SynthesisHernia : the journal of hernias and abdominal wall surgery2025
Open and minimally invasive inguinal hernia repair for patients with previous prostatectomy: a systematic review and proportional meta-analysis.
Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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Authors and funding
7 authors.
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Abstract
backgroundMinimally invasive surgery (MIS) for patients undergoing inguinal hernia repair (IHR) after prostatectomy has been considered a challenging procedure due to the presence of scar tissue and adhesions. We aimed to compare the outcomes of open and MIS IHR outcomes in post-prostatectomy patients through a systematic review and proportional meta-analysis. MATERIAL &
methodsPubMed/MEDLINE, Embase, Cochrane, and Web of Science were searched for studies on open and MIS IHR after prostatectomy. Outcomes such as recurrence, complications, seroma, hematoma, SSI, and conversion rates were analyzed, with subgroup analyses conducted for open, TEP, and TAPP procedures.
resultsAmong 402 screened studies, 18 met the inclusion criteria, covering 8,668 open IHR (64.6%) and 4,761 MIS IHR (35.4%) patients. The rate per 100 events for intraoperative complications was 0.19 (95% CI [0.00; 0.76]; I2 = 71%;), 5.22 per 100 for seroma (95% CI [2.86; 9.34]; I2 = 92%), 0.83 per 100 for SSI (95% CI [0.39; 1.75]; I2 = 48%), 3.16 per 100 for hematoma (95% CI [1.16; 8.31]; I2 = 84%), 3.02 per 100 patients for chronic pain (95% CI [2.53; 3.62]; I2 = 13%), and 0.02 per 100 for recurrence (95% CI [0; 0.16]; I2 = 10%). The conversion rate for MIS was 1.66 per 100 (95% CI [0.89; 3.06]; I2 = 0%). Subgroup analysis revealed no significant difference between TEP and TAPP in intraoperative complications (p = 0.70), but a lower seroma rate in TAPP compared to TEP (5.29 vs. 20 per 100; P = 0.01). MIS had significant reduction in SSI (0.08 vs. 0.34 per 100; P < 0.01), hematoma (1.29 vs. 17.86; p < 0.01), and recurrence (0.08 vs. 0.37; p = 0.04) compared to open, with no difference in seroma rates. Funnel plots revealed no evidence of publication bias.
conclusionsIn experienced hands, MIS IHR is a safe and effective option for post-prostatectomy patients, with lower complication rates compared to open IHR, although high-quality comparative studies are needed to establish definitive conclusions. PROSPERO REGISTRATION: July 7, 2024 (ID CRD42024562863).
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