Recurrent groin hernia surgery

Sevonius, Dan; Gunnarsson, Ulf; Nordin, Pär; Nilsson, Erik; Sandblom, Gabriel

doi:10.1002/bjs.7559

Cited by 50 publications

(38 citation statements)

References 71 publications

(82 reference statements)

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“…13-60 Lichtenstein procedure was described in 8 NRCT (3 case series studies, 5 observational) including 15,121 patients versus 5 RCTs including 291 patients (Table 2). 15,[22][23][24]38,39,46,47,50,59,[61][62][63] Fifteen prospective trials were identified. 13,15,16,18,25,[39][40][41]44,[48][49][50]52,55,59,61 The analysis, due to missing data in the included trials, was limited to outcomes providing comprehensive information.…”

Section: Resultsmentioning

confidence: 99%

Recurrent Inguinal Hernia Repair

Dedemadi

Kalaitzopoulos²,

Loumpias³

et al. 2014

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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To examine, if case series considered together with observational studies tend to produce similar results as randomized-controlled trials (RCTs), on recurrent hernia repair. A systematic literature review and meta-analysis between 1990 and 2013 revealed 46 nonrandomized studies (NRCTs) and 5 RCTs including 25,730 patients. A direct comparison of the summary estimates between RCTs and NRCTs is presented. Outcomes, within or across studies, were compared. Comparisons of all outcomes in NRCTs and RCTs failed to show statistical significance. Prospective/retrospective cohort studies, case series, and RCTs did not differ significantly in their estimates. Adjusted testing for metaregression disclosed that rerecurrence among NRCTs was independent of the study design. The number of included patients and study setting were independent predictors of outcome. Our proposed methodology for a systematic review could potentially give answers where level I evidence is missing or could be a tool for optimization of a RCT design.

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Section: Resultsmentioning

confidence: 99%

Recurrent Inguinal Hernia Repair

Dedemadi

Kalaitzopoulos²,

Loumpias³

et al. 2014

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Repeat endoscopic repair is only feasible when the surgeon has a high level of experience in repeat endoscopic groin hernia repair [26]. However, registry data show that even following previous open suture and mesh repair to treat the primary inguinal hernia, open suture and mesh repair are used once again for a recurrent hernia [27]. That is due to the fact that the skill needed for laparo-endoscopic recurrent inguinal hernia repairs was not always assured.…”

mentioning

confidence: 99%

Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines?

et al. 2016

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IntroductionOn the basis of six meta-analyses, the guidelines of the European Hernia Society (EHS) recommend laparo-endoscopic recurrent repair following previous open inguinal hernia operation and, likewise, open repair following previous laparo-endoscopic operation. So far no data are available on implementation of the guidelines or for comparison of outcomes. Besides, there are no studies for comparison of outcomes for compliance versus non-compliance with the guidelines.Patients and methodsIn total, 4812 patients with elective unilateral recurrent inguinal hernia repair in men were enrolled between September 1, 2009, and September 17, 2014, in the Herniamed Registry. Only patients with 1-year follow-up were included.ResultsOut of the 2482 laparo-endoscopic recurrent repair operations 90.5% of patients, and out of the 2330 open recurrent repair procedures only 38.5% of patients, were operated on in accordance with the guidelines of the EHS. Besides, on compliance with the guidelines multivariable analysis demonstrated for laparo-endoscopic recurrent repair a significantly lower risk of pain at rest (OR 0.643 [0.476; 0.868]; p = 0.004) and pain on exertion (OR 0.679 [0.537; 0.857]; p = 0.001). Comparison of laparo-endoscopic and open recurrent repair in settings of compliance versus non-compliance with the guidelines showed a higher incidence of perioperative complications and re-recurrences for recurrent repairs that did not comply with the guidelines.ConclusionThe EHS guidelines for recurrent inguinal hernia repair are not yet being observed to the extent required. Non-compliance with the guidelines is associated with higher perioperative complication rates and higher risk of re-recurrence. Even on compliance with the guidelines, the risk of pain at rest and pain on exertion is higher after open recurrent repair than after laparo-endoscopic repair.

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“…The followup periods in this study also varied widely. Usually, the recurrence rate is estimated as twice the number of reoperations [31] the reoperation rates following TEP laparoscopic hernioplasty and Lichtenstein hernioplasty were 3.3% and 2.4%, respectively [32]. It therefore suggests that the recurrence rates were around 6.6% and 4.8% for the laparoscopic and Lichtenstein hernioplasties, respectively.…”

Section: Discussionmentioning

confidence: 99%

Total extraperitoneal endoscopic hernioplasty (TEP) versus Lichtenstein hernioplasty: a systematic review by updated traditional and cumulative meta-analysis of randomised-controlled trials

Gavriilidis

Davies

Wheeler

et al. 2019

Hernia

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Background-purpose Totally extraperitoneal (TEP) endoscopic hernioplasty and Lichtenstein hernioplasty are the most commonly used approaches for inguinal hernia repair. However, current evidence on which is the preferred approach is inconclusive. This updated meta-analysis was conducted to track the accumulation of evidence over time. Methods Studies were identified by a systematic literature search of the EMBASE, PubMed, Cochrane Library, and Google Scholar databases. Fixed-and random-effects models were used to cumulatively assess the accumulation of evidence over time. Results The TEP cohort showed significantly higher rates of recurrences and vascular injuries compared to the Lichtenstein cohort; [Peto Odds ratio (OR) = 1.58 (1.22, 2.04), p = 0.005], [Peto OR = 2.49 (1.05, 5.88), p = 0.04], respectively. In contrast, haematoma formation rate, time to return to usual activities, and local paraesthesia were significantly lower in the TEP cohort compared to the Lichtenstein cohort; [Peto OR = 0.26 (0.16, 0.41), p ≤ 0.001], [mean difference = − 6.32 (− 8.17, − 4.48), p ≤ 0.001], [Peto OR = 0.26 (0.17, 0.40), p ≤ 0.001], respectively. Conclusions This study, which is based on randomised-controlled trials (RCTs) of high quality, showed significantly higher rates of recurrences and vascular injuries in the TEP cohort than in the Lichtenstein cohort. In contrast, rate of postoperative haematoma formation, local paraesthesia, and time to return to usual activities were significantly lower in the TEP cohort than in the Lichtenstein cohort. Future multicentre RCTs with strict adherence to the standards recommended in the Consolidated Standards of Reporting Trials guidelines will shed further light on the topic.

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Recurrent groin hernia surgery

Cited by 50 publications

References 71 publications

Recurrent Inguinal Hernia Repair

Recurrent Inguinal Hernia Repair

Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines?

Total extraperitoneal endoscopic hernioplasty (TEP) versus Lichtenstein hernioplasty: a systematic review by updated traditional and cumulative meta-analysis of randomised-controlled trials

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