During laparoscopic hernia repair, hernia sac transection shortens hospital stay compared to hernia sac reduction

There is no consensus regarding hernia sac management during laparoscopic hernia repair, and this systematic review and meta-analysis aimed to compare the postoperative outcomes of sac reduction (RS) and sac transection (TS) during laparoscopic mesh hernia repair.

Researchers conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 and AMSTAR 2 (Assessing the Methodological Quality of Systematic Reviews) guidelines. We used the RevMan 5.4 statistical package from the Cochrane collaboration for meta-analysis. A random effects model was used.

Results

The literature search yielded six eligible studies including 2941 patients: 821 patients in the TS group and 2120 patients in the RS group. In the pooled analysis, the TS group was associated with a lower incidence of seroma (OR = 1.71; 95% CI [1.22, 2.39], p = 0.002) and shorter hospital stay (MD = -0.07; 95% CI [-0.12, -0.02], p = 0.008). There was no significant difference between the two groups in terms of morbidity (OR = 0.87; 95% CI [0.34, 2.19], p = 0.76), operative time (MD = -4.39; 95% CI [-13.62, 4.84], p = 0.35), recurrence (OR = 2.70; 95% CI [0.50, 14.50], p = 0.25), and Postoperative pain.

This meta-analysis showed that hernia sac transection is associated with a lower seroma rate and shorter hospital stay with similar morbidity, operative time, recurrence, and postoperative pain compared to the reduction of the hernia sac.

Reference:

Chaouch, M.A., Hussain, M.I., Gouader, A. et al. A systematic review and meta-analysis of hernia sac management in laparoscopic groin hernia mesh repair: reduction or transection?. BMC Surg 23, 249 (2023). https://doi.org/10.1186/s12893-023-02147-8

Keywords:

During, laparoscopic, hernia repair, hernia sac, transection, associated, shorter, hospital stay, compared, hernia sac reduction, BMC Surgery, Chaouch, M.A., Hussain, M.I., Gouader, A.