In:
Digestive Surgery, S. Karger AG, Vol. 30, No. 4-6 ( 2013), p. 401-409
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Incisional hernia (IH) remains one of the most frequent postoperative complications after abdominal surgery. As a consequence, primary mesh augmentation (PMA), a technique to strengthen the abdominal wall, has been gaining popularity. This meta-analysis was conducted to evaluate the prophylactic effect of PMA on the incidence of IH compared to primary suture (PS). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A meta-analysis was conducted according to the PRISMA guidelines. Randomized controlled trials (RCTs) comparing PMA and PS for closing the abdominal wall after surgery were included. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Out of 576 papers, 5 RCTs were selected comprising 346 patients. IH occurred significantly less in the PMA group (RR 0.25, 95% CI 0.12-0.52, I 〈 sup 〉 2 〈 /sup 〉 0%; p 〈 0.001). No difference could be observed with regard to wound infection (RR 0.86, 95% CI 0.39-1.91, I 〈 sup 〉 2 〈 /sup 〉 0%; p = 0.71) or seroma (RR 1.22, 95% CI 0.64-2.33, I 〈 sup 〉 2 〈 /sup 〉 0%; p = 0.55). A trend was observed for chronic pain in favor of the PS group (RR 5.95, 95% CI 0.74-48.03, I 〈 sup 〉 2 〈 /sup 〉 0%; p = 0.09). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The use of PMA for abdominal wall closure is associated with significantly lower incidence of IH compared to PS.
Type of Medium:
Online Resource
ISSN:
0253-4886
,
1421-9883
Language:
English
Publisher:
S. Karger AG
Publication Date:
2013
detail.hit.zdb_id:
1468560-7
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