Introduction
Materials and methods
Eligibility criteria
Search strategy
Data collection
Risk of bias
Statistical analysis
Results
Quality assessment—Table 1
Mesh | Study | MINORS criteria | Additional criteria for comparative studies | Total | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4.M | 4.R | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | M (% of total) | R (% of total) | ||
Biologic | Brunner [20] | 2 | 2 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | NA | NA | NA | NA | 7 (44%) | 7 (44%) |
Albayati [36] | 2 | 2 | 1 | NA | 1 | 0 | 2 | 1 | 0 | NA | NA | NA | NA | NA | 9 (56%) | |
Franceschilli [43] | 2 | 2 | 2 | ▲ | 2 | 1 | 2 | 2 | 0 | NA | NA | NA | NA | NA | 13 (81%) | |
Mehmood [42] | 2 | 2 | 2 | NA | 2 | 0 | 2 | 2 | 0 | NA | NA | NA | NA | NA | 12 (75%) | |
Wahed [37] | 1 | 2 | 2 | ▲ | 1 | 0 | 1 | 2 | 0 | NA | NA | NA | NA | NA | 9 (56%) | |
Synthetic | Farag [38] | 2 | 2 | 2 | NA | 2 | 1 | 1 | 0 | 0 | NA | NA | NA | NA | NA | 10 (63%) |
Laitakari [44] | 2 | 2 | 2 | NA | 1 | 2 | 2 | 1 | 0 | NA | NA | NA | NA | NA | 12 (75%) | |
Postillon [16] | 1 | 2 | 1 | 0 | 2 | 0 | 1 | 0 | 0 | NA | NA | NA | NA | 5 (31%) | 7 (44%) | |
Tsunoda [21] | 2 | 2 | 1 | 0 | 2 | 0 | 1 | 1 | 0 | NA | NA | NA | NA | 7 (44%) | 9 (56%) | |
Hidaka [3] | 2 | 2 | 2 | 1 | 2 | 0 | 2 | 1 | 1 | NA | NA | NA | NA | 11 (69%) | 12 (75%) | |
Tejedor [25] | 2 | 2 | 1 | 1 | NA | 0 | 1 | 0 | 1 | NA | NA | NA | NA | 8 (50%) | NA | |
Ahmad [22] | 2 | 1 | 2 | 0 | 0 | 0 | 2 | 0 | 0 | NA | NA | NA | NA | 7 (44%) | 7 (44%) | |
Chandra [31] | 1 | 1 | 1 | NA | 1 | 0 | 2 | 1 | 0 | NA | NA | NA | NA | NA | 7 (44%) | |
Mäkelä-Kaik. [23] | 2 | 2 | 1 | 1 | NA | 0 | 1 | 1 | 0 | NA | NA | NA | NA | 8 (50%) | NA | |
Emile [45] | 2 | 2 | 2 | NA | 2 | 0 | 2 | 2 | 2 | NA | NA | NA | NA | NA | 14 (88%) | |
van Iersel [24] | 2 | 2 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | NA | NA | NA | NA | 8 (50%) | 8 (50%) | |
Inaba [17] | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 0 | NA | NA | NA | NA | 4 (25%) | 4 (25%) | |
Luglio [34] | 2 | 1 | 1 | NA | 2 | 0 | 2 | 0 | 0 | NA | NA | NA | NA | NA | 8 (50%) | |
Silveira [32] | 1 | 1 | 2 | NA | 1 | 0 | 2 | 0 | 0 | NA | NA | NA | NA | NA | 7 (44%) | |
Horisberger [33] | 2 | 1 | 0 | NA | 0 | 0 | 1 | 2 | 0 | NA | NA | NA | NA | NA | 6 (38%) | |
Consten [10] | 2 | 2 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | NA | NA | NA | NA | 8 (50%) | 8 (50%) | |
Gosselink [39] | 2 | 2 | 1 | NA | 2 | 0 | 2 | 1 | 0 | NA | NA | NA | NA | NA | 10 (63%) | |
Owais [28] | 1 | 1 | 2 | ▲ | 0 | 0 | 2 | 1 | 0 | NA | NA | NA | NA | NA | 7 (44%) | |
Badrek-Am. [29] | 2 | 1 | 2 | ▲ | 0 | 0 | 1 | 1 | 0 | NA | NA | NA | NA | NA | 7 (44%) | |
Maggiori [40] | 2 | 2 | 2 | NA | 1 | 0 | 2 | 1 | 0 | NA | NA | NA | NA | NA | 10 (63%) | |
Tranchart [18] | 1 | 2 | 0 | 1 | NA | 0 | 0 | 0 | 0 | NA | NA | NA | NA | 4 (25%) | NA | |
Faucheron [26] | 1 | 2 | 2 | 2 | 2 | 0 | 2 | 2 | 0 | NA | NA | NA | NA | 11 (69%) | 11 (69%) | |
Wijffels [30] | 2 | 1 | 2 | ▲ | 1 | 0 | 1 | 1 | 0 | NA | NA | NA | NA | NA | 8 (50%) | |
Boons [35] | 2 | 2 | 2 | ▲ | 2 | 0 | 1 | 1 | 0 | NA | NA | NA | NA | NA | 10 (63%) | |
Collinson [41] | 2 | 2 | 2 | ▲ | 1 | 0 | 1 | 2 | 0 | NA | NA | NA | NA | NA | 10 (63%) | |
D'Hoore [1] | 2 | 2 | 2 | NA | 1 | 0 | 2 | 1 | 0 | NA | NA | NA | NA | NA | 10 (63%) | |
Mix | Gleditsch [19] | 2 | 1 | 1 | 0 | 2 | 0 | 1 | 0 | 0 | NA | NA | NA | NA | 5 (31%) | 7 (44%) |
Fu [27] | 2 | 2 | 1 | 2 | 2 | 0 | 2 | 2 | 0 | 1 | 1 | 0 | 1 | 14 (58%) | 14 (58%) | |
Evans [12] | 2 | 2 | 1 | 2 | NA | 0 | 1 | 0 | 0 | 1 | 1 | 0 | 2 | 12 (50%) | NA |
Study characteristics—Table 2
Mesh | Study | Design |
N
a
| Female | Age (years)b | ERP | Hx RP surgery | Mesh type | FU (mo)b | Mesh compl | Recurrence |
---|---|---|---|---|---|---|---|---|---|---|---|
Biologic | Brunner [20] | R | 123 | 95% | 63 (23–92) | 14% | 20% | PM (84%); BD (16%) | 29 (6–58) | 0% | 3.3% |
Albayati [36] | R | 51 | 100% | 57 ± 3 | 18% | 8% | BD (100) | 23 ± 1 | NR | 5.9% | |
Franceschilli [43] | P | 100 | 100% | 63 ± 13 | 0% | 5% | PM | 20 (6–54) | ▲ | 14.0% | |
Mehmood [42] | RCT | 51 | 94% | 59 (25–89) | 100% | 35% | BD | 12 | NR | 0% | |
Wahed [37] | P | 65 | 95% | 62 (31–89) | 42% | 26% | PM | 12 (1–29) | ▲ | 4.6% | |
Synthetic | Farag [38] | P | 60 | 100% | 48 ± 9 | 100% | 0% | PP | 12 | NR | 3.3% |
Laitakari [44] | RCT | 26 | 100% | 63 ± 11 | 20% | 0% | PE | 60 | NR | 15.4% | |
Postillon [16] | R | 76 | 90% | 62 (16–90) | 100% | 13% | PP | 31 (2–92) | ▽ | 13.2% | |
Tsunoda [21] | R | 50 | 90% | 80 (40–94) | 100% | 19% | PP | 49 (6–92) | 0% | 10.0% | |
Hidaka [3] | RCT | 38 | 92% | 57 (IQR 42–73) | 100% | 0% | PP | 73 (IQR 65–82) | 0% | 7.9% | |
Tejedor [25] | R | 199c | 92% | 66 (IQR 27) | NS | NR | PP | 5 (IQR 10) | 0% | NR | |
Ahmad [22] | P | 58 | 100% | 63 ± 15 | 36% | 14% | PVDF-PP | 35 ± 14 | 0% | 5.2% | |
Chandra [31] | R | 25 | 40% | 38 (14–68) | 100% | NR | PP | 34 (6–82) | NR | 4.0% | |
Mäkelä-Kaik. [23] | R | 508 | 95% | 64 ± 16 | 56% | 7% | PE (84%); PP (10%); otherd (3%) | 44 (1–105) | 1.4% | NR | |
Emile [45] | RCT | 25 | 68% | 37 ± 7 | 100% | 0% | PP | 18 ± 5 | NR | 8.0% | |
van Iersel [24] | R | 258 | 96% | 60 ± 14 | 19% | 4% | PP | 24 ± 22 | 0% | 4.7% | |
Luglio [34] | R | 20 | 100% | Median 68 | 100% | NR | PP | 12 | NR | 2.4% | |
Silveira [32] | R | 71 | 100% | 58 ± 13 | 34% | 28% | PE | 18 | NR | 16.9% | |
Horisberger [33] | NR | 27 | 100% | 60 (24–78) | 0% | NR | PP | 22 (2–39) | NR | 3.7% | |
Consten [10] | R | 919 | 95% | 55.8 | 26% | NR | PP | 34 (0.4–144) | 0.9% | 7.4% | |
Gosselink [39] | R | 91 | 95% | 61 (18–91) | 45% | 0% | PP | 12 | NR | 4.4% | |
Owais [28] | P | 68 | 0% | 35 (IQR 18–51) | 26% | 26% | PPe (46%); PE (32%); PP (21%), other (1%) | 42 (IQR 26–61) | ▲ | 2.9% | |
Badrek-Am. [29] | P | 48 | 79% | 43 (18–80) | 23% | 19% | PP | 33 (1–186) | ▲ | 12.5% | |
Maggiori [40] | P | 33 | 88% | 64 ± 14 | 61% | NR | PP | 42 ± 7 | NR | 6,1% | |
Faucheron [26] | P | 175 | 90% | 58 (16–94) | 100% | NR | PE | 74 (24–181) | 0.6% | 1.1% | |
Wijffels [30] | P | 80 | 98% | 84 (80–97) | 100% | 41% | PP | 23 (2–82) | ▲ | 2.5% | |
Boons [35] | P | 65 | 92% | 72 (16–93) | 100% | NR | PP | 19 (3–41) | ▲ | 1.5% | |
Collinson [41] | P | 75 | 92% | 58 (25–88) | 0% | NR | PP | 12 (3–48) | ▲ | 5.3% | |
D'Hoore [1] | P | 42 | 90% | 50 (22–88) | 100% | 12% | PP | 61 (29–98) | NR | 4.8% | |
Mix | Gleditsch [19] | R | 22 | NR | NR | 100% | 0% | S: PPe (41%); B: PM (59%) | Median 29 | ▽ | S: 11.1% B: 15.4% |
Fu [27] | R | 231 | 100% | 64 (IQR 51–73) | 49% | 17% | S: PP (15%); B: PM (< 1%); BD (86%) | 47 (IQR 29–63) | 0% | S: 18.8% B: 6.0% | |
Evans [12] | R | 2203 | 93% | 56 (15–82) | 28% | NS | S: PP (60%); PPd (7%); PE (13%); B: PM (14%); BD (6%) | 36 (0–162) | S: 2.4% B: 0.7% | NR |
Mesh-related complications—Table 3
Mesh | Study | Design |
N
| Mesh type | Material for fixation to rectum | Mesh-related complications | Time to event (months)b | FU (months)b |
---|---|---|---|---|---|---|---|---|
Biologic | Brunner [20] | R | 123 | PM (n = 103) BD (n = 20) | Ethibond | 0% | – | 29 (6–58) |
Fu [27]a | R | 199 | PM (n = 1) BD (n = 198) | PDS | 0% | – | 47 (IQR 29–63) | |
Evans [12]a | R | 439 | PM (n = 309) BD (n = 130) | NR | PM: 1.0% BD: 0% | 23 (2–78) | 36 (0–162) | |
Tsunoda [21] | R | 50 | PP | Endofascial stapler | 0% | – | 49 (6–92) | |
Hidaka [3] | RCT | 38 | PP | Ethibond | 0% | – | 73 (IQR 65–82) | |
Tejedor [25] | R | 199 | PP | PDS | 0% | – | 5 (IQR 10) | |
Ahmad [22] | P | 58 | PVDF-PP | Ethibond | 0% | – | 35 ± 14 | |
Mäkelä-Kaik. [23] | R | 508 | PE (n = 426) PP (n = 52) Otherc (n = 17) | Ethibond | 1.4% | 9 (2–29) | 44 (1–105) | |
van Iersel [24] | R | 258 | PP | Ethibond | 0% | – | 24 ± 22 | |
Fu [27]a | R | 32 | PP | PDS | 0% | – | 47 (IQR 29–63) | |
Consten [10] | R | 919 | PP | Ethibond | 0.9% | 9 (2–48) | 34 (0.4–144) | |
Evans [12]a | R | 1764 | PP (n = 1325) PPd (n = 160) PE (n = 279) | NR | PP: 1.7% PPd: 0.6% PE: 6.5% | 23 (2–78) | 36 (0–162) | |
Faucheron [26] | P | 175 | PE | Titanium staples | 0.6% | 9 | 74 (24–181) |
Recurrence—Table 4
Mesh | Study | Design |
N
| Mesh type | ERP (%) | Previous RP surgery | Recurrence rate (%) | Time to event (months)b | FU (months)b |
---|---|---|---|---|---|---|---|---|---|
Biologic grafts | Brunner [20] | R | 123 | PM (n = 103) BD (n = 20) | 14 | 20% | 3.3 | NR | 29 (6–58) |
Gleditsch [19]a | R | 13 | PM | 100 | 0% | 15.4 | 3 | 29 | |
Albayati [36] | R | 51 | BD | 18 | 8% | 5.9 | NR | 23 ± 1 | |
Fu [27]a | R | 199 | BD (n = 198) PM (n = 1) | 49 | 17% | 6.0 | 37 IQR (27–52) | 47 (IQR 29–63) | |
Franceschilli [43] | P | 100 | PM | 0 | 5% | 14.0 | 24–36 | 20 (6–54) | |
Mehmood [42] | RCT | 51 | BD | 100 | 35% | 0 | – | 12 | |
Wahed [37] | P | 65 | PM | 42 | 26% | 4.6 | 14 | 12 (1–29) | |
Synthetic grafts | Farag [38] | P | 60 | PP | 100 | 0% | 3.3 | NR | 12 |
Laitakari [44] | RCT | 26 | PE | 20 | 0% | 15.4 | NR | 60 | |
Postillon [16] | R | 76 | PP | 100 | 13% | 13.2 | NR | 31 (2–92) | |
Tsunoda [21] | R | 50 | PP | 100 | 19% | 10.0 | NR | 49 (6–92) | |
Hidaka [3] | RCT | 38 | PP | 100 | 0% | 7.9 | NR | 73 (IQR 65–82) | |
Ahmad [22] | P | 58 | PVDF-PP | 36 | 14% | 5.2 | NR | 35 ± 14 | |
Chandra [31] | R | 25 | PP | 100 | NR | 4.0 | 48 | 34 (6–82) | |
Gleditsch [19]a | R | 9 | PPd | 100 | 0% | 11.1 | 3 | 29 | |
Emile [45] | RCT | 25 | PP | 100 | 0% | 8.0 | NR | 18 ± 5 | |
Fu [27]a | R | 32 | PP | 49 | 17% | 18.8 | 69 (IQR 62–74) | 47 (IQR 29–63) | |
van Iersel [24] | R | 258 | PP | 19 | 4% | 4.7 | NRc | 24 ± 22 | |
Luglio [34] | R | 20 | PP | 100 | NR | 2.4 | NR | 12 | |
Silveira [32] | R | 71 | PE | 34 | 28% | 16.9 | mean 17 | 18 | |
Horisberger [33] | NR | 27 | PP | 0 | NR | 3.7 | NR | 22 (2–39) | |
Consten [10] | R | 919 | PP | 26 | NR | 7.4 | 24 (1–139) | 34 (0.4–144) | |
Gosselink [39] | R | 91 | PP | 45 | 0% | 4.4 | NR | 12 | |
Owais [28] | P | 68 | PPd (n = 31) PE (n = 22) PP (n = 14) | 26 | 26% | 2.9 | NR | 42 (IQR 26–61) | |
Badrek-Am. [29] | P | 48 | PP | 23 | 19% | 12.5 | NRc | 33 (1–186) | |
Maggiori [40] | P | 33 | PP | 61 | NR | 6.1 | 13 (11–14) | 42 ± 7 | |
Faucheron [26] | P | 175 | PE | 100 | NR | 1.1 | 15 (6–24) | 74 (24–181) | |
Wijffels [30] | P | 80 | PP | 100 | 41% | 2.5 | 11 (6–16) | 23 (2–82) | |
Boons [35] | P | 65 | PP | 100 | NR | 1.5 | 12 | 19 (3–41) | |
Collinson [41] | P | 75 | PP | 0 | NR | 5.3 | NR | 12 (3–48) | |
D'Hoore [1] | P | 42 | PP | 100 | 12% | 4.8 | 73 (54–91) | 61 (29–98) |