Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials

A Grant, P Go, A Fingerhut, A Kingsnorth, J Merello, P O'Dwyer, J Payne, N Scott, K Webb, S Ross, P Aitola, B Anderberg, D Arvidsson, J Barkun, M Bay-Nielsen, G Beets, R Bittner, S Bringman, C Castoro, G Champault & 31 others C Dirksen, C Filipi, R Fitzgibbons, R Girao, E Hatzitheoklitos, P Hauters, T Heikkinen, H Jeekel, B Johansson, A Kald, H Kehlet, N Khoury, A Klingler, R Kozol, B Leibl, I Macintre, J McGillicuddy, G Maddern, B Millat, E Nilsson, P Nordin, A Paganini, G Papplardo, J S Pedros, R Schmitz, A Schwarz, S Shah, R Simmermacher, Z Sledzinski, D Stoker, EU Hernia Trialists Collaboration

Research output: Contribution to journalLiterature review

275 Citations (Scopus)

Abstract

Background: Open tension-free methods of groin hernia repair have been widely adopted despite little rigorous evaluation.

Methods: Information was assimilated from all randomized or quasi-randomized trials comparing open mesh with open non-mesh methods to assess benefits and safety. Electronic databases were searched and members of the EU Hernia Trialists Collaboration consulted to identify trials. Prespecified data items were extracted from reports, and quantitative or, if not possible, qualitative meta-analysis was performed.

Results: Fifteen eligible trials, which included 4005 participants, were identified. There were similar numbers of complications in each group, with few data to address short-term pain and length of stay in hospital. Return to usual activities was quicker in the mesh group for seven of ten trials (P not significant). There were fewer reported recurrences in the mesh groups: overall 21 (1.4 per cent) of 1513 versus 72 (4.4 per cent) of 1634 (odds ratio 0.39 (95 per cent confidence interval 0.25-0.59); P < 0.001).

Conclusion: Although the rigorous search maximized trial identification, formal meta-analysis was limited by the variation in trial reporting. Within the data available, mesh repair was associated with fewer recurrences.

Original languageEnglish
Pages (from-to)854-859
Number of pages6
JournalBritish Journal of Surgery
Volume87
Publication statusPublished - 2000

Keywords

  • INGUINAL-HERNIA
  • LICHTENSTEIN
  • SHOULDICE

Cite this

Grant, A., Go, P., Fingerhut, A., Kingsnorth, A., Merello, J., O'Dwyer, P., ... EU Hernia Trialists Collaboration (2000). Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. British Journal of Surgery, 87, 854-859.

Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. / Grant, A ; Go, P ; Fingerhut, A ; Kingsnorth, A ; Merello, J ; O'Dwyer, P ; Payne, J ; Scott, N ; Webb, K ; Ross, S ; Aitola, P ; Anderberg, B ; Arvidsson, D ; Barkun, J ; Bay-Nielsen, M ; Beets, G ; Bittner, R ; Bringman, S ; Castoro, C ; Champault, G ; Dirksen, C ; Filipi, C ; Fitzgibbons, R ; Girao, R ; Hatzitheoklitos, E ; Hauters, P ; Heikkinen, T ; Jeekel, H ; Johansson, B ; Kald, A ; Kehlet, H ; Khoury, N ; Klingler, A ; Kozol, R ; Leibl, B ; Macintre, I ; McGillicuddy, J ; Maddern, G ; Millat, B ; Nilsson, E ; Nordin, P ; Paganini, A ; Papplardo, G ; Pedros, J S ; Schmitz, R ; Schwarz, A ; Shah, S ; Simmermacher, R ; Sledzinski, Z ; Stoker, D ; EU Hernia Trialists Collaboration.

In: British Journal of Surgery, Vol. 87, 2000, p. 854-859.

Research output: Contribution to journalLiterature review

Grant, A, Go, P, Fingerhut, A, Kingsnorth, A, Merello, J, O'Dwyer, P, Payne, J, Scott, N, Webb, K, Ross, S, Aitola, P, Anderberg, B, Arvidsson, D, Barkun, J, Bay-Nielsen, M, Beets, G, Bittner, R, Bringman, S, Castoro, C, Champault, G, Dirksen, C, Filipi, C, Fitzgibbons, R, Girao, R, Hatzitheoklitos, E, Hauters, P, Heikkinen, T, Jeekel, H, Johansson, B, Kald, A, Kehlet, H, Khoury, N, Klingler, A, Kozol, R, Leibl, B, Macintre, I, McGillicuddy, J, Maddern, G, Millat, B, Nilsson, E, Nordin, P, Paganini, A, Papplardo, G, Pedros, JS, Schmitz, R, Schwarz, A, Shah, S, Simmermacher, R, Sledzinski, Z, Stoker, D & EU Hernia Trialists Collaboration 2000, 'Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials', British Journal of Surgery, vol. 87, pp. 854-859.
Grant, A ; Go, P ; Fingerhut, A ; Kingsnorth, A ; Merello, J ; O'Dwyer, P ; Payne, J ; Scott, N ; Webb, K ; Ross, S ; Aitola, P ; Anderberg, B ; Arvidsson, D ; Barkun, J ; Bay-Nielsen, M ; Beets, G ; Bittner, R ; Bringman, S ; Castoro, C ; Champault, G ; Dirksen, C ; Filipi, C ; Fitzgibbons, R ; Girao, R ; Hatzitheoklitos, E ; Hauters, P ; Heikkinen, T ; Jeekel, H ; Johansson, B ; Kald, A ; Kehlet, H ; Khoury, N ; Klingler, A ; Kozol, R ; Leibl, B ; Macintre, I ; McGillicuddy, J ; Maddern, G ; Millat, B ; Nilsson, E ; Nordin, P ; Paganini, A ; Papplardo, G ; Pedros, J S ; Schmitz, R ; Schwarz, A ; Shah, S ; Simmermacher, R ; Sledzinski, Z ; Stoker, D ; EU Hernia Trialists Collaboration. / Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. In: British Journal of Surgery. 2000 ; Vol. 87. pp. 854-859.
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abstract = "Background: Open tension-free methods of groin hernia repair have been widely adopted despite little rigorous evaluation.Methods: Information was assimilated from all randomized or quasi-randomized trials comparing open mesh with open non-mesh methods to assess benefits and safety. Electronic databases were searched and members of the EU Hernia Trialists Collaboration consulted to identify trials. Prespecified data items were extracted from reports, and quantitative or, if not possible, qualitative meta-analysis was performed.Results: Fifteen eligible trials, which included 4005 participants, were identified. There were similar numbers of complications in each group, with few data to address short-term pain and length of stay in hospital. Return to usual activities was quicker in the mesh group for seven of ten trials (P not significant). There were fewer reported recurrences in the mesh groups: overall 21 (1.4 per cent) of 1513 versus 72 (4.4 per cent) of 1634 (odds ratio 0.39 (95 per cent confidence interval 0.25-0.59); P < 0.001).Conclusion: Although the rigorous search maximized trial identification, formal meta-analysis was limited by the variation in trial reporting. Within the data available, mesh repair was associated with fewer recurrences.",
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author = "A Grant and P Go and A Fingerhut and A Kingsnorth and J Merello and P O'Dwyer and J Payne and N Scott and K Webb and S Ross and P Aitola and B Anderberg and D Arvidsson and J Barkun and M Bay-Nielsen and G Beets and R Bittner and S Bringman and C Castoro and G Champault and C Dirksen and C Filipi and R Fitzgibbons and R Girao and E Hatzitheoklitos and P Hauters and T Heikkinen and H Jeekel and B Johansson and A Kald and H Kehlet and N Khoury and A Klingler and R Kozol and B Leibl and I Macintre and J McGillicuddy and G Maddern and B Millat and E Nilsson and P Nordin and A Paganini and G Papplardo and Pedros, {J S} and R Schmitz and A Schwarz and S Shah and R Simmermacher and Z Sledzinski and D Stoker and {EU Hernia Trialists Collaboration}",
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TY - JOUR

T1 - Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials

AU - Grant, A

AU - Go, P

AU - Fingerhut, A

AU - Kingsnorth, A

AU - Merello, J

AU - O'Dwyer, P

AU - Payne, J

AU - Scott, N

AU - Webb, K

AU - Ross, S

AU - Aitola, P

AU - Anderberg, B

AU - Arvidsson, D

AU - Barkun, J

AU - Bay-Nielsen, M

AU - Beets, G

AU - Bittner, R

AU - Bringman, S

AU - Castoro, C

AU - Champault, G

AU - Dirksen, C

AU - Filipi, C

AU - Fitzgibbons, R

AU - Girao, R

AU - Hatzitheoklitos, E

AU - Hauters, P

AU - Heikkinen, T

AU - Jeekel, H

AU - Johansson, B

AU - Kald, A

AU - Kehlet, H

AU - Khoury, N

AU - Klingler, A

AU - Kozol, R

AU - Leibl, B

AU - Macintre, I

AU - McGillicuddy, J

AU - Maddern, G

AU - Millat, B

AU - Nilsson, E

AU - Nordin, P

AU - Paganini, A

AU - Papplardo, G

AU - Pedros, J S

AU - Schmitz, R

AU - Schwarz, A

AU - Shah, S

AU - Simmermacher, R

AU - Sledzinski, Z

AU - Stoker, D

AU - EU Hernia Trialists Collaboration

PY - 2000

Y1 - 2000

N2 - Background: Open tension-free methods of groin hernia repair have been widely adopted despite little rigorous evaluation.Methods: Information was assimilated from all randomized or quasi-randomized trials comparing open mesh with open non-mesh methods to assess benefits and safety. Electronic databases were searched and members of the EU Hernia Trialists Collaboration consulted to identify trials. Prespecified data items were extracted from reports, and quantitative or, if not possible, qualitative meta-analysis was performed.Results: Fifteen eligible trials, which included 4005 participants, were identified. There were similar numbers of complications in each group, with few data to address short-term pain and length of stay in hospital. Return to usual activities was quicker in the mesh group for seven of ten trials (P not significant). There were fewer reported recurrences in the mesh groups: overall 21 (1.4 per cent) of 1513 versus 72 (4.4 per cent) of 1634 (odds ratio 0.39 (95 per cent confidence interval 0.25-0.59); P < 0.001).Conclusion: Although the rigorous search maximized trial identification, formal meta-analysis was limited by the variation in trial reporting. Within the data available, mesh repair was associated with fewer recurrences.

AB - Background: Open tension-free methods of groin hernia repair have been widely adopted despite little rigorous evaluation.Methods: Information was assimilated from all randomized or quasi-randomized trials comparing open mesh with open non-mesh methods to assess benefits and safety. Electronic databases were searched and members of the EU Hernia Trialists Collaboration consulted to identify trials. Prespecified data items were extracted from reports, and quantitative or, if not possible, qualitative meta-analysis was performed.Results: Fifteen eligible trials, which included 4005 participants, were identified. There were similar numbers of complications in each group, with few data to address short-term pain and length of stay in hospital. Return to usual activities was quicker in the mesh group for seven of ten trials (P not significant). There were fewer reported recurrences in the mesh groups: overall 21 (1.4 per cent) of 1513 versus 72 (4.4 per cent) of 1634 (odds ratio 0.39 (95 per cent confidence interval 0.25-0.59); P < 0.001).Conclusion: Although the rigorous search maximized trial identification, formal meta-analysis was limited by the variation in trial reporting. Within the data available, mesh repair was associated with fewer recurrences.

KW - INGUINAL-HERNIA

KW - LICHTENSTEIN

KW - SHOULDICE

M3 - Literature review

VL - 87

SP - 854

EP - 859

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

ER -