Comparison of self-gripping mesh and sutured mesh in open inguinal hernia repair: A meta-analysis of long-term results.

BACKGROUND: Complications after inguinal hernioplasty pose a significant burden on individual patients and society because of high numbers of repair procedures. Recently, the long-term results of a self-gripping ProGrip mesh for open inguinal hernia repair have become available. The aim of this meta-analyses was to compare these long-term results with the results of a Lichtenstein hernioplasty with a sutured mesh focusing on chronic pain, recurrence rate, foreign body sensation, and operation duration.

METHODS: A systematic review of the literature was undertaken to identify randomized controlled trials comparing open inguinal hernia repair with a self-gripping ProGrip mesh and a conventional Lichtenstein hernioplasty.

RESULTS: In the present meta-analysis, the outcomes of 10 randomized controlled trials enrolling 2,541 patients were pooled. The mean follow-up was 24 months (range 6-72 months). There was no significant difference in the incidence of chronic pain (odds ratio = 0.93; 95% confidence interval, 0.74-1.18), recurrence (odds ratio = 1.34; 95% confidence interval, 0.82-2.19), or foreign body sensation (odds ratio = 0.82; 95% confidence interval, 0.65-1.03), between the self-gripping mesh and sutured mesh group at all follow-up time points. The mean operating time was significantly shorter (odds ratio = -7.58; 95% confidence interval, -9.58 to -5.58) in the self-gripping mesh group.

CONCLUSION: The self-gripping mesh has comparable results with a sutured mesh regarding the incidence of chronic postoperative inguinal pain, recurrence and foreign body sensation. However, long-term results still are based on relatively small patient numbers and outcomes measures are heterogenic. The main advantage of the self-gripping mesh is the consistently significantly reduced operation time.