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Hernia
Erschienen in: Hernia 5/2012

01.10.2012 | Review

Lightweight versus heavyweight in inguinal hernia repair: a meta-analysis

verfasst von: J. Li, Z. Ji, T. Cheng

Erschienen in: Hernia | Ausgabe 5/2012

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Abstract

Purpose

The aim of this article is to compare the outcomes of lightweight mesh and heavyweight mesh in inguinal hernia repair.

Method

A comprehensive literature search was undertaken to identify studies comparing the influence of lightweight and heavyweight meshes on inguinal hernia.

Results

The present meta-analysis pooled the effects of outcomes of a total 5,389 patients enrolled into 16 randomized controlled trials and 5 comparative studies. Lightweight mesh repair was associated with a significant less incidence of chronic postoperative pain [OR = 0.72, 95 % CI (0.57, 0.91)] and less feeling of foreign body than heavyweight mesh repair [OR = 0.50, 95 % CI (0.37, 0.67)]. Recurrence at 12 months was marginally increased in lightweight group (p = 0.05) [RD = 0.01, 95 % CI (0.00, 0.02)]. However, statistically there was no difference in the incidence of seroma [OR = 0.80, 95 % CI (0.52, 1.23)], infection [RD = −0.00, 95 % CI (−0.01, 0.00)], and testicular atrophy [RD = 0.01, 95 % CI (−0.01, 0.02)].

Conclusion

There was no difference regarding the incidence of seroma, infection, and testicular atrophy between lightweight mesh versus heavyweight mesh for inguinal hernia. There is a concern on the recurrence when lightweight mesh is used in large inguinal hernias. However, lightweight mesh repair do have advantages in terms of chronic postoperative pain and feeling of foreign body, and further well-structured trials with improved standardization of hernia types, operative techniques are necessary.
Literatur
1.
Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P, Juul P, Callesen T (2001) Quality assessment of 26,304 herniorrhaphies in Denmark; a prospective nationwide study. Lancet 358:1124–1128PubMedCrossRef
2.
Van Veen RN, Wijsmuller AR, Vrijland WW, Hop WC, Lange JF, Jeekel J (2007) Long-term follow-up of a randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia. Br J Surg 94:506–510PubMedCrossRef
3.
Klinge U, Klosterhalfen B, Muller M, Schumpelick V (1999) Foreign body reaction to meshes used for the repair of abdominal wall hernias. Eur J Surg 165:665–673PubMedCrossRef
4.
Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233:1–7PubMedCrossRef
5.
Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewoud H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg 194:394–400PubMedCrossRef
6.
Rutkow IM, Robbins AW (1993) Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States. Surg Clin North Am 73:413–426PubMed
7.
Greca FH, de Paula JB, Biondo-Simoes ML, da Costa FD, da Silva AP, Time S, Mansur A (2001) The influence of differing pore sizes on the biocompatibility of two polypropylene meshes in the repair of abdominal defects. Experimental study in dogs. Hernia 5:59–64PubMedCrossRef
8.
Klosterhallfen B, Klinge U, Hermanns B, Schumpelick V (2000) Pathology of traditional surgical nets for hernia repair after long-term implantation in humans. Chirurg 71:43–51
9.
Weyhe D, Belyaev O, Muller C, Meurer K, Bauer KH, Papapostolou G, Uhl W (2007) Improving outcomes in hernia repair by the use of light meshes: a comparison of different implant constructions based on a critical appraisal of the literature. World J Surg 31:234–244PubMedCrossRef
10.
O’Dwyer PJ, Kingsnorth AN, Molloy RG, Small PK, Lammers B, Horeyseck G (2005) Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. Br J Surg 92:166–170PubMedCrossRef
11.
Koch A, Bringman S, Myrelid P, Smeds S, Kald A (2008) Randomized clinical trial of groin hernia repair with titanium-coated lightweight mesh compared with standard polypropylene mesh. Br J Surg 95:1226–1231PubMedCrossRef
12.
Bowne WB, Morgenthal CB, Castro AE, Shah P, Ferzli GS (2005) The role of endoscopic extraperitoneal herniorrhaphy: where do we stand in? Surg Endosc 2007 21:707–712CrossRef
13.
Higgins JPT, Green S (eds) (2008) Cochrane handbook for systematic reviews of interventions version 5.0.1. The Cochrane Collaboration, Chichester. Available at: http://​www.​cochrane-handbook.​org. Updated September, 2008
14.
Egger M, Smith GD, Altman DG (2001) Systematic reviews in health care: meta-analysis in context, 2nd edn. BMJ Books, LondonCrossRef
15.
Agarwal BB, Agarwal KA, Mahajan KC (2009) Prospective double-blind randomized controlled study comparing heavy- and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early results. Surg Endosc 23:242–247PubMedCrossRef
16.
Akolekar D, Kumar S, Khan LR, de Beaux AC, Nixon SJ (2008) Comparison of recurrence with lightweight composite polypropylene mesh and heavyweight mesh in laparoscopic totally extraperitoneal inguinal hernia repair: an audit of 1,232 repairs. Hernia 12:39–43PubMedCrossRef
17.
Bringman S, Heikkinen TJ, Wollert S, Österberg J, Smedberg S, Granlund H, Ramel S, Felländer G, Anderberg B (2004) Early results of a single-blinded, randomized, controlled, Internet-based multicenter trial comparing Prolene and Vypro II mesh in Lichtenstein hernioplasty. Hernia 8:127–134PubMedCrossRef
18.
Bringman S, Wollert S, Österberg J, Smedberg S, Granlund H, Felländer G, Heikkinen T (2005) One year results of a randomised controlled multi-centre study comparing Prolene and Vypro II-mesh in Lichtenstein hernioplasty. Hernia 9:223–227PubMedCrossRef
19.
Bringman S, Wollert S, Österberg J, Smedberg S, Granlund H, Heikkinen TJ (2006) Three-year results of a randomized clinical trial of lightweight or standard polypropylene mesh in Lichtenstein repair of primary inguinal hernia. Br J Surg 93:1056–1059PubMedCrossRef
20.
Chowbey PK, Garg N, Sharma A, Khullar R, Soni V, Baijal M, Mittal T (2010) Prospective randomized clinical trial comparing lightweight mesh and heavyweight polypropylene mesh in endoscopic totally extraperitoneal groin hernia repair. Surg Endosc 24:3073–3079PubMedCrossRef
21.
Chui LB, Ng WT, Sze YS, Yuen KS, Wong YT, Kong CK (2010) Prospective, randomized, controlled trial comparing lightweight versus heavyweight mesh in chronic pain incidence after TEP repair of bilateral inguinal hernia. Surg Endosc 24:2735–2738PubMedCrossRef
22.
Heikkinen T, Wollert S, Österberg J, Smedberg S, Bringman S (2006) Early results of a randomized trial comparing Prolene and Vypro II-mesh in endoscopic extraperitoneal inguinal hernia repair (TEP) of recurrent unilateral hernias. Hernia 10:34–40PubMedCrossRef
23.
Horstmann R, Hellwig M, Classen C, Röttgermann S, Palmes D (2006) Impact of polypropylene amount on functional outcome and quality of life after inguinal hernia repair by the TAPP procedure using pure, mixed, and titanium-coated meshes. World J Surg 30:1742–1749PubMedCrossRef
24.
Khan LR, Kumar S, Nixon SJ (2006) Early results for new lightweight mesh in laparoscopic totally extra-peritoneal inguinal hernia repair. Hernia 10:303–308PubMedCrossRef
25.
Khan LR, Liong S, de Beaux AC, Kumar S, Nixon SJ (2010) Lightweight mesh improves functional outcome in laparoscopic totally extra-peritoneal inguinal hernia repair. Hernia 14:39–45PubMedCrossRef
26.
Langenbach MR, Schmidt J, Zirngibl H (2006) Comparison of biomaterials: three meshes and TAPP for inguinal hernia. Surg Endosc 20:1511–1517PubMedCrossRef
27.
Langenbach MR, Schmidt J, Ubrig B, Zirngibl H (2008) Sixty-month follow-up after endoscopic inguinal hernia repair with three types of mesh: a prospective randomized trial. Surg Endosc 22:1790–1797PubMedCrossRef
28.
Lauscher JC, Yafaei K, Buhr HJ, Ritz JP (2008) Total extraperitoneal hernioplasty: does the long-term clinical course depend on the type of mesh? J Laparoendosc Adv Surg Tech 18:803–808CrossRef
29.
Nikkolo C, Lepner U, Murruste M, Vaasna T, Seepter H, Tikk T (2010) Randomised clinical trial comparing lightweight mesh with heavyweight mesh for inguinal hernioplasty. Hernia 14:253–258PubMedCrossRef
30.
Paajanen H (2007) A single-surgeon randomized trial comparing three composite meshes on chronic pain after Lichtenstein hernia repair in local anesthesia. Hernia 11:335–339PubMedCrossRef
31.
Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48PubMedCrossRef
32.
Smietanski M, for the Polish Hernia Study Group (2008) Randomized clinical trial comparing a polypropylene with a poliglecaprone and polypropylene composite mesh for inguinal hernioplasty. Br J Surg 95:1462–1468PubMedCrossRef
33.
Bringman S, Wollert S, Österberg J, Heikkinen T (2005) Early results of a randomized multicenter trial comparing Prolene and Vypro II mesh in bilateral endoscopic extraperitoneal hernioplasty (TEP). Surg Endosc 19:536–540PubMedCrossRef
34.
Bay-Nielsen M, Nordin P, Nilsson E, Kehlet H (2001) Operative findings in recurrent hernia after a Lichtenstein procedure. Am J Surg 182:134–136PubMedCrossRef
35.
Mokete M, Earnshaw JJ (2001) Evolution of an inguinal hernia surgery practice. Postgrad Med J77:188–190
36.
EU Hernia Trialists Collaboration (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:854–859CrossRef
37.
Fitzgibbons RJ Jr (2005) Can we be sure polypropylene mesh causes infertility? Ann Surg 241:559–561PubMedCrossRef
38.
Harrell AG, Novitsky YW, Cristiano JA, Gersin KS, Norton HJ, Kercher KW, Heniford BT (2007) Prospective histologic evaluation of intra-abdominal prosthetics four months after implantation in a rabbit model. Surg Endosc 21:1170–1174PubMedCrossRef
39.
Klinge U, Conze J, Limberg W, Brucker C, Ottinger AP, Schumpelick V (1996) Pathophysiology of the abdominal wall. Chirurg 67:229–233PubMed
40.
Gao M, Han J, Tian J, Yang K (2010) Vypor II mesh for inguinal hernia repair, a meta analysis of Randomized controlled trials. Ann Surg 251:838–842PubMedCrossRef
41.
Markar SR, Karthikesalingam A, Alam F, Tang TY, Walsh SR, Sadat U (2010) Partially or completely absorbable versus nonabsorbable mesh repair for inguinal hernia: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech 20(4):213–219PubMedCrossRef
42.
Schmedt CG, Sauerland S, Bittner R (2005) Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair. Surg Endosc 19:188–199PubMedCrossRef
43.
Scheidbach H, Tamme C, Tannapfel A, Lippert H, Kockerling F (2004) In vivo studies comparing the biocompatibility of various polypropylene meshes and their handling properties during endoscopic total extraperitoneal (TEP) patchplasty. Surg Endosc 18:211–220PubMedCrossRef
44.
Poobalan AS, Bruce J, Cairns W, Smith S, King PM, Krukowski ZH, Chambers WA (2003) A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 19:48–54PubMedCrossRef
45.
Johner A, Faulds J, Wiseman SM (2011) Planned ilioinguinal nerve excision for prevention of chronic pain after inguinal hernia repair: A meta-analysis. Surgery (Epub ahead of print)
46.
Rosch R, Junge K, Quester R, Klinge U, Klosterhalfen B, Schumpelick V (2003) VyproII mesh in hernia repair: impact of polyglactin on long-term incorporation in rats. Eur Surg Res 35:445–450PubMedCrossRef
Metadaten
Titel
Lightweight versus heavyweight in inguinal hernia repair: a meta-analysis
verfasst von
J. Li
Z. Ji
T. Cheng
Publikationsdatum
01.10.2012
Verlag
Springer-Verlag
Erschienen in
Hernia / Ausgabe 5/2012
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-012-0928-z

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