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Glue Versus Suture Fixation of Mesh During Open Repair of Inguinal Hernias: A Systematic Review and Meta-analysis

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Abstract

Background

Glue fixation of mesh has been explored for some time as a strategy for reducing postoperative chronic groin pain. Previous studies have come to different conclusions about the superiority of one method over another. We conducted a meta-analysis of randomized control trials comparing the performance of glue versus suture fixation of mesh in open inguinal hernioplasty.

Methods

Studies published up to November 2012 were searched using PubMed, EMBASE, MEDLINE, Cochrane Library, and the international standard randomised controlled trials number (ISRCTN) register. Mean differences (MDs) were derived from secondary continuous outcomes and pooled risk ratios (RRs) for categoric outcomes. Meta-analysis was conducted utilizing the random-effects and fixed-effects models as appropriate.

Results

Ten randomized controlled studies were selected, with a total of 1,623 patients. Glue fixation for open inguinal hernioplasty reduced chronic groin pain (RR 0.46, 95 % confidence interval (CI) 0.22–0.97), hematoma (RR 0.56, 95 % CI 0.34–0.90), acute postoperative pain (MD −7.92, 95 % CI, −13.17 to −2.66), and time taken to return to normal activities (MD −1.39, 95 % CI, −2.58 to −0.21). There was no evidence of an increase in adverse outcomes including recurrence with glue fixation (RR 0.83, 95 % CI 0.30–2.35).

Conclusions

Glue fixation of mesh for open inguinal hernioplasty is superior in many outcomes including the reduction of chronic groin pain. Glue fixation was not associated with an increased risk of hernia recurrence.

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References

  1. Lichtenstein IL, Shulman AG (1986) Ambulatory outpatient hernia surgery: including a new concept, introducing tension-free repair. Int Surg 71:1–4

    PubMed  CAS  Google Scholar 

  2. http://www.nice.org.uk/media/D7A/57/UptakeReportLapHerniaPublicationApril.pdf. Accessed 1 Nov 2012

  3. Awad S, Fagan S (2004) Current approaches to inguinal hernia repair. Am J Surg 118:9S–16S

    Article  Google Scholar 

  4. Kumar S, Wilson RG, Nixon SJ et al (2002) Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg 89:1476–1479

    Article  PubMed  CAS  Google Scholar 

  5. Callesen T, Bech K, Kehlet H (1999) Prospective study of chronic pain after groin hernia repair. Br J Surg 86:1528–1531

    Article  PubMed  CAS  Google Scholar 

  6. Bay-Nielsen M, Perkins FM, Kehlet H, Database Danish Hernia (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233:1–7

    Article  PubMed  CAS  Google Scholar 

  7. Poobalan AS, Bruce J, King PM et al (2001) Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 88:1122–1126

    Article  PubMed  CAS  Google Scholar 

  8. PaajanenH Scheinin T, Vironen J (2010) Commentary: Nationwide analysis of complications related to inguinal hernia surgery in Finland: a 5 year register study of 55,000 operations. Am J Surg 199:746–751

    Article  Google Scholar 

  9. Nahabedian MY, Dellon AL (1997) Outcome of the operative management of nerve injuries in the ilioinguinal region. J Am Coll Surg 184:265–268

    PubMed  CAS  Google Scholar 

  10. Di Vita G, Milano S, Grazzetta M et al (2000) Tension-free hernia repair is associated with an increase in inflammatory response markers against the mesh. Am J Surg 180:203–207

    Article  PubMed  Google Scholar 

  11. Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518

    Article  PubMed  CAS  Google Scholar 

  12. McCormack K, Scott NW, Go PM et al (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1:CD001785

    PubMed  Google Scholar 

  13. Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12

    Article  PubMed  CAS  Google Scholar 

  14. Campanelli G, Pascual MH, Hoeferlin A et al (2012) Randomized, controlled, blinded trial of Tiseel/Tissucol for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair: results of the TIMELI trial. Ann Surg 225:650–657

    Article  Google Scholar 

  15. Dabrowiecki S, Pierscinski S, Szczesny W (2012) Glubran 2 glue for mesh fixation in Lichtenstein’s hernia repair: a double-blind randomized study. Wideochir Inne Tech Malo Inwazyjne 7:96–104

    PubMed  Google Scholar 

  16. Kim-Fuchs C, Angst E, Vorburger S et al (2012) Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results. Hernia 16:21–27

    Article  PubMed  CAS  Google Scholar 

  17. Eldabe Mikhail A, Palomo Luquero A, Reoyo Pascual JF et al (2012) Prosthetic material fixation in open inguinal hernioplasty: suture vs synthetic glue. Cir Esp 90:446–452

    Article  PubMed  Google Scholar 

  18. Nowobilski W, Dobosz M, Wojciechowicz T et al (2004) Lichtenstein inguinal hernioplasty using butyl-2-cyanoacrylate versus sutures. Eur Surg Res 36:367–370

    Article  PubMed  CAS  Google Scholar 

  19. Paajanen H, Kossi J, Silvasti S et al (2011) Randomized clinical trial if tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair. Br J Surg 98:1245–1251

    Article  PubMed  CAS  Google Scholar 

  20. Shen YM, Sun WB, Chen J et al (2012) NBCA medical adhesive (n-butyl-2-cyanoacrylate) versus suture for patch fixation in Lichtenstein inguinal herniorrhaphy: a randomized controlled trial. Surgery 151:550–555

    Article  PubMed  Google Scholar 

  21. Sozen S, Cetinkunar S, Emir S, et al (2012) Comparing sutures and human fibrin glue for mesh fixation during open inguinal hernioplasty. Ann Ital Chir [Epub ahead of print]

  22. Testini M, Lissidini G, Poli E et al (2010) A single-surgeon randomized trial comparing sutures, n-butyl-2-cyanoacrylate and human fibrin glue for mesh fixation during primary inguinal hernia repair. Can J Surg 53:155–160

    PubMed  Google Scholar 

  23. Wong JU, Leung TH, Huang CC et al (2011) Comparing chronic pain between fibrin sealant and suture fixation for bilayer polypropylene mesh inguinal hernioplasty: a randomized clinical trial. Am J Surg 202:34–38

    Article  PubMed  Google Scholar 

  24. Moher D, Liberati A, Tetzlaff J et al (2009) The PRISMA group: preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. 6:e1000097

    Google Scholar 

  25. http://130.226.106.152/openlearning/html/mod13-4.htm. Accessed 1 Nov 2012

  26. Courtney CA, Duffy K, Serpell MG et al (2002) Outcome of patients with severe chronic pain following repair of groin hernia. Br J Surg 89:1310–1314

    Article  PubMed  CAS  Google Scholar 

  27. Kaul A, Hutfless S, Le H et al (2012) Staple versus fibrin glue fixation in laparoscopic total extraperitoneal repair of inguinal hernia: a asystematic review and meta-analysis. Surg Endosc 26:1269–1278

    Article  PubMed  Google Scholar 

  28. Nienhuijs S, Staal E, Strobbe L et al (2007) Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg 194:394–400

    Article  PubMed  Google Scholar 

  29. Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95:69–76

    Article  PubMed  CAS  Google Scholar 

  30. Canonico S (2003) The use of human fibrin glue in the surgical operations. Acta Biomed 74:S21–S25

    Google Scholar 

  31. http://www.tisseelhernia.co.uk/what-is-tisseel.html. Accessed 1 Nov 2012

  32. Katkhouda N, Mavor E, Friedlander MH et al (2001) Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair. Ann Surg 233:18–25

    Article  PubMed  CAS  Google Scholar 

  33. Zieren J, Castenholz E, Baumgart E et al (1999) Effects of fibrin glue and growth factors released from platelets on abdominal hernia repair with a resorbable PGA mesh: experimental study. J Surg Res 85:267–272

    Article  PubMed  CAS  Google Scholar 

  34. Petter-Puchner AH, Fortelny R, Mittermayr R et al (2005) Fibrin sealing versus stapling of hernia meshes in an onlay model in the rat. Hernia 9:322–329

    Article  PubMed  Google Scholar 

  35. Eriksen JR, Bech JI, Linnemann D et al (2008) Laparoscopic intraperitoneal mesh fixation with fibrin sealant (Tisseel) vs. titanium tacks: a randomised controlled experimental study in pigs. Hernia 12:483–491

    Article  PubMed  CAS  Google Scholar 

  36. Kukleta JF, Freytoy C, Weber M (2012) Efficiency and safety of mesh fixation in laparoscopic inguinal hernia repair using n-butyl cyanoacrylate: long-term biocompatibility in over 1,300 mesh fixations. Hernia 16:153–162

    Article  PubMed  CAS  Google Scholar 

  37. http://www.openepi.com/OE2.3/Menu/OpenEpiMenu.htm. Accessed 1 Nov 2012

  38. Bruna EM, Cantos PM, Artigues SD (2010) Use of adhesive mesh in hernioplasty compared to the conventional technique: results of a randomised prospective study. Cir Esp 88:253–258

    Article  Google Scholar 

  39. Torcivia A, Vons C, Barrat C et al (2011) Influence of mesh type on the quality of early outcomes after inguinal hernia repair in ambulatory setting controlled study: Glucamesh® vs Polypropylene®. Langenbecks Arch Surg 396:173–178

    Article  PubMed  Google Scholar 

  40. Kapischke M, Schulze H, Caliebe A (2010) Self-fixating mesh for the Lichtenstein procedure: a prestudy. Langenbecks Arch Surg 395:317–322

    Article  PubMed  Google Scholar 

  41. Pierides G, Scheinin T, Remes V et al (2012) Randomized comparison of self-fixating and sutured mesh in open inguinal hernia repair. Br J Surg 99:630–636

    Article  PubMed  CAS  Google Scholar 

  42. Sajid MS, Leaver C, Baig MK et al (2012) Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair. Br J Surg 99:29–37

    Article  PubMed  CAS  Google Scholar 

  43. O’Reilly EA, Burke JP, O’Connell PR (2012) A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Ann Surg 255:846–853

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Mr. Lawrence Colvin for proofreading this article.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, UK

    Hugh Shunsuke Colvin

  2. Department of General Surgery, Ninewells Hospital, Dundee, DD1 9SY, UK

    Ahsan Rao

  3. Department of Surgery, University of Insubria, Istituto Clinico Sant’ Ambrogio, Milano, Italy

    Marta Cavali & Giampiero Campanelli

  4. Department of General Surgery, Victoria Hospital Hayfield Road, Kirkcaldy, Fife, KY2 5AH, UK

    Amin Ibrahim Amin

Authors
  1. Hugh Shunsuke Colvin
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  2. Ahsan Rao
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  4. Giampiero Campanelli
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Correspondence to Hugh Shunsuke Colvin.

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Colvin, H.S., Rao, A., Cavali, M. et al. Glue Versus Suture Fixation of Mesh During Open Repair of Inguinal Hernias: A Systematic Review and Meta-analysis. World J Surg 37, 2282–2292 (2013). https://doi.org/10.1007/s00268-013-2140-4

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