Systematic review and network meta‐analysis of methods of mesh fixation during laparoscopic ventral hernia repair. BJS 2018; 105: 37-47.
Published: 11th December 2017
Authors: J. J. Baker, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg
Ventral hernia repairs are common and have high recurrence rates. They are usually repaired laparoscopically with an intraperitoneal mesh, which can be fixed in various ways. The aim was to evaluate the recurrence rates for the different fixation techniques.
This systematic review included studies with human adults with a ventral hernia repaired with an intraperitoneal onlay mesh. The outcome was recurrence at least 6 months after operation. Cohort studies with 50 or more participants and all RCTs were included. PubMed, Embase and the Cochrane Library were searched on 22 September 2016. RCTs were assessed with the Cochrane risk‐of‐bias assessment tool and cohort studies with the Newcastle–Ottawa scale. Studies comparing fixation techniques were included in a network meta‐analysis, which allowed comparison of more than two fixation techniques.
Fifty‐one studies with a total of 6553 participants were included. The overall crude recurrence rates with the various fixation techniques were: absorbable tacks, 17·5 per cent (2 treatment groups); absorbable tacks with sutures, 0·7 per cent (3); permanent tacks, 7·7 per cent (20); permanent tacks with sutures, 6·0 per cent (25); and sutures, 1·5 per cent (6). Six studies were included in a network meta‐analysis, which favoured fixation with sutures. Although statistical significance was not achieved, there was a 93 per cent chance of sutures being better than one of the other methods.
Both crude recurrence rates and the network meta‐analysis favoured fixation with sutures during laparoscopic ventral hernia repair.Read more
You may also be interested in
Authors: J. MacFie
Authors: S. Paterson‐Brown
Normothermic machine perfusion for the assessment and transplantation of declined human kidneys from donation after circulatory death donors.
Authors: S. A. Hosgood, E. Thompson, T. Moore, C. H. Wilson, M. L. Nicholson
Notes: Increases available kidneys
Authors: S. Carpinteri, S. Sampurno, J. Malaterre, R. Millen, M. Dean, J. Kong et al.
Notes: Reduced tissue injury
Growth rates of pulmonary metastases after liver transplantation for unresectable colorectal liver metastases.
Authors: H. Grut, S. Solberg, T. Seierstad, M. E. Revheim, T. S. Egge, S. G. Larsen et al.
Notes: Immunosuppression may not accelerate growth
Authors: J. Mayol, J. Dziakova
Patient‐reported rates of chronic pain and recurrence after groin hernia repair. BJS 2018; 105: 106-112.
Authors: K.‐J. Lundström, H. Holmberg, A. Montgomery, P. Nordin
Notes: Higher chronic pain rate than expected
Population‐based incidence rate of inpatient and outpatient surgical procedures in a high‐income country. BJS 2018; 105: 86-95.
Authors: E. Omling, A. Jarnheimer, J. Rose, J. Björk, J. G. Meara, L. Hagander et al.
Notes: Higher than previously reported
Authors: H. T. Malik, J. Marti, A. Darzi, E. Mossialos
Notes: Considerable savings possible
All‐cause and cardiovascular mortality risk after surgery versus radioiodine treatment for hyperthyroidism.
Authors: P. Giesecke, V. Frykman, G. Wallin, S. Lönn, A. Discacciati, O. Törring et al.
Notes: Surgery preferable for men
Optimal extent of completion lymphadenectomy for patients with melanoma and a positive sentinel node in the groin. BJS 2018; 105: 96-105.
Authors: D. Verver, M. F. Madu, C. M. C. Oude Ophuis, M. Faut, J. H. W. de Wilt, J. J. Bonenkamp et al.
Notes: Inguinal is enough
Authors: V. Wanjura, E. Szabo, J. Österberg, J. Ottosson, L. Enochsson, G. Sandblom et al.
Notes: Avoid unnecessary surgery