Stina Öberg1, Kristoffer Andresen2, Tobias W Klausen3, Jacob Rosenberg2. 1. Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Denmark. Electronic address: stina.oeberg@gmail.com. 2. Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Denmark. 3. Clinical Research Unit, Statistical Section, Department of Hematology, Herlev Hospital, University of Copenhagen, Denmark.
Abstract
BACKGROUND: Chronic pain affects 10%-12% of patients after inguinal hernia repairs. Some have suggested that less foreign material may theoretically prevent pain. If the prevalence of chronic pain is less after nonmesh repairs, selected hernias might be repaired without mesh. Our aim was to clarify if nonmesh repairs are superior to mesh repairs regarding chronic pain. METHODS: For this systematic review, searches were conducted in five databases. The main outcome was chronic pain reported a minimum of six months after mesh and nonmesh repair in adult patients with a primary inguinal hernia. Only randomized controlled trials (RCTs) were included. RESULTS: A total of 23 RCTs with 5,444 patients were included. The median follow up was 1.4 years (range 0.5-10). Twenty-one studies reported crude chronic pain rates, and when considering moderate and severe pain, the prevalences of pain after nonmesh repairs and mesh repairs were similar: median 3.5% (0%-16.2%) versus median 2.9% (0%-27.6%), respectively. Both the meta-analyses and the network meta-analysis indicated no difference in chronic pain rates when comparing nonmesh repairs with open- and laparoscopic mesh repairs. CONCLUSION: Mesh may be used without fear of causing a greater rate of chronic pain.
BACKGROUND:Chronic pain affects 10%-12% of patients after inguinal hernia repairs. Some have suggested that less foreign material may theoretically prevent pain. If the prevalence of chronic pain is less after nonmesh repairs, selected hernias might be repaired without mesh. Our aim was to clarify if nonmesh repairs are superior to mesh repairs regarding chronic pain. METHODS: For this systematic review, searches were conducted in five databases. The main outcome was chronic pain reported a minimum of six months after mesh and nonmesh repair in adult patients with a primary inguinal hernia. Only randomized controlled trials (RCTs) were included. RESULTS: A total of 23 RCTs with 5,444 patients were included. The median follow up was 1.4 years (range 0.5-10). Twenty-one studies reported crude chronic pain rates, and when considering moderate and severe pain, the prevalences of pain after nonmesh repairs and mesh repairs were similar: median 3.5% (0%-16.2%) versus median 2.9% (0%-27.6%), respectively. Both the meta-analyses and the network meta-analysis indicated no difference in chronic pain rates when comparing nonmesh repairs with open- and laparoscopic mesh repairs. CONCLUSION: Mesh may be used without fear of causing a greater rate of chronic pain.
Authors: Felipe Girón; Juan David Hernandez; Juan David Linares; Alberto Ricaurte; Andres Mauricio García; Roberto Javier Rueda-Esteban; Lina Rodríguez; Ricardo Nassar Journal: Sci Rep Date: 2021-06-15 Impact factor: 4.379