Estudio prospectivo y aleatorizado de los resultados a largo plazo de la hernioplastia inguinal con malla autoadhesiva frente a la técnica convencional con malla de polipropileno y sutura de fijación

Esteban, Marcos Bruna; Pallarés, Miriam Cantos; Rojas, Elirub; Vila, María José

doi:10.1016/j.ciresp.2013.03.009

Cited by 11 publications

(1 citation statement)

References 16 publications

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“…Three additional RCTs were published in 2014, 178 – 180 and another two were published with long-term data from an RCT published earlier. 181 , 182 All confirmed comparable recurrence rates and acute and chronic pain incidence in both groups. The self-fixation mesh is likely to be more expensive than standard fixation, but the operative time was shorter in the Progrip© group (by a range of 1–12 min).…”

Section: Surgical Treatment Of Inguinal Herniassupporting

confidence: 58%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,557

712

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IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

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Section: Surgical Treatment Of Inguinal Herniassupporting

confidence: 58%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,557

712

View full text Add to dashboard Cite

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Meta‐analysis of postoperative pain using non‐sutured or sutured single‐layer open mesh repair for inguinal hernia

et al. 2019

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Background Chronic postoperative pain occurs in up to 21·7 per cent of patients undergoing open inguinal hernia repair. Several mesh fixation techniques using glue or self‐gripping meshes have been developed to reduce postoperative pain. The aim of this meta‐analysis was to evaluate RCTs comparing adhesional/self‐gripping and sutured single‐layer open mesh fixations in the repair of inguinal herniation, with postoperative pain as endpoint. Methods PubMed, Embase and Cochrane CENTRAL databases were searched systematically for RCTs according to the PRISMA guidelines; the study was registered at PROSPERO (CRD42017056373). Different fixation methods were analysed. The primary outcome, chronic pain, was defined as a postoperative visual analogue scale (VAS) score of at least 3 at 12 months. Secondary outcomes were mean VAS score at 1 week and at 1 month after surgery. Results Twenty‐three studies including 5190 patients were included in the meta‐analysis. Adhesional (self‐adhering or glued) or self‐gripping fixation methods were associated with a significantly lower VAS score at 1 week (mean difference –0·49, 95 per cent c.i. ‐0·81 to –0·17; P = 0·003) and at 1 month (mean difference –0·31, –0·58 to –0·04; P = 0·02) after surgery than suture fixation, but the incidence of chronic pain after 12 months was similar in the two groups (odds ratio 0·70, 95 per cent c.i. 0·30 to 1·66). Differences in recurrences and complications between groups did not reach statistical significance. Conclusion There was no difference in the incidence of chronic pain 12 months after different mesh repair fixation techniques despite significant reductions in short‐term postoperative pain favouring a non‐sutured technique. There were no differences in recurrence rates or in rates of other complications at 1 year.

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Results and Complications of Inguinal Hernia Repair

Nguyen

Chen

2018

The Art of Hernia Surgery

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Estudio prospectivo y aleatorizado de los resultados a largo plazo de la hernioplastia inguinal con malla autoadhesiva frente a la técnica convencional con malla de polipropileno y sutura de fijación

Cited by 11 publications

References 16 publications

International guidelines for groin hernia management

International guidelines for groin hernia management

Meta‐analysis of postoperative pain using non‐sutured or sutured single‐layer open mesh repair for inguinal hernia

Results and Complications of Inguinal Hernia Repair

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