Fibrin versus cyanoacrylate glue for fixation in laparoscopic inguinal hernia repair: a network meta-analysis and indire
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REVIEW
Fibrin versus cyanoacrylate glue for fixation in laparoscopic inguinal hernia repair: a network meta‑analysis and indirect comparison Kelli Tavares1 · John Mayo1 · Kenneth Bogenberger1 · S. Scott Davis Jr.2 · Christopher Yheulon1,2 Received: 18 June 2019 / Accepted: 19 October 2019 © Springer-Verlag France SAS, part of Springer Nature 2019
Abstract Introduction Evidence has demonstrated that biosynthetic glue for laparoscopic inguinal hernia repair results in decreased pain. However, the two glue sub-types (biologic—fibrin based; synthetic—cyanoacrylate based) have never been compared. This study aims to assess the outcomes of those subtypes. Method and procedures A systematic review of the MEDLINE database was undertaken. Randomized trials assessing the outcomes of laparoscopic inguinal hernia repair with penetrating and glue fixation methods were considered for inclusion and data analysis. Thirteen trials involving 1947 laparoscopic inguinal hernia repairs were identified with eight trials utilizing fibrin and five trials utilizing cyanoacrylate. Results There were no differences in recurrence or wound infection between the glue subtypes when compared individually to penetrating fixation alone or indirectly to each other. There were non-significant trends in reduction of hematoma and seroma for both glue subtypes when compared to penetrating fixation (OR 0.73, 95% CI 0.39–1.40). There was a significant reduction in urinary retention with glue fixation (pooled results of both sub-types) when compared to penetrating fixation (OR 0.33, 95% CI 0.13–0.83). Conclusions Glue fixation in laparoscopic inguinal hernia repair reduces the incidence of urinary retention and may reduce the rate of hematoma or seroma formation. As there are no differences in outcomes when comparing fibrin or cyanoacrylate glue, surgeons should choose the glue that is available at the lowest cost at their respective institutions. Keywords Fibrin glue · Cyanoacrylate glue · Laparoscopic inguinal hernia repair · Fixation
Introduction Inguinal hernia is a common surgical pathology with over 800,000 inguinal hernia repairs performed in the United States annually [1]. Chronic groin pain is the most significant complication following any type of inguinal hernia repair, affecting up to 5–10% of patients and can negatively impact a patient’s quality of life [2]. Laparoscopic inguinal Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10029-019-02072-x) contains supplementary material, which is available to authorized users. * Kelli Tavares [email protected] 1
Department of Surgery, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA
Department of Surgery, Emory University School of Medicine, Atlanta, USA
2
hernia repair (LIHR) is becoming increasingly popular, especially given its shorter recovery and decreased chronic pain when compared to the open approach [3, 4]. However, recent studies have implicated fixation techniques as contributing facto
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