Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair
Purpose The hypothesis of this meta-analysis was to assess whether laparoscopic approach shows real benefits over Lichtenstein technique in recurrent inguinal hernia repair. Methods A literature search for prospective randomized trials comparing laparoscopic and Lichtenstein procedure in recurrent i...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2015-06, Vol.19 (3), p.355-366 |
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| creator | Pisanu, A. Podda, M. Saba, A. Porceddu, G. Uccheddu, A. |
| description | Purpose
The hypothesis of this meta-analysis was to assess whether laparoscopic approach shows real benefits over Lichtenstein technique in recurrent inguinal hernia repair.
Methods
A literature search for prospective randomized trials comparing laparoscopic and Lichtenstein procedure in recurrent inguinal hernia repair was performed. Trials were reviewed for primary outcome measures: re-recurrence, chronic inguinal pain and ischemic orchitis; and for secondary outcome measures. Standardized mean difference (SMD) was calculated for continuous variables and odds ratio for dichotomous variables.
Results
Seven studies comparing laparoscopic and Lichtenstein technique were considered suitable for the pooled analysis. Overall 647 patients with recurrent inguinal hernia were randomized to either laparoscopic repair (333, 51.5 %, transabdominal preperitoneal approach, TAPP and totally extraperitoneal approach, TEP) or anterior open repair (314, 48.5 %, Lichtenstein operation). Patients who underwent laparoscopic repair experienced significantly less chronic pain (9.2 % vs. 21.5 %,
p
= 0.003). Patients of the laparoscopic group had a significantly earlier return to normal daily activities (13.9 vs. 18.4 days, SMD = −0.68, 95 % CI = −0.94 to –0.43,
p
|
| doi_str_mv | 10.1007/s10029-014-1281-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1685746184</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3701185991</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-206aeb57b94e3f7527564d4963fec6c79f340b38720b09625bc373cc6541104a3</originalsourceid><addsrcrecordid>eNp1kctu1TAQhi0Eohd4ADbIEhs2Lr47WVYV0EoHsYG15fhMelwlTmo7rdqn4JHr9BRUVWJjezTf_DOeH6EPjJ4wSs2XXE_eEsokYbxhhL1Ch4zLhrScytfrWysiW6oP0FHOV5TSRurmLTrgigrRSnGI_vyA4oiLbrjLIWMXtzjBTYBbPPV4TlOewZdwAzjV1DSGe9jikoIbMvbTOLsU4iUeXH1M2U9z8I8Sm-B3BWIuECIu4HcxXC-QcY0S-CUliKUGl0uojfEOUgyuZmYX0jv0pq_q8P7pPka_v339dXZONj-_X5ydboiXoimEU-2gU6ZrJYjeKG6UllvZatGD1960vZC0E43htKOt5qrzwgjvtZKMUenEMfq8162fXGcrdgzZwzC4CNOSLdONMlKzRlb00wv0alpSnfyRkoZrRlWl2J7ydRU5QW_nFEaX7iyjdrXL7u2y1S672mVZrfn4pLx0I2z_Vfz1pwJ8D-R53TSkZ63_q_oANiOiAQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1684726105</pqid></control><display><type>article</type><title>Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Pisanu, A. ; Podda, M. ; Saba, A. ; Porceddu, G. ; Uccheddu, A.</creator><creatorcontrib>Pisanu, A. ; Podda, M. ; Saba, A. ; Porceddu, G. ; Uccheddu, A.</creatorcontrib><description>Purpose
The hypothesis of this meta-analysis was to assess whether laparoscopic approach shows real benefits over Lichtenstein technique in recurrent inguinal hernia repair.
Methods
A literature search for prospective randomized trials comparing laparoscopic and Lichtenstein procedure in recurrent inguinal hernia repair was performed. Trials were reviewed for primary outcome measures: re-recurrence, chronic inguinal pain and ischemic orchitis; and for secondary outcome measures. Standardized mean difference (SMD) was calculated for continuous variables and odds ratio for dichotomous variables.
Results
Seven studies comparing laparoscopic and Lichtenstein technique were considered suitable for the pooled analysis. Overall 647 patients with recurrent inguinal hernia were randomized to either laparoscopic repair (333, 51.5 %, transabdominal preperitoneal approach, TAPP and totally extraperitoneal approach, TEP) or anterior open repair (314, 48.5 %, Lichtenstein operation). Patients who underwent laparoscopic repair experienced significantly less chronic pain (9.2 % vs. 21.5 %,
p
= 0.003). Patients of the laparoscopic group had a significantly earlier return to normal daily activities (13.9 vs. 18.4 days, SMD = −0.68, 95 % CI = −0.94 to –0.43,
p
< 0.000001). Operative time was significantly longer in laparoscopic operations (62.9 vs. 54.2 min, SMD 0.46, 95 % CI 0.03, 0.89;
p
= 0.04). No other differences were found.
Conclusions
Laparoscopy showed reduced chronic inguinal pain and an earlier return to normal daily activities but significantly longer operative time. Despite the expected advantages, the choice between laparoscopy and other techniques still depends on local expertise availability. Only dedicated centers are able to routinely offer laparoscopy for recurrent inguinal hernia repair.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-014-1281-1</identifier><identifier>PMID: 25033943</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdominal Surgery ; Hernia, Inguinal - surgery ; Herniorrhaphy - methods ; Humans ; Laparoscopy ; Medicine ; Medicine & Public Health ; Randomized Controlled Trials as Topic ; Recurrence ; Review ; Surgical Mesh</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2015-06, Vol.19 (3), p.355-366</ispartof><rights>Springer-Verlag France 2014</rights><rights>Springer-Verlag France 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-206aeb57b94e3f7527564d4963fec6c79f340b38720b09625bc373cc6541104a3</citedby><cites>FETCH-LOGICAL-c438t-206aeb57b94e3f7527564d4963fec6c79f340b38720b09625bc373cc6541104a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-014-1281-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-014-1281-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25033943$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pisanu, A.</creatorcontrib><creatorcontrib>Podda, M.</creatorcontrib><creatorcontrib>Saba, A.</creatorcontrib><creatorcontrib>Porceddu, G.</creatorcontrib><creatorcontrib>Uccheddu, A.</creatorcontrib><title>Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Purpose
The hypothesis of this meta-analysis was to assess whether laparoscopic approach shows real benefits over Lichtenstein technique in recurrent inguinal hernia repair.
Methods
A literature search for prospective randomized trials comparing laparoscopic and Lichtenstein procedure in recurrent inguinal hernia repair was performed. Trials were reviewed for primary outcome measures: re-recurrence, chronic inguinal pain and ischemic orchitis; and for secondary outcome measures. Standardized mean difference (SMD) was calculated for continuous variables and odds ratio for dichotomous variables.
Results
Seven studies comparing laparoscopic and Lichtenstein technique were considered suitable for the pooled analysis. Overall 647 patients with recurrent inguinal hernia were randomized to either laparoscopic repair (333, 51.5 %, transabdominal preperitoneal approach, TAPP and totally extraperitoneal approach, TEP) or anterior open repair (314, 48.5 %, Lichtenstein operation). Patients who underwent laparoscopic repair experienced significantly less chronic pain (9.2 % vs. 21.5 %,
p
= 0.003). Patients of the laparoscopic group had a significantly earlier return to normal daily activities (13.9 vs. 18.4 days, SMD = −0.68, 95 % CI = −0.94 to –0.43,
p
< 0.000001). Operative time was significantly longer in laparoscopic operations (62.9 vs. 54.2 min, SMD 0.46, 95 % CI 0.03, 0.89;
p
= 0.04). No other differences were found.
Conclusions
Laparoscopy showed reduced chronic inguinal pain and an earlier return to normal daily activities but significantly longer operative time. Despite the expected advantages, the choice between laparoscopy and other techniques still depends on local expertise availability. Only dedicated centers are able to routinely offer laparoscopy for recurrent inguinal hernia repair.</description><subject>Abdominal Surgery</subject><subject>Hernia, Inguinal - surgery</subject><subject>Herniorrhaphy - methods</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Recurrence</subject><subject>Review</subject><subject>Surgical Mesh</subject><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kctu1TAQhi0Eohd4ADbIEhs2Lr47WVYV0EoHsYG15fhMelwlTmo7rdqn4JHr9BRUVWJjezTf_DOeH6EPjJ4wSs2XXE_eEsokYbxhhL1Ch4zLhrScytfrWysiW6oP0FHOV5TSRurmLTrgigrRSnGI_vyA4oiLbrjLIWMXtzjBTYBbPPV4TlOewZdwAzjV1DSGe9jikoIbMvbTOLsU4iUeXH1M2U9z8I8Sm-B3BWIuECIu4HcxXC-QcY0S-CUliKUGl0uojfEOUgyuZmYX0jv0pq_q8P7pPka_v339dXZONj-_X5ydboiXoimEU-2gU6ZrJYjeKG6UllvZatGD1960vZC0E43htKOt5qrzwgjvtZKMUenEMfq8162fXGcrdgzZwzC4CNOSLdONMlKzRlb00wv0alpSnfyRkoZrRlWl2J7ydRU5QW_nFEaX7iyjdrXL7u2y1S672mVZrfn4pLx0I2z_Vfz1pwJ8D-R53TSkZ63_q_oANiOiAQ</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Pisanu, A.</creator><creator>Podda, M.</creator><creator>Saba, A.</creator><creator>Porceddu, G.</creator><creator>Uccheddu, A.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20150601</creationdate><title>Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair</title><author>Pisanu, A. ; Podda, M. ; Saba, A. ; Porceddu, G. ; Uccheddu, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-206aeb57b94e3f7527564d4963fec6c79f340b38720b09625bc373cc6541104a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdominal Surgery</topic><topic>Hernia, Inguinal - surgery</topic><topic>Herniorrhaphy - methods</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Recurrence</topic><topic>Review</topic><topic>Surgical Mesh</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pisanu, A.</creatorcontrib><creatorcontrib>Podda, M.</creatorcontrib><creatorcontrib>Saba, A.</creatorcontrib><creatorcontrib>Porceddu, G.</creatorcontrib><creatorcontrib>Uccheddu, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pisanu, A.</au><au>Podda, M.</au><au>Saba, A.</au><au>Porceddu, G.</au><au>Uccheddu, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>19</volume><issue>3</issue><spage>355</spage><epage>366</epage><pages>355-366</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Purpose
The hypothesis of this meta-analysis was to assess whether laparoscopic approach shows real benefits over Lichtenstein technique in recurrent inguinal hernia repair.
Methods
A literature search for prospective randomized trials comparing laparoscopic and Lichtenstein procedure in recurrent inguinal hernia repair was performed. Trials were reviewed for primary outcome measures: re-recurrence, chronic inguinal pain and ischemic orchitis; and for secondary outcome measures. Standardized mean difference (SMD) was calculated for continuous variables and odds ratio for dichotomous variables.
Results
Seven studies comparing laparoscopic and Lichtenstein technique were considered suitable for the pooled analysis. Overall 647 patients with recurrent inguinal hernia were randomized to either laparoscopic repair (333, 51.5 %, transabdominal preperitoneal approach, TAPP and totally extraperitoneal approach, TEP) or anterior open repair (314, 48.5 %, Lichtenstein operation). Patients who underwent laparoscopic repair experienced significantly less chronic pain (9.2 % vs. 21.5 %,
p
= 0.003). Patients of the laparoscopic group had a significantly earlier return to normal daily activities (13.9 vs. 18.4 days, SMD = −0.68, 95 % CI = −0.94 to –0.43,
p
< 0.000001). Operative time was significantly longer in laparoscopic operations (62.9 vs. 54.2 min, SMD 0.46, 95 % CI 0.03, 0.89;
p
= 0.04). No other differences were found.
Conclusions
Laparoscopy showed reduced chronic inguinal pain and an earlier return to normal daily activities but significantly longer operative time. Despite the expected advantages, the choice between laparoscopy and other techniques still depends on local expertise availability. Only dedicated centers are able to routinely offer laparoscopy for recurrent inguinal hernia repair.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>25033943</pmid><doi>10.1007/s10029-014-1281-1</doi><tpages>12</tpages></addata></record> |
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| ispartof | Hernia : the journal of hernias and abdominal wall surgery, 2015-06, Vol.19 (3), p.355-366 |
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| language | eng |
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| subjects | Abdominal Surgery Hernia, Inguinal - surgery Herniorrhaphy - methods Humans Laparoscopy Medicine Medicine & Public Health Randomized Controlled Trials as Topic Recurrence Review Surgical Mesh |
| title | Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair |
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