Suture Versus Mesh Repair in Primary and Incisional Ventral Hernias: A Systematic Review and Meta‐Analysis
- 12 November 2015
- journal article
- review article
- Published by Wiley in World Journal of Surgery
- Vol. 40 (4), 826-835
- https://doi.org/10.1007/s00268-015-3311-2
Abstract
Today, ventral hernia repair is predominantly performed with meshes. There is no meta-analysis of high quality evidence that compares the results of suture to mesh repair. The objective of this systematic review with meta-analysis is to compare patient centred outcomes of suture versus mesh repair. A systematic literature search was performed in EMBASE, MEDLINE and CENTRAL (inception to 06/2014). Furthermore a hand search was performed. RCTs comparing suture versus mesh repair in primary and incisional ventral hernia repair were included. Data on patient characteristics, interventions and results were extracted in standardized tables. Risk of bias was assessed with the cochrane risk of bias tool. Results of studies were pooled with a meta-analysis. All steps were performed by two reviewers. Discrepancies were discussed until a consensus. The search in the databases resulted in 1560 hits. After screening, 10 randomized controlled trials including 1215 patients satisfied all inclusion criteria. Risk of bias was moderate to high. The relative risk for recurrence was 0.36 [95% CI (0.27, 0.49); I 2 = 0; heterogeneity p = 0.70]. Other complications did not differ significantly. Results for chronic pain were heterogeneous across studies. Mesh repair reduces the number of recurrences significantly. In patients without recurrence mesh repairs seem to be associated with a risk of chronic pain especially if the mesh is fixed sublay.This publication has 24 references indexed in Scilit:
- Testing the Risk of Bias tool showed low reliability between individual reviewers and across consensus assessments of reviewer pairsJournal of Clinical Epidemiology, 2013
- A meta-analysis comparing tacker mesh fixation with suture mesh fixation in laparoscopic incisional and ventral hernia repairHernia, 2012
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trialsBMJ, 2011
- Laparoscopic versus open surgical techniques for ventral or incisional hernia repairCochrane Database of Systematic Reviews, 2011
- Kedvezőbb műtéti eredmények „onlay” hálóval, mint „sublay” helyzetben beültetettelMagyar Sebeszet, 2010
- One-year follow-up after incisional hernia treatment: results of a prospective randomized studyHernia, 2010
- Repair of Giant Midline Abdominal Wall Hernias: “Components Separation Technique” versus Prosthetic RepairWorld Journal of Surgery, 2007
- Comparison of prosthetic mesh repair and tissue repair in the emergency management of incarcerated para-umbilical hernia: a prospective randomized studyHernia, 2007
- Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adultsBritish Journal of Surgery, 2001
- Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral herniaSurgical Endoscopy, 2000