Randomized Clinical Trial Comparing Cyanoacrylate Glue Versus Suture Fixation in Lichtenstein Hernia Repair: 7‐Year Outcome Analysis

Matikainen, M; Kössi, Jyrki; Silvasti, S.; Hulmi, T.; Paajanen, Hannu

doi:10.1007/s00268-016-3801-x

Cited by 18 publications

(9 citation statements)

References 60 publications

(76 reference statements)

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“…Several studies suggested that glue fixation was not associated with an increased risk of hernia recurrence and was a feasible alternative for mesh fixation with sutures in Lichtenstein inguinal hernia repair. [ 2 , 23 , 29 ] The present meta-analysis indicated that both early and late recurrence rates between the glue and suture fixation groups were similar. For the chronic groin pain, fixation with synthetic glue or biological glue showed similar results to fixation with suture, with the exception of early chronic pain, where there was a statistical reduction of early chronic pain rate in the biological glue fixation group.…”

Section: Discussionmentioning

confidence: 54%

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A meta-analysis of randomized control trials assessing mesh fixation with glue versus suture in Lichtenstein inguinal hernia repair

Lin

Zhuang²,

Ma³

et al. 2018

Medicine

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Background:The use of glue to fix mesh instead of sutures in Lichtenstein inguinal hernia repair has been accepted worldwide, with the increasing worries about postoperative chronic groin pain and recurrence. The aim of this meta-analysis was to clarify which mesh fixation method was more suitable in Lichtenstein inguinal hernia repair.Methods:Articles published up to July 2017 were searched using MEDLINE, the Cochrane Library, Embase, and the Web of Science. Randomized controlled trials (RCTs) comparing glue versus suture mesh fixation in Lichtenstein inguinal hernia repair were included in the review. The quality assessment and data extraction of included studies were applied by 2 independent authors. Statistical analysis was performed using RevMan 5.2 software.Results:Thirteen RCTs with 2375 patients were eligible for inclusion. Eight trials compared synthetic glue with suture fixation and 5 compared biological glue with suture fixation. The results showed that there was a lower incidence of early chronic pain (subgroup analysis, biological glue versus sutures, odds ratio (OR) = 0.41; 95% confidence interval (CI), 0.19–0.90; P = .03), and hematoma (subgroup analysis, synthetic glue versus sutures, OR = 0.56; 95% CI, 0.34–0.95; P = .03) in the glue fixation group. Suture mesh fixation method cost more time in operation than glue (mean difference = −4.60, 95% CI −7.60 to −1.60; P = .003). There was no evidence of an increase in chronic pain or recurrence rates with glue fixation method in the long-term follow-up.Conclusions:Mesh fixation with glue compared with sutures in Lichtenstein repair inguinal hernia is faster and less painful, without an increasing in terms of recurrence rates in the long term.

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Section: Discussionmentioning

confidence: 54%

“…In our systematic research, only 2 controlled trials comparing synthetic glue versus suture fixation have reported long-term results of Lichtenstein inguinal herniorrhaphy. [ 2 , 23 ] We showed that there was no significant difference in terms of late chronic pain or recurrence between the 2 groups in the long-term follow-up.…”

Section: Discussionmentioning

confidence: 77%

A meta-analysis of randomized control trials assessing mesh fixation with glue versus suture in Lichtenstein inguinal hernia repair

Lin

Zhuang²,

Ma³

et al. 2018

Medicine

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“…However, there was no difference in the chronic pain experienced by both the groups. [19] Quyn et al found a significantly lower acute and chronic pain with the use of glue. [20] A lower immediate and chronic post-operative pain with the use of glue was also concluded in the study by Sun P et al [21] The usage of glue in mesh fixation has significantly proved its efficacy with regard to decreasing the time needed for mesh fixation in open inguinal hernia repair, as the mean time taken for mesh fixation with glue was 1.73 minutes in our study.…”

Section: Discussionmentioning

confidence: 97%

N-Butyl-2-Cyanoacrylate Glue versus Suture for Mesh Fixation in Open Inguinal Hernioplasty

Shukla¹,

Mathur²,

Sheikh³

et al. 2019

jemds

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BACKGROUND One of the most common surgical issues presenting to the surgical clinics is inguinal hernia. Pain after inguinal hernia surgery is debilitating and hampers the quality of life in many patients. This has been found to be due to the trauma caused by fixation of mesh with sutures. This study compares the traumatic (sutures) and nontraumatic (glue) methods of mesh fixation in inguinal hernioplasty. We wanted to compare suture and N-butyl-2-cyanoacrylate glue in fixation of mesh in open inguinal hernia repair in terms of immediate & chronic post-operative pain, intraoperative time, recurrence, length of hospital stay & complications, if any. METHODS This study was done in the department of General Surgery after Institutional Scientific & Ethical Committee clearance. It is a prospective study conducted on 120 patients with two groups of 60 each for suture and glue (N-butyl-2-cyanoacrylate) fixation of mesh. Pain in Numerical Rating Scale, operative time and any complications were recorded with follow up at 1 week, 1 month, 3 months and 6 months. RESULTS It was observed that glue takes significantly lower time than suture for fixation of mesh, thereby reducing the intraoperative time significantly. Using glue reduced the mean fixation time for mesh from 10 minutes in conventional suture method to 1.7 minutes. There was also significant reduction in immediate and chronic postoperative pain in the glue group. The length of hospital stay was found to be comparable in both the groups. No post-operative complications or recurrence were recorded in either group. CONCLUSIONS This study confirms the effectiveness and superiority of glue over suture for mesh fixation in open inguinal hernia repair in terms of reduced immediate and chronic post-operative pain and operative time.

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“…Thirteen RCTs [17][18][19]23,26,29,30,33,[35][36][37]39,40 reported infection, The number of included studies and percent contribution of each direct comparison are described in Figure S15. Node splitting did not show evidence of a lack of consistency (Fig.…”

Section: Infectionmentioning

confidence: 99%

“…Twenty-eight RCTs [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][33][34][35][36]38,40,41 reported chronic postoperative inguinal pain. The number of included studies and the percent contribution of each direct comparison are described in Figure S6.…”

Section: Chronic Groin Painmentioning

confidence: 99%

Mesh fixation techniques in Lichtenstein tension‐free repair: a network meta‐analysis

Jiang

Zhang

Wang

et al. 2022

ANZ Journal of Surgery

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Backgrounds: To compare the clinical effectiveness of different mesh fixation techniques in Lichtenstein tension-free repair using network meta-analysis. Methods: Cochrane Library, Medline, EMBASE, and Web of Science databases were searched until 1 December 2020, and randomized controlled trials (RCTs) comparing outcomes between different mesh fixation techniques were included. The primary endpoints were chronic postoperative inguinal pain (CPIP) and hernia recurrence. The second endpoint was seroma and infection. Data were processed using Stata MP16.0, and R x64 3.6.1. Results: The results demonstrated that 32 RCTs (n = 6362) were eligible for pooling. Six types of mesh fixation techniques were used: non-absorbable suture, absorbable suture, chemical glue, fibrin glue, self-gripping mesh, and staple fixation. Network meta-analysis indicated that the incidence of CPIP with fibrin glue was lower than that with nonabsorbable sutures (relative risk [RR] = 0.23, 95% credibility interval [95%CrI] [0.09, 0.50]), absorbable sutures (RR = 0.24, 95%CrI [0.08, 0.60]), chemical glue (RR = 0.36, 95%CrI [0.13, 0.87]), and self-gripping mesh (RR = 0.27 95%CrI [0.09, 0.62]). Selfgripping mesh was superior to non-absorbable sutures (RR = 0.44, 95%CrI [0.23, 0.74]) in reducing postoperative infection. Conclusion: This network meta-analysis suggests that fibrin glue might be best for reducing CPIP and recurrence. However, a large-scale RCT is warranted to confirm the results. MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement for this systematic review and network meta-analysis. The study protocol was registered on PROSPERO (CRD42021231978).

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Randomized Clinical Trial Comparing Cyanoacrylate Glue Versus Suture Fixation in Lichtenstein Hernia Repair: 7‐Year Outcome Analysis

Abstract: NCT00659542.

Cited by 18 publications

References 60 publications

A meta-analysis of randomized control trials assessing mesh fixation with glue versus suture in Lichtenstein inguinal hernia repair

A meta-analysis of randomized control trials assessing mesh fixation with glue versus suture in Lichtenstein inguinal hernia repair

N-Butyl-2-Cyanoacrylate Glue versus Suture for Mesh Fixation in Open Inguinal Hernioplasty

Mesh fixation techniques in Lichtenstein tension‐free repair: a network meta‐analysis

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