| Objective:Meta-analysis was performed to compare the efficacy and safety of IPOM-PLUS and IPOM in the treatment of incision hernia,and to provide a reliable surgical approach for the choice of repairing the incision hernia in clinical practice.Methods:Through searching professional medical databases such as PubMed,Ovid,Embase,Cochrane Library,CBM,CNKI,Wan Fang Data,VIP Data,a comparative study of laparoscopic hernior repairing by IPOM-PLUS and IPOM was selected from the date of database construction to February 2018,including Chinese and English study.According to the NOS scale,the study were selected and evaluated.We extracted the data from those literatures.The data is analyzed by Revman5.3.By evaluating the size of the abdominal wall defect,the size of the mesh,the incidence of seroma,the incidence of bulging,the incidence of chronic pain,the time of hospitalization,the time of operation,the score of pain,the chronic pain,the cardiopulmonary complications,the gastrointestinal complications,the complication of the incision,and the other complications,we compaired the two operative methods in the treatment of abdominal incisional hernia.Results:644 articles were retrieved and 9 studies(1059 cases)were included.The results showed that compared with the IPOM method,IPOM-PLUS could reduce the incidence of.seroma(P=0.003,OR=0.45,95%CI[0.27,0.76]),bulging of the mesh(P=0.0002,OR=0,07,95%CI[0.02,0.28])and recurrence(P=0.01,P=0.01,0.56,).But in operation time,IPOM-PLUS operation was significantly longer than IPOM operation(P=0.009,MD= 13.91,95%CI[3.53,24.29]).There was no significant difference in the size of defect(P=0.08,MD=-5.36,95%CI[-11.34,0.62]),time of hospitalization(P=0.06,MD=-0.83,95%CI[-1.68,0.33]),chronic pain(P=0.94,OR=0.96,95%CI[0.30,3.11]),other complications of mesh(P=0.26,OR=0.57,95%CI[0.21,1.53]),gastrointestinal complications(P=0.88,OR=0.94,95%CI[0.43,2.06]),cardiopulmonary complications(P=0.95,OR=1.04,95%CI[0.33,3.30]),incision complications(P=0.22,OR=0.50,95%CI[0.17,1.50]),and other complications(P=0.28,OR=0.62,95%CI[0.27,1.46]).Conclusion:Because we included a few of research and studies was low quality,few samples in this Meta analysis,there are more different among each of studies and many factors could affect the reliability of the results.Therefore,this study is difficult to judge the advantages of IPOM-PLUS and IPOM.It is necessary to be cautious about the results of this study.If we want to get more effective and reliable conclusions,we need more clinical comparative studies with high quality and large samples. |
