Sac transection versus sac reduction during laparoscopic herniorrhaphy: A systematic review and meta-analysis

Chai, Shion Wei; Chiang, Po-Hsing; Chien, Chin-Ying; Chen, Yi-Chan; Soong, Ruey-Shyang; Huang, Tsun‐Sheng

doi:10.1016/j.asjsur.2021.08.058

Cited by 3 publications

(7 citation statements)

References 15 publications

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“…In a systematic review of the literature, Li et al [ 25 ] found no statistically significant difference in the length of hospital stay between the two procedures. However, these findings were consistent with those of Chai et al [ 8 ], who reported a significantly shorter hospital stay after sac transection than after sac reduction. Although advances in surgical techniques and the use of meshes have improved outcomes for inguinal hernia repair, recurrence rates remain a significant concern, ranging from 1 to 7.9% [ 33 , 34 ].…”

Section: Discussionsupporting

confidence: 92%

“…Two studies were RCTs [ 6 , 24 ] and four studies were CCTs [ 20 – 23 ]. Four studies were excluded: one systematic review with a meta-analysis of this subject [ 8 ], one systematic review [ 25 ], one narrative review [ 26 ], and one CCT comparing hernia remnant sac fixation with no fixation [ 27 ]. The number of involved patients was 2941 patients:821 patients in the TS group and 2120 patients in the RS group, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Our research found both techniques to be safe and feasible, with comparable rates of complications. Nevertheless, previous studies have identified a higher incidence of postoperative seroma [ 8 , 24 ]. This complication was defined as fluid exudation and accumulation in the surgical field.…”

Section: Discussionmentioning

confidence: 99%

“…The pooled results indicated that indirect hernia sac transection was associated with an increased seroma rate. A meta-analysis performed by Chai et al [ 8 ], which included 848 patients, concluded that sac transection may increase the risk of seroma formation. Several therapeutic modalities have been reported to prevent seroma formation.…”

Section: Discussionmentioning

confidence: 99%

“…However, the residual sac tissue may increase the risk of postoperative seroma formation. Several studies have investigated Postoperative outcomes, with controversial results [ 8 ]. Therefore, we conducted a systematic review and meta-analysis to present a higher level of evidence concerning the management of the hernia sac in laparoscopic hernia repair using TEP or TAPP.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?

Chaouch,

Hussain,

Gouader

et al. 2023

BMC Surg

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Background There is no consensus regarding hernia sac management during laparoscopic hernia repair, and this systematic review and meta-analysis aimed to compare the postoperative outcomes of sac reduction (RS) and sac transection (TS) during laparoscopic mesh hernia repair. Methods We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 and AMSTAR 2 (Assessing the Methodological Quality of Systematic Reviews) guidelines. We used the RevMan 5.4 statistical package from the Cochrane collaboration for meta-analysis. A random effects model was used. Results The literature search yielded six eligible studies including 2941 patients: 821 patients in the TS group and 2120 patients in the RS group. In the pooled analysis, the TS group was associated with a lower incidence of seroma (OR = 1.71; 95% CI [1.22, 2.39], p = 0.002) and shorter hospital stay (MD = -0.07; 95% CI [-0.12, -0.02], p = 0.008). There was no significant difference between the two groups in terms of morbidity (OR = 0.87; 95% CI [0.34, 2.19], p = 0.76), operative time (MD = -4.39; 95% CI [-13.62, 4.84], p = 0.35), recurrence (OR = 2.70; 95% CI [0.50, 14.50], p = 0.25), and Postoperative pain. Conclusions This meta-analysis showed that hernia sac transection is associated with a lower seroma rate and shorter hospital stay with similar morbidity, operative time, recurrence, and postoperative pain compared to the reduction of the hernia sac. Protocol The protocol was registered in PROSPERO with ID CRD42023391730.

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Section: Discussionsupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?

Chaouch,

Hussain,

Gouader

et al. 2023

BMC Surg

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Endo-laparoscopic scrotal hernia surgery: which technique must we choose to reduce seroma—sac transection or complete sac reduction? A prospective study

Yildiz,

Yucel

2023

Updates Surg

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Increased age and the volume of intraoperative fluid administered predict urinary retention after elective inguinal herniorrhaphy

Wu,

Yeh,

Wei

et al. 2024

Perioper Med

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Background Inguinal hernia repair (IHR) is a common surgical procedure worldwide. Although IHR can be performed by the minimally invasive method, which accelerates recovery, postoperative urinary retention (POUR) remains a common complication that significantly impacts patients. Thus, it is essential to identify the risk factors associated with POUR to diminish its negative impact. Methods We conducted a single-center retrospective review of elective IHR from 2018 to 2021. POUR was defined as the postoperative use of straight catheter or placement of an indwelling catheter to relieve the symptoms. Adjusted multivariate regression analysis was performed to address the associations of clinicodemographic, surgical, and intraoperative factors with POUR. Results A total of 946 subjects were included in the analysis after excluding cases of emergent surgery, recurrent hernia, or concomitant operations. The median age was 68.4 years, and 92.0% of the patients were male. Twenty-three (2.4%) patients developed POUR. In univariate analysis, POUR in comparison with non-POUR was significantly associated with increased age (72.2 versus 68.3 years, P = 0.012), a greater volume of intraoperative fluid administered (500 versus 400 ml, P = 0.040), and the diagnosis with benign prostate hypertrophy (34.8% versus 16.9%, P = 0.025). In the multivariate model, both increased age (odds ratio [OR] 1.04, 95% CI 1.01–1.08; P = 0.049) and a greater volume of intraoperative fluid administered (OR 1.12 per 100-mL increase, 95% CI 1.01–1.27; P = 0.047) were significantly associated with the occurrence of POUR. Conclusions We found that increased age and a greater volume of intraoperative fluid administered were significantly associated with the occurrence of POUR. Limiting the administration of intraoperative fluid may prevent POUR. From the perspective of practical implications, specific guidelines or clinical pathways should be implemented for fluid management and patient assessment.

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Sac transection versus sac reduction during laparoscopic herniorrhaphy: A systematic review and meta-analysis

Cited by 3 publications

References 15 publications

A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?

A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?

Endo-laparoscopic scrotal hernia surgery: which technique must we choose to reduce seroma—sac transection or complete sac reduction? A prospective study

Increased age and the volume of intraoperative fluid administered predict urinary retention after elective inguinal herniorrhaphy

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