title: Fibrin glue versus staple for mesh fixation in laparoscopic transabdominal preperitoneal repair of inguinal hernia: a meta-analysis and systematic review.
abstract: The aim of this study was to compare outcomes of mesh fixation using fibrin glue versus staple in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia.
  
  
  
  Database searches were carried out in PubMed, Embase, Cochrane Library, Web of Science and Cochrane databases until February 2016 using specific search terms. Studies which compared fibrin glue and staple for mesh fixation in laparoscopic transabdominal preperitoneal repair of inguinal hernia were enrolled. Outcomes, including inguinal hernia recurrence, chronic inguinal pain, seroma or hematoma formation and operating time, were measured.
  
  
  
  Four randomized controlled trials (RCTs, 430 patients) and six non-randomized controlled trials (non-RCTs, 8637 patients) were analyzed. Meta-analysis of the four RCTs showed no significant difference in hernia recurrence (OR 2.10, 95 % CI 0.61, 7.22), seroma or hematoma formation (OR 0.55, 95 % CI 0.27, 1.14) and operating time (SMD 0.80, 95 % CI -0.34, 1.94). Similarly, there was no significant difference in most of the outcomes of the six non-RCTs.
  
  
  
  Our meta-analysis and systematic review shows that the use of fibrin glue fixation may provide an alternative approach to staple fixation in TAPP inguinal hernia repair without increasing the postoperative morbidity. Large-scale RCTs with long-term follow-up are still needed to further assess postoperative outcomes such as chronic pain and disease recurrence.
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Rd, Hangzhou, 310016, China.
authors.forename: Zhaoqi
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Rd, Hangzhou, 310016, China.
authors.forename: Xiaoxiao
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Rd, Hangzhou, 310016, China.
authors.forename: Shuting
authors.initials: S
authors.lastname: Zhai
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Rd, Hangzhou, 310016, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhong
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Rd, Hangzhou, 310016, China. huangdiyu2000@163.com.
authors.forename: Diyu
authors.identifier: 0000-0001-7549-5106
authors.initials: D
authors.lastname: Huang
mesh_terms: D015718:Fibrin Tissue Adhesive; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D010537:Peritoneum / Q000601:surgery; D013526:Surgical Mesh; D013537:Sutures; D014014:Tissue Adhesives; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives
keywords: Inguinal hernia; Laparoscopic; Mesh fixation; Meta-analysis; Transabdominal preperitoneal repair