This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Systematic review and network meta‐analysis of methods of mesh fixation during laparoscopic ventral hernia repair. BJS 2018; 105: 37-47.
Published: 11th December 2017
Authors: J. J. Baker, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg
Background
Ventral hernia repairs are common and have high recurrence rates. They are usually repaired laparoscopically with an intraperitoneal mesh, which can be fixed in various ways. The aim was to evaluate the recurrence rates for the different fixation techniques.
Method
This systematic review included studies with human adults with a ventral hernia repaired with an intraperitoneal onlay mesh. The outcome was recurrence at least 6 months after operation. Cohort studies with 50 or more participants and all RCTs were included. PubMed, Embase and the Cochrane Library were searched on 22 September 2016. RCTs were assessed with the Cochrane risk‐of‐bias assessment tool and cohort studies with the Newcastle–Ottawa scale. Studies comparing fixation techniques were included in a network meta‐analysis, which allowed comparison of more than two fixation techniques.
Results
Fifty‐one studies with a total of 6553 participants were included. The overall crude recurrence rates with the various fixation techniques were: absorbable tacks, 17·5 per cent (2 treatment groups); absorbable tacks with sutures, 0·7 per cent (3); permanent tacks, 7·7 per cent (20); permanent tacks with sutures, 6·0 per cent (25); and sutures, 1·5 per cent (6). Six studies were included in a network meta‐analysis, which favoured fixation with sutures. Although statistical significance was not achieved, there was a 93 per cent chance of sutures being better than one of the other methods.
Conclusion
Both crude recurrence rates and the network meta‐analysis favoured fixation with sutures during laparoscopic ventral hernia repair.
Full textYou may also be interested in
Leading article
Authors: C. Chamberlain, J. M. Blazeby
Original article
Authors: S. J. Chapman, R. C. Grossman, M. E. B. FitzPatrick, R. R. W. Brady
Systematic review
Authors: H. K. James, A. W. Chapman, G. T. R. Pattison, D. R. Griffin, J. D. Fisher
Systematic review
Authors: J. H. H. Olsen, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg
Original article
Authors: L. Heylen, J. Pirenne, U. Samuel, I. Tieken, M. Coemans, M. Naesens et al.
Original article
Authors: L. Cairncross, H. A. Snow, D. C. Strauss, M. J. F. Smith, O. Sjokvist, C. Messiou et al.
Original article
Authors: R. J. Dinsdale, J. Hazeldine, K. Al Tarrah, P. Hampson, A. Devi, C. Ermogenous et al.
Original article
Authors: C. A. Sewalt, E. Venema, E. J. A. Wiegers, F. E. Lecky, S. C. E. Schuit, D. den Hartog et al.
Article
Authors: A. M Lacy, R. Bravo, A. M. Otero‐Piñeiro, R. Pena, F. B. De Lacy, R. Menchaca et al.
Original article
Authors: P. Ghorbani, T. Troëng, O. Brattström, K. G. Ringdal, T. Eken, A. Ekbom et al.
Original article
Authors: E. H. Wright, M. Tyler, B. Vojnovic, J. Pleat, A. Harris, D. Furniss et al.
Original article
Authors: N. Patel, R. J. Egan, B. R. Carter, D. M. Scott‐Coombes, M. J. Stechman, A. Afzaal et al.