OBJECTIVE: To perform a systematic review and network meta-analysis of randomised control trials (RCTs) to investigate the advantages and disadvantages associated with absorbable tacks, non-absorbable tacks, non-absorbable sutures, non-absorbable staples, absorbable synthetic glue, absorbable sutures and non-absorbable tacks, and non-absorbable sutures and non-absorbable tacks.
METHODS: A systematic review was performed as per PRISMA-NMA guidelines. Odds ratios (ORs) and mean differences (MDs) were extracted to compare the efficacy of the surgical approaches.
RESULTS: Nine RCTs were included with 707 patients. Short-term pain was significantly reduced in non-absorbable staples (MD; -1.56, confidence interval (CI); -2.93 to -0.19) and non-absorbable sutures (MD; -1.00, CI; -1.60 to -0.40) relative to absorbable tacks. Recurrence, length of stay, operative time, conversion to open surgery, seroma and haematoma formation were unaffected by mesh fixation technique.
CONCLUSIONS: Short-term post-operative pain maybe reduced by the use of non-absorbable sutures and non-absorbable staples. There is clinical equipoise between each modality in relation to recurrence, length of stay, and operative time.
目的:对随机对照试验(RCTs)进行系统评价和网络荟萃分析,以研究与可吸收钉相关的利弊,不可吸收的大头钉,不可吸收缝线,不可吸收的钉,可吸收合成胶,可吸收缝线和不可吸收平头钉,和不可吸收的缝合线和不可吸收的钉。
方法:按照PRISMA-NMA指南进行系统评价。提取赔率比(OR)和平均差异(MD)以比较手术入路的疗效。
结果:纳入了707例患者的9个随机对照试验。相对于可吸收钉,不可吸收钉(MD;-1.56,置信区间(CI);-2.93至-0.19)和不可吸收缝线(MD;-1.00,CI;-1.60至-0.40)的短期疼痛显着减少。复发,逗留时间,手术时间,转换为开放手术,血清瘤和血肿的形成不受网片固定技术的影响。
结论:使用不可吸收的缝线和不可吸收的钉可以减轻术后短期疼痛。每种模式与复发之间存在临床平衡,逗留时间,和手术时间。