Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair.
Br J Surg
; 106(7): 824-836, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-30990238
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Laparoscopia
/
Herniorrafia
/
Medidas de Resultados Relatados pelo Paciente
/
Hérnia Inguinal
Tipo de estudo:
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Systematic_reviews
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Br J Surg
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Reino Unido