Lightweight versus heavyweight in inguinal hernia repair: a meta-analysis.
OBJECTIVE
The aim of this article is to compare the outcomes of lightweight mesh and heavyweight mesh in inguinal hernia repair.


METHODS
A comprehensive literature search was undertaken to identify studies comparing the influence of lightweight and heavyweight meshes on inguinal hernia.


RESULTS
The present meta-analysis pooled the effects of outcomes of a total 5,389 patients enrolled into 16 randomized controlled trials and 5 comparative studies. Lightweight mesh repair was associated with a significant less incidence of chronic postoperative pain [OR = 0.72, 95 % CI (0.57, 0.91)] and less feeling of foreign body than heavyweight mesh repair [OR = 0.50, 95 % CI (0.37, 0.67)]. Recurrence at 12 months was marginally increased in lightweight group (p = 0.05) [RD = 0.01, 95 % CI (0.00, 0.02)]. However, statistically there was no difference in the incidence of seroma [OR = 0.80, 95 % CI (0.52, 1.23)], infection [RD = -0.00, 95 % CI (-0.01, 0.00)], and testicular atrophy [RD = 0.01, 95 % CI (-0.01, 0.02)].


CONCLUSIONS
There was no difference regarding the incidence of seroma, infection, and testicular atrophy between lightweight mesh versus heavyweight mesh for inguinal hernia. There is a concern on the recurrence when lightweight mesh is used in large inguinal hernias. However, lightweight mesh repair do have advantages in terms of chronic postoperative pain and feeling of foreign body, and further well-structured trials with improved standardization of hernia types, operative techniques are necessary.
Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing 210009, JiangSu, People's Republic of China. Lijunshenghd@126.com
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Li
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Ji
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Cheng
D001284:Atrophy / Q000209:etiology; D059350:Chronic Pain / Q000209:etiology; D005547:Foreign Bodies / Q000150:complications; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D011126:Polypropylenes / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012677:Sensation; D049291:Seroma / Q000209:etiology; D013526:Surgical Mesh / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology; D013737:Testis / Q000473:pathology*
D011126:Polypropylenes