轻型补片与传统补片在腹股沟疝修补术中有效性和安全性的荟萃分析

Comparison of lightweight mesh and heavyweight mesh in inguinal hernia repair: A Meta-analysis

目的系统评价轻量型补片与传统补片在腹股沟疝修补术中的有效性和安全性。方法计算机检索Pub Med、Embase、Cochrane Library、中国生物医学文献数据库、中国科技期刊全文数据库、中国期刊全文数据库。全面收集比较轻量型补片与传统补片在腹股沟疝修有效性和安全性的随机对照试验(randomized controlled trials,RCTs),2名评价者独立评价纳入文献的方法学质量,用Rev Man 5.3软件进行统计分析。结果共纳入19篇RCTs,Meta分析结果显示,轻量型补片组与传统传统补片组患者在复发率方面比较,差异无统计学意义[RR=0.82,95%CI(0.56~1.19),P=0.30];在慢性疼痛[RR=0.68,95%CI(0.57~0.81),P<0.000 1]、异物感[RR=0.67,95%CI(0.56~0.81),P<0.000 1]及其并发症[RR=0.63,95%CI(0.51~0.77),P<0.000 1]方面比较,差异均有统计学意义。结论轻量型补片与传统传统补片在无张力疝修补术中的复发率方面相似,而轻量型补片减轻慢性疼痛、异物感及并发症发生方面优于传统补片。

Objective To systematic review the efficacy and safety of use of lightweight versus heavyweight mesh in inguinal hernia repair. Methods We searched Pub Med, Embase, Cochrane Library, Chinese biomedicine literature database, Chinese Journal full-text database and Chinese Scientific Journals full-text database for randomized controlled trials comparing lightweight mesh with heavyweight mesh in inguinal hernia repair. Two reviewers independently assessed the quality of included studies. We analyzed the statistic data using Review Manager（version 5.3）. Results 19 randomized controlled trials were included. Meta analysis showed that there was no significant difference between lightweight mesh and heavyweight mesh in recurrence rate [RR=0.82, 95% CI（0.56, 1.19）, P=0.30], but significant differences were existed in chronic groin pain [RR=0.68, 95% CI（0.57,0.81）, P〈0.000 1], foreign body sensation [RR=0.67, 95% CI（0.56, 0.81）, P〈0.000 1] and complication incidence [RR=0.63, 95% CI（0.51, 0.77）, P〈0.000 1]. Conclusion Compared with heavyweight mesh, the application of lightweight mesh for inguinal hernia repair was similar in hernia recurrence rate. Lightweight mesh reduced the incidence of chronic groin pain and the risk of foreign body sensation as well as complication incidence.