: To conduct a systematic review on the clinical effectiveness and relative efficiency of stapled and unstapled mesh in laparoscopic inguinal hernia repair. Methods: PubMed, EMBASE, CENTREN, Cochrane Central Register of Controlled Trials (CENTRAL), CBMdisk, and National Knowledge Infrastructure (CNKI) database were searched for randomized controlled trials comparing stapled and unstapled mesh in the laparoscopic repair of inguinal hernia; manual search was also conducted. The obtained literatures were rated and eligible trails were subjected to meta-analysis using RevMan5.0 software. Results: Eight trials assessing 1,619 participants were finally included. Meta-analysis showed that there were no significant differences between the compared arms in post-operation recurrence rate (RR=1.24, 95%CI 0.36-4.26, P = 0.74), total complication (RR=1.18, 95% CI 0.84-1.65, P = 0.34), time to return to normal activity(MD=0.14, 95% CI -0.16-0.44, P = 0.37). The mesh staple group needed more operative time(MD= 4.52, 95% CI 1.46-7.59, P = 0.004), cost more, and there was no definite conclusion on the post-operative pain in the two groups. Conclusion: There is no noticeable difference in the clinical effectiveness between the stapled and unstapled mesh in laparoscopic inguinal hernia repair; the stapled mesh costs more, needs more time; and the post-operative pain still needs to be studied by more well-designed and large sample randomized controlled trials.