Does mesh offer an advantage over tissue in the open repair of umbilical hernias? A systematic review and meta-analysis

Aslani, Nava; Brown, C. J.

doi:10.1007/s10029-010-0705-9

Cited by 106 publications

(65 citation statements)

References 23 publications

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“…This is regarded as an acceptable recurrence rate. In one study, it was found that the recurrence rate was decreased tenfold since the use of mesh [11].…”

Section: Discussionmentioning

confidence: 99%

“…A clear benefit of the laparoscopic approach is that it allows the operating surgeon to perform a diagnostic laparoscopy to detect possible other defects. In addition, laparoscopy makes it easier to place a sizeable mesh in an intraperitoneal position with an adequate overlap of the borders of defect [11]. The result for complications in the pooled laparoscopic mesh placement group could be biased.…”

Section: Discussionmentioning

confidence: 99%

“…However, in contrast to all other primary hernias, there is no consensus whether the repair of umbilical and epigastric hernias should be mesh-based. Several randomized controlled trials (RCTs) as well as various cohort studies and a systematic review have pointed out the superiority of mesh over sutures in terms of recurrences [6][7][8][9][10][11]. Complication rates and postoperative pain after mesh repair are investigated for inguinal hernias, but are not reviewed for umbilical and epigastric hernias [12].…”

Section: Introductionmentioning

confidence: 99%

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A Collective Review on Mesh-Based Repair of Umbilical and Epigastric Hernias

2013

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In accordance with the tension-free principles for other hernias, umbilical and epigastric hernia repair should probably be mesh-based. The number of randomized studies is increasing, most of them showing significantly less recurrences with the use of a mesh. Different devices are available and are applicable by several approaches. The objective of this review was to evaluate recent literature for the different types of mesh for umbilical and epigastric hernia repair and recurrences after mesh repair. A multidatabase search was conducted to reveal relevant studies since 2001 reporting mesh-based repair of primary umbilical/epigastric hernia and their outcomes in adult patients. A total of 20 studies were included, 15 of them solely involved umbilical hernias, whereas the remaining studies included epigastric hernias as well. A median of 124 patients (range, 17-384) was investigated per study. Three quarters of the included studies had a follow-up of at least 2 years. Six studies described the results of laparoscopic approach, of which one reported a recurrence rate of 2.7 %; in the remaining studies, no recurrences occurred. Two comparative studies reported a lower incidence of complications and postoperative pain after laparoscopic repair compared to open repair. Seventeen studies reported results of open techniques, of which seven studies showed no recurrence. Other studies reported recurrence rates up to 3.1 %. A wide range of complication rates were reported (0-33 %). This collective review showed acceptable recurrence rates for mesh-based umbilical and epigastric hernia repair. A wide range of devices was investigated. A tendency toward more complications after laparoscopic repair was found compared to open repair.

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“…This is regarded as an acceptable recurrence rate. In one study, it was found that the recurrence rate was decreased tenfold since the use of mesh [11].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Collective Review on Mesh-Based Repair of Umbilical and Epigastric Hernias

2013

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“…http://www.prisma-statement.org [15], f MOOSE statement: Metaanalysis of Observational Studies in Epidemiology [16] regardless wether the patient actually received the treatment or not [18]. 10 In some specific clinical situations, an equivalence or non-inferiority design is preferred. An equivalence study investigates whether a new treatment is equivalent to the control with respect to a predefined indifference.…”

Section: The Research Question and The Primary Endpointmentioning

confidence: 99%

“…For some less common conditions, a multi-centre approach is prerequisite to enrol a large enough cohort of patients. It is 10 According to the International Conference on Harmonisation (ICH) guidelines of Good Clinical Practice (GCP) a statistical test decision of a study should be conservative [18]. This is the rationale to use the ITT population for superiority studies and the PP population for equivalence studies.…”

Section: Mono-centre Versus Multi-centre Studiesmentioning

confidence: 99%

Recommendations for reporting outcome results in abdominal wall repair

Muysoms

Deerenberg

Peeters

et al. 2013

Hernia

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Background The literature dealing with abdominal wall surgery is often flawed due to lack of adherence to accepted reporting standards and statistical methodology. Materials and methods The EuraHS Working Group (European Registry of Abdominal Wall Hernias) organised a consensus meeting of surgical experts and researchers with an interest in abdominal wall surgery, including a statistician, the editors of the journal Hernia and scientists experienced in meta-analysis. Detailed discussions took place to identify the basic ground rules necessary to improve the quality of research reports related to abdominal wall reconstruction. Hernia (2013) 17:423-433 DOI 10.1007/s10029-013-1108 Results A list of recommendations was formulated including more general issues on the scientific methodology and statistical approach. Standards and statements are available, each depending on the type of study that is being reported: the CONSORT statement for the Randomised Controlled Trials, the TREND statement for non randomised interventional studies, the STROBE statement for observational studies, the STARLITE statement for literature searches, the MOOSE statement for metaanalyses of observational studies and the PRISMA statement for systematic reviews and meta-analyses. A number of recommendations were made, including the use of previously published standard definitions and classifications relating to hernia variables and treatment; the use of the validated Clavien-Dindo classification to report complications in hernia surgery; the use of ''time-to-event analysis'' to report data on ''freedom-of-recurrence'' rather than the use of recurrence rates, because it is more sensitive and accounts for the patients that are lost to follow-up compared with other reporting methods. Conclusion A set of recommendations for reporting outcome results of abdominal wall surgery was formulated as guidance for researchers. It is anticipated that the use of these recommendations will increase the quality and meaning of abdominal wall surgery research.

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