he Efficacy of Lichtenstein Self-Fixation Mesh and Suture Mesh in Inguinal Hernia Repair: A Meta-Analysis.

Objective: To compare the effect of self-gripping mesh and suture mesh in Lichtenstein inguinal hernia repair.

Methods: A computer search of the Cochrane Library, PubMed, Ovid, and Web of Science databases for randomized controlled trials (RCTs) was conducted from January 2010 to October 2021 to compare the efficacy of self-gripping mesh versus suture mesh in Lichtenstein tension-free hernia repair. After screening the literature based on the inclusion and exclusion criteria, the literature was assessed for quality and poor quality literature was excluded and subsequently meta-analyzed using Review Manager 5.3 software.

Results: A total of 4003 patients were included in 15 RCTS, including 1978 patients in the self-gripping mesh group and 2025 patients in the suture mesh group. Meta-analysis showed that compared to the suture mesh group, the operation time of the self-gripping mesh group was significantly shorter (SMD = -0.73, 95%CI = -0.89 to -0.58, P < .001), the incidence of postoperative incision infection was significantly reduced (RR = 0.46, 95%CI = 0.27 - 0.80, P = .006), but the recurrence rate of postoperative hernia was high (RR = 1.62, 95%CI = 1.09 - 2.40, P = 0.02). There was no significant difference in the incidence of postoperative chronic inguinal pain, foreign body sensation, hematoma, and seroma between the 2 groups (all P > .05).

Conclusions: Compared to the application effect of traditional suture mesh in Lichtenstein tension-free inguinal hernia repair, self-gripping mesh has the advantage of shortening the operative time and reducing the incidence of postoperative incision infection. However, the recurrence rate of hernia may increase in the short term (within 1 year) after surgery, but this conclusion needs to be verified by a larger sample of high-quality studies.