Laparoscopic vs open mesh repair for the treatment of recurrent inguinal hernia：A meta-analysis

doi:10.3877/cma.j.issn.1674-392X.2025.03.014

Abstract

Abstract:

Objective

To evaluate the effects of laparoscopic and open mesh repair in the treatment of recurrent inguinal hernia by a meta-analysis of randomized controlled trials （RCTs）.

Methods

A comprehensive， systematic meta- analysis of RCTs on the effects of laparoscopic and open mesh repair in the treatment of recurrent inguinal hernia was performed. Studies were identified by searching PUBMED， EMBASE， Science Direct， Cochrane registered controlled trials and China national knowledge infrastructure （CNKI）， Wanfang， and other major domestic and foreign databases （until December 30， 2021）. Summary odd ratios or weighted mean differences with 95% confidence intervals were adopted for the calculation of each outcome by fixed or random effects model.

Results

A total of 10 RCTs involving 1034 patients were included. No statistically significant difference were found between the two groups in the recurrent rate （P=0.07； OR=0.61， 95% CI 0.35-1.05）， hematoma （P=0.16； OR=0.45， 95%CI 0.14-1.38）， urinary retention （P=0.82； OR=0.92， 95% CI 0.43-1.96）， acute pain （P=0.07， OR=1.83， 95%CI 0.95-3.54）） and operation times （P=0.62， MD 5.92， 95% CI -17.22-29.07）. The laparoscopic group had lower rates of incision infection （P=0.03； OR=0.31， 95% CI 0.11-0.91）， less chronic pain （P=0.001；OR=0.36， 95% CI 0.19-0.67）， and shorter hospital stays （P=0.004； MD -1.30， 95% CI -2.19--0.42）.

Conclusion

In terms of incisional infection， postoperative chronic pain， and hospital stay， laparoscopic surgery for recurrent inguinal hernia is superior to open mesh repair. This provides reliable evidence for the objective evaluation of the difference between laparoscopic and open mesh repair for recurrent inguinal hernias， and for the management of recurrent inguinal hernias. In the future， high-quality research on laparoscopic and open mesh repair treatments for recurrent inguinal hernia should be conducted to enhance the reliability of the conclusions.

Key words: Herniorrhaphy, Laparoscopic, Open repair, Recurrent inguinal hernia, Meta-analysis

Kai Lin, Fan Luo, Chun Yang. Laparoscopic vs open mesh repair for the treatment of recurrent inguinal hernia：A meta-analysis[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(03): 317-324.

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URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2025.03.014

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Figures/Tables 13

References 39

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第一作者	发表时间	国家	样本(例，男性/女性)		年龄（岁）		干预措施比较		随访期(年)
第一作者	发表时间	国家	L	O	L	O	L	O	L	O
祖连平^[12]	2021	China	30(23/7)	30(24/6)	56.73±7.68	56.52±7.33	TAPP	GPRVS	NA	NA
Dedemadi^[13]	2006	Greece	50	32	65 (28~92)^a		TAPP/TEP	LI	3	3
Demetrashvili^[14]	2011	USA	24(22/2)	28(26/2)	58.7±9.1	63.7±12.9	TAPP	LI	4.9±1.0	5.2±1.2
Eklund^[15]	2007	Sweden	73	74	52±10.4	55±11.3	TAPP	LI	5	5
黄广荣^[16]	2014	China	50	50	43.5±3.1	42.8±2.9	TAPP/TEP	LI	NA	NA
Kouhia^[17]	2009	Finland	49(47/2)	47(46/1)	57.8±12.6	55.8±12.0	TEP	LI	5.2±3.8	5.6±3.5
高飞^[18]	2021	China	42	42	39.00±1.60	42.00±1.40	TEP	LI	NA	NA
刘登国^[19]	2013	China	102(79/23)	102(80/22)	59.13±5.11	57.97±7.85	TAPP	LI	NA	NA
Neumayer^[20]	2004	USA	81(81/0)	78(78/0)	≥18	≥18	NA	NA	2	2
张萍^[21]	2012	China	25(25/0)	25(25/0)	NA	NA	NA	Rutkow 填充式	NA	NA

第一作者	发表时间	国家	样本(例，男性/女性)		年龄（岁）		干预措施比较		随访期(年)
第一作者	发表时间	国家	L	O	L	O	L	O	L	O
祖连平^[12]	2021	China	30(23/7)	30(24/6)	56.73±7.68	56.52±7.33	TAPP	GPRVS	NA	NA
Dedemadi^[13]	2006	Greece	50	32	65 (28~92)^a		TAPP/TEP	LI	3	3
Demetrashvili^[14]	2011	USA	24(22/2)	28(26/2)	58.7±9.1	63.7±12.9	TAPP	LI	4.9±1.0	5.2±1.2
Eklund^[15]	2007	Sweden	73	74	52±10.4	55±11.3	TAPP	LI	5	5
黄广荣^[16]	2014	China	50	50	43.5±3.1	42.8±2.9	TAPP/TEP	LI	NA	NA
Kouhia^[17]	2009	Finland	49(47/2)	47(46/1)	57.8±12.6	55.8±12.0	TEP	LI	5.2±3.8	5.6±3.5
高飞^[18]	2021	China	42	42	39.00±1.60	42.00±1.40	TEP	LI	NA	NA
刘登国^[19]	2013	China	102(79/23)	102(80/22)	59.13±5.11	57.97±7.85	TAPP	LI	NA	NA
Neumayer^[20]	2004	USA	81(81/0)	78(78/0)	≥18	≥18	NA	NA	2	2
张萍^[21]	2012	China	25(25/0)	25(25/0)	NA	NA	NA	Rutkow 填充式	NA	NA

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