Open and minimally invasive inguinal hernia repair for patients with previous prostatectomy: a systematic review and proportional meta-analysis
- 01.12.2025
- Review
Erschienen in:
- Verfasst von
- João Pedro Gonçalves Kasakewitch
- Carlos A Balthazar da Silveira
- Marina Eguchi Inaba
- Raquel Nogueira
- Ana Caroline Dias Rasador
- Diego L Lima
- Flavio Malcher
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Background
Minimally invasive surgery (MIS) for patients undergoing inguinal hernia repair (IHR) after prostatectomy has been considered a challenging procedure due to the presence of scar tissue and adhesions. We aimed to compare the outcomes of open and MIS IHR outcomes in post-prostatectomy patients through a systematic review and proportional meta-analysis.
Material & methods
PubMed/MEDLINE, Embase, Cochrane, and Web of Science were searched for studies on open and MIS IHR after prostatectomy. Outcomes such as recurrence, complications, seroma, hematoma, SSI, and conversion rates were analyzed, with subgroup analyses conducted for open, TEP, and TAPP procedures.
Results
Among 402 screened studies, 18 met the inclusion criteria, covering 8,668 open IHR (64.6%) and 4,761 MIS IHR (35.4%) patients. The rate per 100 events for intraoperative complications was 0.19 (95% CI [0.00; 0.76]; I2 = 71%;), 5.22 per 100 for seroma (95% CI [2.86; 9.34]; I2 = 92%), 0.83 per 100 for SSI (95% CI [0.39; 1.75]; I2 = 48%), 3.16 per 100 for hematoma (95% CI [1.16; 8.31]; I2 = 84%), 3.02 per 100 patients for chronic pain (95% CI [2.53; 3.62]; I2 = 13%), and 0.02 per 100 for recurrence (95% CI [0; 0.16]; I2 = 10%). The conversion rate for MIS was 1.66 per 100 (95% CI [0.89; 3.06]; I2 = 0%). Subgroup analysis revealed no significant difference between TEP and TAPP in intraoperative complications (p = 0.70), but a lower seroma rate in TAPP compared to TEP (5.29 vs. 20 per 100; P = 0.01). MIS had significant reduction in SSI (0.08 vs. 0.34 per 100; P < 0.01), hematoma (1.29 vs. 17.86; p < 0.01), and recurrence (0.08 vs. 0.37; p = 0.04) compared to open, with no difference in seroma rates. Funnel plots revealed no evidence of publication bias.
Conclusions
In experienced hands, MIS IHR is a safe and effective option for post-prostatectomy patients, with lower complication rates compared to open IHR, although high-quality comparative studies are needed to establish definitive conclusions.
PROSPERO registration
July 7, 2024 (ID CRD42024562863).
Anzeige
- Titel
- Open and minimally invasive inguinal hernia repair for patients with previous prostatectomy: a systematic review and proportional meta-analysis
- Verfasst von
-
João Pedro Gonçalves Kasakewitch
Carlos A Balthazar da Silveira
Marina Eguchi Inaba
Raquel Nogueira
Ana Caroline Dias Rasador
Diego L Lima
Flavio Malcher
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03323-w
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
