Abstract：
BACKGROUND: There is uncertainty regarding the optimal mesh fixation techniques for laparoscopic ventral and incisional hernia repair.
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.
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.
摘要：
背景：关于腹腔镜腹侧和切口疝修补术的最佳网片固定技术存在不确定性。
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。
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。
