自固定补片与普通聚丙烯补片在腹腔镜经腹腹膜前疝修补术中有效性和安全性的Meta分析

The Comparison of Self-gripping mesh and Polypropylene mesh in Laparoscopic Transabdominal Preperitoneal Repair of Inguinal hernia:the results of meta-analysis

目的分析比较自固定补片与普通聚丙烯补片在腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)中的有效性和安全性。方法查找比较自固定补片与普通聚丙烯补片在TAPP中应用的临床对照研究,使用RevMan5.3软件进行Meta分析。结果共纳入2项随机对照临床研究和1项前瞻性临床对照研究,包括256例患者。对纳入研究进行整体分析显示,自固定补片组与普通聚丙烯补片组患者在复发率[OR=0.31,95%CI(0.03~3.06),P=0.32]、手术时间[MD=1.25,95%CI(-5.20~7.71),P=0.70]及血肿发生率[OR=0.62,95%CI(0.16~2.46),P=0.49]方面比较,差异均无统计学意义。结论自固定补片与普通聚丙烯补片在TAPP中的复发率、手术时间及血肿发生率等方面相似,但本研究入组患者数量较少,尚需大样本长期研究证实。

Objective The aim of this study was to compare outcomes of self-gripping mesh and polypropylene mesh in laparoscopic transabdominal preperitoneal(TAPP)repair of inguinal hernia.Methods A systematic literature review was undertaken to identify studies comparing the results of self-gripping mesh and conventional mesh in laparoscopic TAPP repair of inguinal hernia.Statistical analysis was performed by Review Manager version 5.3 software.Results 2 randomized controlled trials and 1 prospective comparative study were analyzed.There was no significant difference in hernia recurrence(OR 0.31,95%CI 0.03,3.06),operation time(MD 1.25,95%CI-5.20,7.71)and hematoma(OR 0.62,95%CI 0.16,2.46).Conclusions The self-gripping mesh has comparable results with polypropylene mesh in laparoscopic TAPP inguinal hernia repair regarding hernia recurrence,operation time and hematoma.The results are based on relatively small patient numbers and large-scale trials with long-term follow-up are still needed to assess postoperative outcomes.