Safety and effectiveness of laparoscopic adult groin hernia repair in Africa: a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Surgery is the recommended treatment of groin hernia, and laparoscopic approach is increasingly accepted due to lower risk of chronic pain. This systematic review aims to evaluate results of laparoscopic groin hernia repair (LGHR) in Africa. METHODS: We performed a literature search of published studies using electronic databases. Included African articles reported at least one of outcomes after LGHR in adult population. Newcastle-Ottawa Scale was used for quality assessment. A quantitative meta-analysis was performed to estimate the pooled prevalence of the post-operative outcomes. RESULTS: We included 19 studies from 6 countries which totalized 2329 hernia cases. Mean age was 44.5 years and male patients were predominant (sex-ratio 19.8). The mean operative time was 69.1 min. The pooled prevalence of conversion to open procedure was 2.578% (95% IC 1.209-4.443). The pooled prevalence of surgical site infection and Hematoma/Seroma was respectively 0.626% (95%IC 0.332-1.071) and 4.617% (95% IC 2.990-6.577). The pooled prevalence of recurrence and chronic pain was respectively 2.410% (95% IC 1.334-3.792) and 3.180% (95% IC 1.435-5.580). We found that total morbidity for TAPP procedure was higher than TEP procedure (p = 0.0006; OR 1.8443). CONCLUSION: These results confirm that LGHR is safe and feasible and would be recommended in our African context.