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Does mesh offer an advantage over tissue in the open repair of umbilical hernias? A systematic review and meta-analysis

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Abstract

Purpose

To determine the best surgical approach for the open repair of primary umbilical hernias.

Methods

Studies were identified through searching MEDLINE, EMBASE, and the Cochrane database, as well as hand-searching references. Randomized controlled trials (RCTs) and observational studies comparing mesh to suture repair for primary umbilical hernias published between January 1965 and October 2009 were included. Data regarding the recurrence rate, complications, number of subjects, length of follow-up, size of hernia, and type of mesh were extracted. Log odds ratios were calculated and weighed by the Mantel–Haenszel method to obtain a pooled estimate with 95% confidence interval (CI). A fixed effects model was used.

Results

Three RCTs and ten observational studies were identified. The pooled odds ratio (OR) for RCTs was 0.09 in favor of mesh (95% CI 0.02–0.39). The pooled OR for observational studies was 0.40 in favor of mesh (95% CI 0.21–0.75). There was no difference in complication rates between mesh and tissue repair in RCTs or observational studies.

Conclusions

The use of mesh in umbilical hernia repair results in decreased recurrence and similar wound complications rates compared to tissue repair for primary umbilical hernias.

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Acknowledgments

The authors declare that they have no conflict of interest. Search strategies guidance: Mimi Doyle-Waters, MA, MLIS.

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Authors and Affiliations

  1. Division of General Surgery, Providence Health Care, St. Paul’s Hospital, Centre for Health Evaluation and Outcomes Research, University of British Columbia, Room C310, 1,081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    C. J. Brown

  2. University of British Columbia, Room 3,100, 910 West 10th Avenue, Vancouver, BC, V5Z 4E3, Canada

    N. Aslani

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  1. N. Aslani
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  2. C. J. Brown
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Correspondence to C. J. Brown.

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Aslani, N., Brown, C.J. Does mesh offer an advantage over tissue in the open repair of umbilical hernias? A systematic review and meta-analysis. Hernia 14, 455–462 (2010). https://doi.org/10.1007/s10029-010-0705-9

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  • DOI: https://doi.org/10.1007/s10029-010-0705-9

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