Non-mesh Desarda Technique Versus Standard Mesh-Based Lichtenstein Technique for Inguinal Hernia Repair: A Systematic Re
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SCIENTIFIC REVIEW
Non-mesh Desarda Technique Versus Standard Mesh-Based Lichtenstein Technique for Inguinal Hernia Repair: A Systematic Review and Meta-analysis Ali Yasen Y. Mohamedahmed1 Abdul Karim Sillah1
•
Hasham Ahmad1 • Areeg A. N. Abdelmabod2
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Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background The aims of the present systematic review and meta-analysis were to compare non-mesh Desarda technique with standard mesh-based Lichtenstein technique for inguinal hernia repair. Methods A systematic literature search for RCTs comparing between DT and LT was conducted using electronic databases and Google scholar service. Studies were evaluated for recurrence and post-operative complications. We pooled the data using fixed effects model and random effects model after assessing the heterogeneity among the included studies. Results A total number of 8 RCTs studies were included in this meta-analysis with total number of 3177 patients divided between Desarda group and Lichtenstein group as follows: 1551 patients and 1,626 patients, respectively. There was no difference in terms of recurrence between the Desarda repair and Lichtenstein repair groups [P = 0.44]. There was a lower rate of overall post-operative complications [P = 0.003], seroma [P = 0.0004] and surgical site infections (SSIs) [P = 0.04] in the Desarda group. Conclusion DT and LT were found to have comparable results in terms of recurrence rate, haematoma formation, testicular atrophy and time to return to normal daily activity/work. DT is superior to LT in terms of reducing postoperative mesh-attributed complications, such as SSI and Seroma formation.
Introduction Inguinal hernias are one of the most common surgical presentations worldwide, with an estimated lifetime risk of occurrence of 27 and 3% for men and women, respectively [1]. Bassini reported the first technique for inguinal hernias repair in 1887, and since then, several methods and operations have been developed [2]. Further techniques ranged from tissue repairs such as modified Bassini, Shouldice, & Ali Yasen Y. Mohamedahmed [email protected] 1
Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
2
Department of General Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
Nylon–Darn, Halsted–Tanner and McVay to the free of tension repair with mesh. Over the past 20 years, hernia repair has become increasingly complex not only due to the establishment of laparoscopic surgery but also development of traditional open techniques [2]. Lichtenstein mesh repair [LT] has been recognised as a standard and safe operation for surgical repair of inguinal hernias. However, its limitation with the use of Mesh working as a mechanical barrier reduces the physiological mobility of the posterior wall [3]. Recent studies have highlighted the complications that the synthetic prostheses have, such as foreign body sensation, local reactions (meshoma or plugoma tumours) as well as discomfort and abdominal wall stiffness. These consequently affect the
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