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.Full text
You may also be interested in
Authors: S. Di Saverio, E. Segalini, A. Birindelli, S. Todero, M. Podda, A. Rizzuto et al.
Notes: Useful option
Systematic review of the prevalence, impact and mitigating strategies for bullying, undermining behaviour and harassment in the surgical workplace.
Authors: U. A. Halim, D. M. Riding
Notes: Common and damaging
Authors: A. Endo, A. Shiraishi, K. Fushimi, K. Murata, Y. Otomo
Notes: Mortality similar among low, medium and high ratios
Authors: N. Patani, F. MacAskill, S. Eshelby, A. Omar, A. Kaura, K. Contractor et al.
Notes: Outcomes improve
Meta‐analysis of in‐hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. BJS 2018; 105: 933-945.
Authors: S. T. van Dijk, A. H. van Dijk, M. G. Dijkgraaf, M. A. Boermeester
Notes: Delay is safe
Authors: T. G. Weiser, A. B. Haynes
Meta‐analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer. BJS 2018; 105: 946-958.
Authors: E. Versteijne, J. A. Vogel, M. G. Besselink, O. R. C. Busch, J. W. Wilmink, J. G. Daams et al.
Notes: Improved survival with neoadjuvant treatment
Authors: F. P. Prete, T. Abdel‐Aziz, C. Morkane, C. Brain, T. R. Kurzawinski, P. Hindmarsh et al.
Notes: Centralization needed
Authors: M. Mansourati, V. Kumar, M. Khajanchi, M. L. Saha, S. Dharap, R. Seger et al.
Notes: High burden of late mortality
Meta‐analysis evaluating music interventions for anxiety and pain in surgery. BJS 2018; 105: 773-783.
Authors: A. Y. R. Kühlmann, A. de Rooij, L. F. Kroese, M. van Dijk, M. G. M. Hunink, J. Jeekel et al.