Retrospective Comparison And Meta-analysis On The Therapeutic Effecy Of Lightweight Mesh Versus(Middleweight)highweight Mesh In Open Repair For Inguinal Hernia

Objective To compare the therapeutic benefits of the lightweight mesh and high weight mesh used in the open repair to inguinal hernia.Methods A total of 145 cases/152 sides of inguinal hernia repair with non-stress in our department from January 2011 to January 2014 were retrospectively investigated. Two kinds of operations including the lightweight mesh(LWM, 59 cases/60 sides) and the middleweight mesh(MWM, 86 cases/92 sides) were applied. At 3 mo., 6 mo. and 1 yr after operation, the patients in these two groups were assessed for chronic pain, foreign body sensation, groin discomfort, hard feelings, and so on by questionnaire, and by clinical examinations. Furthermore, after searching Pubmed, Ebsco, Embase and Web of Science, a total of 10 randomized control trials comparing the therapeutic benefits of the lightweight mesh(LWM) versus(middleweight))highweight mesh(HWM) in open repair for inguinal hernia were selected in this Meta- analysis.Results The recurrence rates in the LWM group and the MWM group were respectively 1.67% and 1.09%(P=0.762). At 3 mo. and 6 mo. After operation, no significant difference could be respectively identified in the incidences of chronic pain, groin discomfort, uncomfortably pulling sensation and foreign body sensations. At 1 yr after operation, compared the LWM group and the MWM group, there was no significant difference in the VAS score, the incidence of chronic pain(8.51% vs 12.50%), foreignbody sensation(4.26% vs 12.50%) and uncomfortably pulling sensation(6.38% vs 5.35%). The incidence of discomfort in inguinal region in the lightweight mesh group was 17.02%, significantly lower than the middleweight mesh group 37.50%(P=0.021). 10 randomized trials containing 2322 patients were included in this review. In the fixed-effects model, there was not statistical difference concerning the overall recurrence rate [OR=1.34, 95%CI(0.74~2.43), P=0.33]. The subgroup analysis showed it was in the group where the meshes pore size of included RCTs vary greatly, that the presence of chronic pain at 12 months was favoring the lightweight group[OR=0.65, 95%CI(0.47~0.90), P=0.01].Conclusions This study showed that the application of LWM was safe and effective in the open hernia repair, and LWM could significantly improve the incidence of discomfort in inguinal region at 1 yr after surgery. The pore size of the mesh might play a greater role than the weight did.