Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair. Issue 7 (20th March 2019)

• Record Type: Journal Article
• Authors: Patterson, T J; Beck, J; Currie, P J; Spence, R A J; Spence, G
• Is Part Of: British journal of surgery. Volume 106:Issue 7(2019)
• Page Start: 824
• Page End: 836
• Publication Date: 2019-03-20
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.11139
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: Inguinal hernia repair is a common low-risk intervention. Patient-reported outcomes (PROs) are being used increasingly as primary outcomes in clinical trials. The aim of this study was to review and meta-analyse the PROs in RCTs comparing laparoscopic versus open inguinal hernia repair techniques in adult patients. Methods: A systematic review and meta-analysis was carried out in accordance with PRISMA guidelines. Only RCTs in peer-reviewed journals were considered. PubMed, Ovid Embase, Scopus and the Cochrane Library were searched. In addition, four trial registries were searched. The search interval was between 1 January 1998 and 1 May 2018. Identified publications were reviewed independently by two authors. The review was registered in the PROSPERO database (CRD42018099552). Bias was assessed using the Cochrane Collaboration risk-of-bias tool. Results: Some 7192 records were identified, from which 58 unique RCTs were selected. Laparoscopic hernia repair was associated with significantly less postoperative pain in three intervals: from 2 weeks to within 6 months after surgery (risk ratio (RR) 0·74, 95 per cent c.i. 0·62 to 0·88), 6 months to 1 year (RR 0·74, 0·59 to 0·93) and 1 year onwards (RR 0·62, 0·47 to 0·82). Paraesthesia (RR 0·27, 0·18 to 0·40) and patient-reported satisfaction (RR 0·91, 0·85 to 0·98) were also significantly better in the laparoscopic repair group. Conclusion: The data and analysis reported in this study reflect the most up-to-date evidence available for the surgeon to counsel patients. It was constrained by heterogeneity of reporting for several outcomes. Graphical Abstract: Detailed knowledge of patient-reported outcomes is becoming increasingly important in the counselling of the surgical patient. The authors of this study have conducted a systematic review examining open versus laparoscopic methods of inguinal hernia repair. They have found that laparoscopic techniques, as a group, have favourable results in the areas of pain, paraesthesia and patient satisfaction. Laparoscopic generally advantageous