A Meta-analysis Comparing Lightweight Meshes With Heavyweight Meshes in Lichtenstein Inguinal Hernia Repair

Abstract

Background. To evaluate the influence of lightweight and heavyweight mesh on postoperative recovery in Lichtenstein inguinal hernia repair. Methods. PubMed, EMBASE, and the Cochrane library were used to search for published clinical randomized controlled trials (RCTs), which compared lightweight meshes with heavyweight meshes in Lichtenstein inguinal hernia repair. Two independent reviewers assessed the trials for eligibility and quality, and all the related data matching our standards were abstracted for meta-analysis by RevMan 5.0 software. The evaluation criteria included recurrence, pain, seroma, hematoma, the sensation of a foreign body, wound infection, urine retention, and testicular atrophy. Results. A total of 2231 hernias from 11 RCTs were included. Compared with a heavyweight polypropylene mesh, the lightweight mesh led to less postoperative chronic pain (odds ratio [OR] = 0.64, 95% confidence interval (CI) = 0.51-0.82; P < .05) and less sensation of a foreign body (OR = 0.56; 95% CI = 0.40-0.78; P < .05), regardless of whether the mesh was made of partially absorbable or nonabsorbable material. There was no significant difference in postoperative recurrence, seroma, hematoma, wound infection, urine retention, and testicular atrophy. Conclusion. Current evidence suggests that the use of a lightweight mesh is associated with less postoperative pain and less sensation of a foreign body, without increasing the incidence of recurrence. Further high-quality, long-term follow-up RCTs are needed to provide more reliable evidence.